NR 228 Nutrition, Health & Wellness

NR 228 Nutrition, Health & Wellness

NR 228 Week 1 Discussion Question: Digestive System

Let’s follow the path of a delicious ham and cheese sandwich with lettuce and pickles as it is eaten and digested! Start at the beginning and discuss the anatomical parts as well as the biochemical roles that contribute to this sandwich being turned into chemical energy. Be sure to include mechanical and chemical mechanisms, along with how they are metabolized in the body!

What happens if one part does not function? For example, what happens to digestion if the person is missing many teeth but can’t afford dentures or perhaps has a digestive disorder?

  1. What stress factors may cause issues in the digestive tract for some people?
  2. How can a regular exercise program aid in the development of a healthy digestive tract?
  3. How might digestion and metabolism be different over the life span?
NR 228 Week 1 Study Guide: Chapters 1 and Chapter 2
  1. Identify the WHO definition of health and explain how it differs from the definition of health presented in Chapter 1 by Rene Dubos. Contrast both those definitions to the Chamberlain definition of health you learned in NR222 “A dynamic and holistic process in a person’s perceived state of being.”
  2. Discuss the role that nutrition plays in “Health Promotion” in no less than 1 paragraph (5-6 sentences minimum).
  3. Explain what “health literacy” means and how it relates to health promotion.
  4. Describe the 6 known essential nutrients
  5. Explain the difference between “essential” and non-essential” nutrients.
  6. Identify the kilocalorie per gram for the following:
  7. Explain Dietary Reference Intakes (DRI’s) and ………………..
  8. Define the following:
  • EAR (Estimated Average requirement):
  • RDA (Recommended Dietary Allowance):
  • AI (Adequate Intake):
  • UL (Tolerable Upper Intake Level):
  • AMDRs (Acceptable Macronutrient Distribution Ranges):
  1. Differentiate between the terms “undernutrition” and “malnutrition
  2. Explain the difference between “MyPlate” and “MyPyramid” dietary guidelines.
  3. Identify nutrients that your book indicates Americans it too few of and too much of. (page 19
  4. Compare and contrast serving size with “exchanges”. Identify how my grams of carbohydrate are in one fruit or starch “exchange”. How many calories does that equate to
  5. Review Figure 2-9 and explain the food labeling system in the United States.
  6. Who, besides doctors and nurses, do patients with low literacy skills tend to use for health and nutrition advice?
  7. Differentiate labeling for organic foods.

NR 228 Nutrition, Health & Wellness

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NR 228 Week 2 Discussion Question: Carbs, Culture, and Diabetes

In order to fully understand Hannah’s situation, please answer the following first: When are carbohydrates good for us? What are “good” versus “bad” carbohydrates? When are they not good for us or our bodies? What chemistry is involved in their breakdown, usage, and storage? Once you have discussed this, then consider Hannah and Rose’s situation, and think like a nurse!
Hannah is a 12-year-old who has had Type I diabetes for a few years. Her mother, Rose, is a strict vegetarian and believes this is also the best diet plan for her daughter. Hannah says, “I just want to eat like all my friends do!” As a result, she often cheats, and lately, there has been a steady increase in Hannah’s blood sugars. What are the first steps you would take, as Hannah’s nurse, to assess her eating habits and understanding of diabetes mellitus? What did Hannah and Rose tell you (subjective) and what did you see (objective)?

NR 228 Week 2 Study Guide: Chapters 4, 7 and 8

Chapter 4: Carbohydrates

  1. Carbohydrate:
  2. What is the Dietary Reference Intake (DRI) and Acceptable Macronutrient Distribution Range (AMDR) for carbohydrates?
  3. According to your book Chapter 4 paragraph 3, what are the recommended average daily servings for
  4. Review Box 4-1 and compare and contrast whole grains with refined grains.
  5. What does the term “enriched” mean?
  6. How much of grain consumption should be whole grains?
  7. What enzymes are required to metabolize disaccharides? Lactase deficiency is common in what ethnic groups? What other factor contributes to lactase deficiency?
  8. (We will look at this is class, do not complete) Then review Box 4-1, or go through you cupboards at home and complete the table to describe a 1 ounce serving of the following foods. Then review The Diabetic Exchange List document and include the serving sizes for one 15 gram CARB exchange. Add the calories.  Add the glycemic index from Table 4-2. Look up the information for the fruits and vegetables and add to your table.
  9. Compare and contrast 1 ounce serving of grains with the 15 gram carb exchange. Compare and contrast 1 ounce serving of fruits with the 15 gram carb exchange. Why are fruits and vegetables different? Why do pancakes and tortilla show 2 exchanges instead of 1 in the Exchange table? (1 carb + 1 fat)? Draw some conclusions about how exchanges are different than carb counting for meal planning? Only counting the carb grams, not including the protein or fat grams found in an exchange.
  10. Compare and contrast monosaccharides, disaccharides and polysaccharides.
  11. Explain the function of carbohydrates as a nutrient in the body.
  12. In what form does the liver and muscles store glucose?
  13. What is a normal blood glucose range according to your text? (p. 67)
  14. What gland produces insulin and what is insulin’s role in the body?
  15. What do all forms of “sugar” including white sugar, brown sugar, dextrose, high fructose corn syrup, honey, maple syrup, and glucose have in common? (p. 69)
  16. What are the health concerns related to sugar consumption?
  17. Explain the difference between nutritive and non-nutritive sweeteners. (Table 4-3)
  18. Which non-nutritive sweetener should people with PKU not consume and why
  19. What are the health effects of fibers?
  20. Identify several foods that have more than 3—4 grams of fiber in them

