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

Counting carbohydrates will ensure glucose levels stay within a normal range is accurate. When providing dietary education to a client with Type 2 diabetes mellitus, it's important to emphasize the role of carbohydrate counting in managing blood glucose levels. Carbohydrate intake significantly impacts blood sugar levels, and counting carbohydrates can help the client make informed decisions about their meals and medications to maintain glucose levels within a normal range.

Choice B

Many carbohydrates are found in starches and fruits is not accurate. Carbohydrates are present in a variety of foods, including starches (such as bread, rice, and pasta) but not fruits. Educating the client about sources of carbohydrates can help them make choices that support blood sugar management.

Choice C

It is best to count carbohydrates when it feels like blood glucose is low is not accurate. Counting carbohydrates is an ongoing practice that helps individuals with diabetes maintain consistent blood sugar levels throughout the day, not just when blood glucose feels low.

Choice D

Examples of complex carbohydrates are white rice and cereals is inaccurate. White rice and many cereals are actually exampling of simple carbohydrates. Complex carbohydrates include foods like whole grains, legumes, and vegetables. It's important to provide accurate information about carbohydrate types.