Question

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Mrs. B is a short term rehab patient undergoing chemotherapy and radiation for lung cancer. She has lost 15 pounds in 2 months. She reports that she does not have an appetite and gets full fast.  She also complains of nausea and a bitter taste in her mouth.  As her nurse, you are concerned with her nutritional status, want to prevent further weight loss and increase her by mouth intake.

1 Question: Develop a care plan to help address her issues of anorexia, early satiety, nausea and weight loss.  Your goal is to help her increase her food intake. Provide at least 4-6 suggestions and recommendations for each of her problems contributing to her reduced intake.

Please number and organize your care plan. Make sure to address all concerns: anorexia, weight loss, nausea, early satiety and bad taste in mouth.

Answer 1

Anorexia

1. Try to eat small snack every 2 to 3 hours, instead of three large meals. Don't expect to eat regular size meal.
2. Food that are high in protein or calories are good snacks to have handy.  
3. Avoid low calorie food that fill you up.
4. Avoid food that cause gas production
5. Prepare food that is colorful and appealing to eye
6. Make eating a social event. Try to eat with family or friends.

Weight loss

1. Eat foods that are rich in calories and nutrients
2. Avoid heavy meals, greasy or fried food
3. Small and frequent diets
4. When choosing beverage, select nutrient dense fluid such as milk, milkshake, juice etc

Nausea

1. Watch your favorite TV program while you eat.
2. Try changing the time, place, and surroundings of meals.
3. Avoid smells that are bothersome while you are eating

Early satiety

1. Eat small portions frequently
2. Avoid oily or greasy foods.
3. Avoid gas producing foods .
4. Limit the amount of fluid while eating the regular meals

Bad taste

1. Try to add different seasonings to the food.
2. Try sucking on hard candies /mints/chewing gum. Keep your mouth clean by brushing at least two times per day and rinse your mouth with water between meals.
3. Avoid toothpaste and mouthwashes that contains alcohol