Nurses' Notes

A 28-year-old female who has started weightlifting. g nutritional counselling due to unwanted weight loss. 8, and she is hoping to build muscle mass and see weight gain. The client denies drinking, smoking, or drug es an oral contraceptive and uses melatonin for sleep.

Review H and P and nurse's notes.

Click to highlight the foods that are both nutrient and energy dense. 24-hour diet history:

0630

1 whole-wheat tortilla, 4 oz chicken breast, 4 of an avocados, 1/4 cup of salsa

1030

1 cup coffee, 2 tbsp half and half, 1 small apple, 1 tbsp almond butter

1200

1 cup spinach, 4 oz ground turkey with taco seasoning. 1/4 cup cheddar cheese, 2 bananas

1500

6 cashews

1900

1 cup regular soda, 6 oz white fish, 1/2 white potato, 2 tbsp butter, 1⁄2 cup green beans

2200

Choice A

Nuts is incorrect. Nuts are a good source of healthy fats, including monounsaturated and polyunsaturated fats, which can actually have a positive impact on heart health. They have been associated with improving HDL cholesterol levels and can be a part of a heart-healthy diet. While nuts are calorie-dense, small portions can be included as part of the client's diet to replace less healthy snacks. Therefore, nuts might not need to be completely avoided.

Choice B

Shellfish Is incorrect. Shellfish, including shrimp, crab, and lobster, are relatively low in saturated fat and cholesterol. While they do contain cholesterol, dietary cholesterol has less impact on blood cholesterol levels compared to saturated and trans fats. The client's main concern is elevated LDL cholesterol, which is influenced more by saturated fat intake. Therefore, avoiding shellfish might not be as crucial as focusing on saturated fat sources.

Choice C

Eggs is incorrect. Eggs are a source of dietary cholesterol, but they also provide essential nutrients. Recent research suggests that dietary cholesterol from foods like eggs has less impact on blood cholesterol levels for most people than was previously thought. For the client, the more significant concern is the elevated LDL cholesterol level. If the client enjoys eggs, they might not need to completely avoid them, but they should consume them in moderation and consider other dietary changes to reduce saturated fat intake.

Choice D

Cheese is correct. Cheese is often high in saturated fats, which can contribute to elevated LDL cholesterol levels. Therefore, it would be important for the client to limit their intake of high-fat cheeses.

Choice A

Explain the benefits of a high fibre diet is not correct response. While a high fibre diet can indeed be beneficial for individuals with haemorrhoids by promoting regular bowel movements and reducing strain during defecation, the immediate concern here is addressing the client's understanding about avoiding nuts and seeds. This information could be provided as a follow-up after confirming the client's understanding in response to option B.

Choice B

Confirm that these foods should be avoided is the correct response. In this situation, the nurse's first response should be to confirm the client's understanding and provide accurate information about the need to avoid certain foods. Nuts and seeds can be challenging to digest and may lead to irritation and inflammation in individuals with haemorrhoids. Confirming the client's understanding and providing guidance aligns with the nurse's role in patient education and care.

Choice C

Encourage soft foods such as yogurt is not the correct response. Encouraging soft foods like yogurt is a reasonable suggestion for someone with haemorrhoids, as soft foods are generally easier to digest and less likely to cause irritation. However, the client's statement was specifically about avoiding nuts and seeds. While this choice might be relevant, it doesn't directly address the client's statement.

Choice D

Suggest that the client also avoid fruit skins is not the correct response. This option is not directly related to the client's concern about nuts and seeds. Fruit skins generally contain dietary fibre, which can be beneficial for maintaining regular bowel movements. While some individuals might find that certain fruits with tough skins could exacerbate their haemorrhoid symptoms, this advice might be better suited for a separate discussion about dietary choices rather than as a direct response to the client's statement.