Exam 18: Nutrition and Lower Gastrointestinal Disorders

Many lactose-intolerant individuals can tolerate up to 2 cups of milk a day when intake is divided throughout the day and taken with food.

MCT oil does not require bile for digestion and absorption.

Nursing Exam Review The nurse is planning for the nutritional needs of a patient with acute pancreatitis accompanied by pain and nausea. The nurse understands that initially:

Celiac disease affects intestinal tissue and results in:

A patient with an ostomy is concerned about excessive odor from his stoma. He should be advised to avoid what food?

Nursing Exam Review Which food would the nurse include in a diet plan for a patient with celiac disease?

To be considered "probiotic," bacteria must meet what criteria?

Celiac disease is characterized by an abnormal immune response to certain amino acids.

The client with a colostomy or ileostomy should have a diet that is restricted in fluids.

A patient who takes pancreatic enzyme replacements is at risk of what type of gastrointestinal side effects?

Kelly is a 27-year-old Caucasian who works as a bank teller. She is 5'3" tall and weighs 102 pounds. She began experiencing recurrent gastrointestinal disturbances such as diarrhea, steatorrhea, and flatulence several months ago. She made an appointment with her physician after noticing that she was losing weight. Laboratory tests confirmed a diagnosis of celiac disease. Kelly will require nutrition education aimed at eliminating gluten from her diet. The dietitian will teach Kelly to:

Medical History: A.R. is a healthy 51-year old premenopausal Caucasian woman with pallor who is employed full-time in an office job. She had a pancreatic cyst removed six years ago. She was asymptomatic until one year ago when she developed acute pancreatitis flare-ups after consuming fatty foods. The condition was attributed to scarring at the pancreatic duct, which secretes pancreatic lipase, and was accompanied by severe abdominal pain radiating to her back, vomiting, and steatorrhea. She was placed on oral pancreatic lipase enzyme tablets (Pancrease™) that digest fat and was prescribed to follow a "low-fat diet." The medication and diet help to reduce her symptoms, and she notes that flare-ups generally only occur when she eats too much fat.   Anthropometric: Ht: 5'2. Wt: 156 lbs. Wt 1 yr ago: 199 lbs. Frame size: Medium. Clinical/Labs: A.R.'s serum vitamin D was low (20 ng/mL; normal is 25-80 ng/mL), but all other labs were within normal limits when she last visited her internal medicine physician several months ago. She was placed on a 5,000-IU vitamin D supplement, to be reduced to a 2,000-IU vitamin D supplement thereafter; she takes no other vitamins or minerals. Other medications include Synthroid and Aygestin. Current Chief Complaints: A.R.'s current problems include constipation and dry skin. Diet: "My usual grocery list consists of boneless chicken breasts, turkey, pork chops (infrequently), strip steak (infrequently), 90/10 ground beef, pasta (half whole-wheat, half regular), tomatoes and sauce to make pasta sauce, 90 percent fat-free lunch meat ham or turkey, brown rice, steamable microwave vegetables, red and green lettuce, tomatoes, onions, cereal, blueberries if on sale, apples, tangerines, red licorice, bread, crackers, and canned soup. I am concerned about not having enough protein or iron because I am afraid to eat very much red meat. The foods I miss the most include iced tea, which I skip because of caffeine-I am getting bored with water. I like to bake and I miss baked goods, and I also miss cheese-I am afraid it is too high in fat. I have a hard time figuring out what to pack for lunch. The restaurants I go to if I do go out are Chick-Fil-A, Panera, Viva, a local diner, and an Italian restaurant. I like Italian and Mexican food. Usually if I do eat out it is for lunch but it is sometimes hard to figure out something safe to eat..." Dairy foods: Twice a day, drinks 2 8-oz glasses of 1% milk. Fruits: 1 cup per day.  A.R.'s doctor recommends that she take a multivitamin-mineral supplement because:

Mr. Taylor seeks medical treatment for frequent, urgent bowel movements streaked with mucus and blood, and tests reveal a large, continuous area of inflammation affecting the first two layers of tissue in his rectum. What is Mr. Taylor's likely diagnosis?

The initial treatment for acute pancreatitis includes:

Patients with celiac disease must avoid foods that contain:

A patient with an ileostomy should be counseled to avoid ____ to best prevent an obstruction at the stoma site.

What situation is most commonly associated with development of diverticular disease?

Nursing Exam Review Mrs. Burgess is a 67-year-old female who was recently diagnosed with depression and prescribed a tricyclic antidepressant drug. In addition, she is on medication for high blood pressure and high cholesterol and takes a calcium supplement. She phones her physician's office complaining of problems with constipation. The nurse suspects that the problems may be due to:

Nursing Exam Review Sarah is a 21-year-old college student who has been diagnosed with Crohn's disease. She is underweight and has a poor appetite. Realizing that Sarah is at nutritional risk, the nurse advises that Sarah: