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NCLEX-RN® Test Plan: Client Needs
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Nutrition and Oral Hydration

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NCLEX-RN® Test Plan: Client Needs | Registered Nurse (RN) School Study Aid

Nutrition and Oral Hydration
28 Picmonics to Learn | 57 mins
Diet Progression
Types of Diets
Clear Liquid
Full Liquid
Pureed
Mechanical Soft
Low Residue (Fiber)
High Fiber
Regular
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1 min
Therapeutic Diets
Common Therapeutic Diets
High Fiber
Low Residue (Fiber)
Low Sodium
Low Cholesterol
Diabetic
Renal
Dysphagia
Nursing Considerations
Diet Education
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2 mins
Dysphagia
Etiology
Neurological Disorders
Muscular Disorders
Structural Abnormalities
Gastroesophageal Reflux Disease (GERD)
Inflammatory Conditions
Signs & Symptoms
Difficulty Swallowing
Choking or Coughing
Regurgitation
Diagnosis
Clinical History and Physical Examination
Fiberoptic Endoscopic Evaluation of Swallowing (FEES)
Videofluoroscopy (Modified Barium Swallow Study - MBSS)
Interventions
Treat Underlying Cause
Therapy
Dietary Modifications
Medications
Surgery
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3 mins
Religion and Dietary Preferences Overview
Buddhism
Natural Foods of Earth
Hinduism
Cow is Sacred
Islam (Muslim)
Halal Foods
No Alcohol
Judaism
Kosher Meals
No Pork or Shellfish
Mormonism (Latter Day Saints)
The Word of Wisdom
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1 min
Total Parenteral Nutrition (TPN)
Mechanism
Nutrition Given Outside GI
Side Effects
Hyperglycemia
Hyperlipidemia
Refeeding Syndrome
Nausea and Vomiting
Considerations
Slow IV Infusion
Use Large Central Vein
No Added Meds to TPN Line
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2 mins
Tyramine Containing Foods
Aged Cheeses
Pepperoni
Pickled Foods
Wine
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49 secs
Food Allergies and Restrictions
Gluten-Free
Lactose-Free
Plant-Based
Diabetic and Sugar-Free
Nut Allergy
Soy Allergy
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4 mins
Vitamin A (Retinol)
Mechanism
Maintains Mucous Membranes
Eyes and Skin
Indications
Dietary Deficiency
Skin Disorders
Side Effects
Hepatosplenomegaly
Jaundice
Increased ICP
Vomiting
Considerations
Teratogen
Animal Food Products
Dark Green and Orange Fruits/Vegetables
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2 mins
Vitamin B1 (Thiamine)
Mechanism
Carbohydrate Metabolism
Indications
Dietary Deficiency
Beriberi
Wernicke-Korsakoff
Considerations
Alcoholics Highest Risk
Give Before Glucose
Give IM or IV
Enriched Whole Grains
Pork
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2 mins
Beriberi (Thiamine Deficiency)
Mechanism
Thiamine Deficiency
Assessment
Dry Beriberi
Polyneuritis
Muscle Wasting
Wet Beriberi
Dilated Cardiomyopathy
Edema
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2 mins
Vitamin B3 - Niacin (Nicotinic Acid)
Mechanism
Decreases Triglycerides
Decreases LDL
Increases HDL
Indications
Dyslipidemia
Pellagra
Diarrhea
Dermatitis
Dementia
Side Effects
Flushing
GI Distress
Hepatotoxicity
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2 mins
Vitamin B6 (Pyridoxine)
Mechanism
Amino Acid and Protein Metabolism
Heme Synthesis
Neurotransmitters
Indications
Adjunct to Isoniazid
Dietary Deficiency
Premenstrual Syndrome (PMS)
Side Effects
Ataxia
Peripheral Neuropathy
Contraindications
Levodopa
Considerations
Cereals and Meats
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3 mins
Cobalamin (Vitamin B12)
Mechanism
Vitamin B12
Indications
Vitamin Deficiency
Pernicious Anemia
Side Effects
Hypokalemia
Arthralgia
Dizziness
Considerations
IM Injection for Pernicious Anemia
Never Give IV
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2 mins
Vitamin C (Ascorbic Acid)
Mechanism
Antioxidant
Collagen Formation
Steroid Synthesis
Indications
Dietary Deficiency
Scurvy
Side Effects
GI Distress
Considerations
Citrus Fruits
May Improve Healing
