Question

Hilda is being admitted to the hospital for open heart surgery. She reports being diagnosed with hypertension and Type 2 Diabetes, and taking medication for both disorders. Hilda is 65 years old. She reports her usual weight is 320 pounds. Hilda is able to provide a typical day of food intakes prior to admission that you enter into diet analysis software. During your assessment, you obtain a current weight of 290 pounds and height of 5 feet 6 inches. You observe physical signs of edema in her limbs.   She is currently NPO in preparation for surgery.

Answer the following:

1) During your assessment, you ask Hilda what dietary restrictions (if any) she has been following for her hypertension and diabetes. What type of historical information does this provide?

a) Lab history

b) Social history

c) Medical history

d) Diet history

2) Which physical test finding in the case study is the most accurate indicator of fluid imbalance in her body?

a) Presence of edema

b) Low albumin

c) Low water intake reported prior to admission

d) %IBW = 223%

3) Which of the following assessment measures in the case study identifies risk of malnutrition?

a) Hilda’s %UBW of 91% indicates significant weight loss.

b) Hilda’s edema dilutes lab values.

c) Hilda’s %IBW of 223% shows excess weight.

d) Hilda is NPO for one day prior to surgery

4) What other measure could be obtained to strengthen the assessment for malnutrition?

a) Past medical history to identify severity of illness.

b) Physical test of head, hands, and upper body to identifying muscle loss.

c) Prescribed medications to identify interactions.

d) C-reactive protein to identify signs of inflammation.

5) To meet the goal of maintaining Hilda’s weight, what intervention would be appropriate for the nurse?

a) Order labs to assess protein status.

b) Write a diet order for her to receive food.

c) Assess for nutritional adequacy in her diet.

d) Weigh her regularly.

Answer 1

1) d. Diet history.This includes the history of diet about intake of foods .The other options are incorrect .Lab history gives the lab values of the patient.Social history includes name,age,date of birth etc.Meical history list the disease and the age at which the patient has suffered ,history of allergies,heart disese etc suffered in the past life are of importance.

2) b.Presence of edema.This is the most accurate method to assess the fluid imbalance.It states that an excessive amount of fluid in the body tissues.The other options are not appropriate for this question.

3)a. Hilda's %UBW of 91% indicates significant weight loss.UBW refers usual body weight and these helps to identify weight loss by comparing usual weight with normal weight ,thus identify the risk of malnutrition.

4)b .Physical test of head,hands,and upper body to identify muscle loss.When compare with other option this is the most appropriate answer.

5)c. Assess for nutritional adequency in her diet.Including nutritional food helps to improve weight along with help to reduce the risk of malnutition and promote health also.