NR 228 Nutrition, Health & Wellness

Chapter 07: Vitamins

  1. Describe the difference between primary and secondary vitamin deficiency.
  2. Discuss the subgroups of Americans who are at risk for vitamin deficiencies.
  3. List two distinguishing characteristics of water-soluble and fat-soluble vitamins.
  4. List the vitamins needed for blood health, bone health, energy metabolism, and fluid and electrolyte balance.
  5. Merge Tables 7-3 and 7-6 to include both water and fat-soluble vitamins. List the alternative names, primary functions, and food sources for each vitamin. *Study these tables only; do not recreate
  6. Name the main deficiency diseases associated with inadequate intake of the following water-soluble vitamins:
  7. Name the deficiency diseases or symptoms associated with inadequate intake of the fat-soluble vitamins:

Chapter 08: Water and Minerals

  1. Identify at least three functions of water.
  2. Describe fluid volume deficit (FVD) and fluid volume excess (FVE).
  3. List three factors that may affect the bioavailability of minerals.
  4. Do minerals provide energy? Why or why not?
  5. How are blood calcium levels regulated?
  6. List several nondairy sources of calcium.
  7. Name several factors that hinder calcium absorption.
  8. List three risk factors for osteoporosis.
  9. Name the seven major minerals, and list one good food source of each.
  10. Name the nine trace minerals, and describe one function of each.
  11. Which vitamin enhances the absorption of iron?
  12. Name three life cycle stages that have an increased risk for anemia.
  13. Explain two possible reasons for hemosiderosis.

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NR-228 Week 3 Discussion Question: Diet and Lab Values

NR 228 Nutrition, Health & Wellness

Proteins have many functions within our bodies. List the functions, and explain why proteins are crucial to growth and maintenance. Why are the protein diets of children different from adults?

Mark, a single father of a 2-year-old son, Jacob, stops every morning at a local fast food restaurant to pick up breakfast for himself and his son on their way to daycare. Mark says, “I don’t have time to cook in the mornings, and I can’t feed Jacob anything I would ever make at home any cheaper than this! Besides, he really loves these sausage and egg sandwiches, and at least I can get him to eat them!” Mark has a family history of diabetes, as well as hyperlipidemia, and has the following risk factors for cardiovascular disease: primary hypertension (treated with medication), cigarette smoking, inactive lifestyle, and occasionally eating foods high in sodium. Both of his parents died at young ages due to what Mark calls “heart troubles,” and his brother has high cholesterol. During his physical, Mark learns that his lipid panel is as follows: total cholesterol 245 mg/dl, LDL 180 mg/dl, and HDL 35 mg/dl.

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NR 228 Week 4 Discussion Question: Bone Health

Mrs. Law, a 77-year-old female, is at home recovering from surgery that she had after falling and breaking her hip 5 days ago. She lives with her husband, Dean, who helps to care for her. Mrs. Law is a former smoker and has a past medical history of hypertension and hyperlipidemia. You are the visiting nurse, assigned to check on her postoperative progress. You ask the client how she is feeling, do an assessment, and inquire as to what she has eaten over the past 24 hours. Mrs. Law states that she has “No pep, no appetite, has been taking her pain medication as prescribed (every 4 hours—but not real helpful!), cannot sleep well, doesn’t feel much like walking, except for to the bathroom, and has been unable to move her bowels for several days.”

  • Breakfast: Two glazed doughnuts, coffee (black)
  • Lunch: Tossed salad with oil and vinegar, diet soda
  • Dinner: Tomato soup, 1 cup; four soda crackers; and red homemade wine
  • Snack: Pretzels, diet soda

What nutrients that contribute to bone health are missing in Mrs. Law’s diet? What other dietary concerns do you have? Is Mrs. Law getting the appropriate amount of vitamins and minerals for her age and current condition? Why or why not?

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NR-228 Week 5 Discussion Question: Case Study Discussion

You are asked to see Mr. Basset, who is 80 years old, currently living alone, and has recently lost his wife. His children do not live nearby, but Mr. Basset sees them on holidays. Mr. Basset was recently diagnosed with lung cancer and has had an unexplained weight loss of 20 pounds in 3 months. He is getting chemotherapy as well as taking oral medication for hypertension and arthritis, and is showing signs of dehydration.

Mr. Basset reports that his wife did most of the cooking and he has limited cooking skills. He usually has cereal with milk and coffee for breakfast and soup for a second meal later in the day. He eats crackers throughout the day if he is hungry, but admits that he doesn’t have much of an appetite. In addition, Mr. Basset has ill-fitting dentures and claims that food just does not taste the same. He is also on a limited budget.

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NR 228 Week 6 Discussion Question: Case Studies

Jordan is a 14 year old middle school student, weighing 275 pounds and is 5’6” tall.  Over the past 2 years, he has gained 60 pounds, as he has begun to withdraw from social activities, and avoid other students, due to bullying from others his age about his weight/appearance. Lately, Jordan has been missing a great deal of school too, particularly on the days he has gym. Jordan’s parents are both average in height and weight, and Jordan’s mother says that he just takes after his grandfather William, who “was a husky man, and died of a sudden heart attack at the age of 44”. She says “We just have fat genes in the family; you can’t do anything about that”!

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NR-228 Week 7 Discussion Question: Supplementing Your Diet

It has become common practice for people to supplement their diets with pills, smoothies, teas, herbals, and other complementary practices. Select 2 from the list below and locate an evidence-based article for each. Summarize the intended use, recommended dosage, and side effects and known interactions with over the counter and prescription medications. What if any contraindications are identified for a patient with liver and/or kidney disease?

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NR 228 Week 8 Discussion Question: Team presentation

Comparing and explaining the nutritional needs of long term care facilities in the North & the South regions.

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