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2 mins
Ergocalciferol (Vitamin D2)
Mechanism
Vitamin D2
Indications
Hypoparathyroidism
Rickets
Hypophosphatemia
Side Effects
Fatigue
Constipation
Hypercalcemia
Kidney Stones
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2 mins
Vitamin E (Alpha-tocopherol)
Mechanism
Antioxidant
Indications
Fat Malabsorption Syndrome
Alpha-TTP Deficiency
Side Effects
Bleeding
Considerations
Increased Risk Hemorrhagic Stroke
Limit Doses < 200 IU per Day
Nuts and Whole Grains
Vegetable Oils
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2 mins
Vitamin K1 (Phytonadione)
Mechanism
Synthesizes Clotting Factors II, VII, IX, X
Indications
Hypoprothrombinemia
Newborn Prophylaxis
Bleeding from Warfarin Overdose
Side Effects
Shock
Kernicterus
Cardiac Arrest
Considerations
Bile Salts required for Intestinal Absorption
Increased Risks with IV Administration
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2 mins
Iron (Ferrous Sulfate)
Mechanism
Ferrous Salts
Indications
Anemia
Side Effects
GI Distress
Nausea and Vomiting
Dark Stools
Considerations
Take Between Meals
Liquid can Stain Teeth
Keep out of Reach from Children
Caution with GI Disorders
Avoid Antacids
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3 mins
Cholecalciferol (Vitamin D3)
Mechanism
Vitamin D3
Indications
Dietary Supplement
Vitamin D Deficiency
Side Effects
Fatigue
Constipation
Hypercalcemia
Kidney Stones
Considerations
More Effective Than Ergocalciferol
Hypervitaminosis D
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2 mins
Marasmus
Deficiency of all Nutrients
Body Weight < 60% of Normal
Tissue and Muscle Wasting
Loss of Subcutaneous Fat (Buttocks and Thighs)
Variable Edema
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2 mins
Kwashiorkor
Protein Deficiency
Swollen Belly
MEALS
Malnutrition
Edema
Anemia
Liver Malfunction
Skin Lesions
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2 mins
Hypoglycemia Assessment
Mechanism
Too much insulin
Decreased glucose
Assessment
< 70 mg/dL
Change in LOC
Lethargic
Confusion and Irritability
Tremors
Diaphoresis
Tachycardia
Vision Changes
Weakness
Seizures
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2 mins
Hypoglycemia Intervention
Interventions
Mild to Moderate Hypoglycemia
Simple Carbohydrate (Oral Dextrose, Fruit Juice, Candies)
Complex Carbohydrate (Whole Grains, Vegetables)
Severe Hypoglycemia or Unconscious
50% Dextrose
Glucagon
Considerations
Monitor Blood Glucose Q 10-15 Minutes
Give Small Meal After Intervention
Patient Education
Hypoglycemia Prevention
Encourage Self-Monitoring
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3 mins
Hyperglycemia
Mechanism
Insulin Resistance
Too Little Insulin/Medication
Infection/Illness
Corticosteroids
Assessment
Elevated Blood Glucose
Polyphagia
Polydipsia
Polyuria
Hypotension
Fatigue/Drowsiness
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1 min
Anorexia Nervosa Assessment
Adolescent Girls
Fear of Gaining Weight
Assessment
Excessive Dieting
Distorted Body Image
Decreased Bone Density
Stress Fractures
Lanugo
Amenorrhea
Anemia
Diagnostic Criteria
BMI < 18.5
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3 mins
Bulimia Nervosa Assessment
Assessment
Normal Body Weight
Binge and Purge
Electrolyte Disturbances
Alkalosis
Hypokalemia
Parotitis
Enamel Erosion
Russell's Sign
Diagnosis
Once Weekly For 3 Months
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2 mins
Anorexia Nervosa and Bulimia Nervosa Interventions
Interventions
Build Trust
Plan Caloric Intake
Supervise Meals
Supervise Elimination
Encourage Liquids
Daily Weights
Use Matter-of-Fact Statements
Give Feelings of Control
Considerations
Tube Feedings If Further Weight Loss
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2 mins
Metabolic Syndrome
Assessment
Dyslipidemia
Central Obesity
Insulin Resistance
Hypertension
Increased C-Reactive Protein (CRP)
Increased Fibrinogen
Considerations
Increased Risk Cardiovascular Disease
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1 min

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