Nutrition ------------- 1) What is the difference between fat-soluble and water-soluble vitamins in deficiency and toxicity levels? How do deficiencies and toxicities occur for each? 2) Tonya is 5' 3" tall, weighs 151 pounds, and is 38 years old. Her waist circumference is 37". Her life is busy but sedentary. She simply does not have the time or energy to stay with an exercise program after working all day as receptionists and caring for her two socially active children. She would like to lose about 20 pounds but knows dieting doesnt work for herall the diets she has tried in the past have left her hungry and feeling deprived. Losing weight has taken on greater importance since her doctor told her that both her blood pressure and glucose levels are at borderline high levels. What is her BMI? Assess her weight based on BMI. Estimate her total calorie requirements using the rule-of-thumb method of calculating BMR and adding calories for a sedentary lifestyle. How does it compare to the level of calories recommended in Table 7.3 of your text for a woman her age with a sedentary lifestyle? Which calorie level do you think is most accurate? Why? How many calories would she need to eat to lose 1 pound of weight per week if her activity level stays the same? Two pounds per week? Is a 2-pound weight loss per week a reasonable goal? To help her avoid feeling hungry while eating fewer calories, what foods would you recommend she consume more of? She knows she should drink fewer soft drinks. What advice would you give her to help her do that? 3) Explain supplement regulations. Choose a supplement (from your own home or online) and imagine you are educating your patient who states that she takes the supplement. What should she understand about the items on the label, the packaging, supplement regulations or lack thereof, and interactions or side effects? Attach a picture of the supplement label and packaging you are discussing. Cite at least one scholarly source other than your text using APA. Do not choose a supplement that has already been explained. 4) Locate an article that explores issues related to culture and religion in healthcare settings. Provide a summary of the article along with a link to the article. What concerns are raised? How are conflicts resolved or not resolved? How does the information you learned in the article shape your views on culture and religion in health care? Choose an article that comes from a credible source. The source does not necessarily need to be scholarly for this discussion; you may use news stories. 5) Describe some of the diet and health connections between a child and a senior citizen? Provide examples. 6) (You need to respond to one question from A, and one question from B, based on the information) Sarah is 28 years old and 7 months pregnant with her third child. Her other children are 2-12 and 1-12 years old. She had uncomplicated pregnancies and deliveries. Sarah is 5' 6" tall; she weighed 142 pounds at the beginning of this pregnancy, which made her pre-pregnancy BMI 23. She has gained 24 pounds so far. Prior to her first pregnancy, her BMI was 20 (124 pounds). She is unhappy about her weight gain, but the stress of having two young children and being a stay-at-home mom made losing weight impossible. She went online for her MyPlate plan, which recommends she consume 2,400 calories per day. She doesn't think she eats that much because she seems to have constant heartburn. She takes a prenatal supplement, so she feels confident that even if her intake is not perfect, she is getting all the nutrients she needs through her supplement. Category A Does she have any risk factors for a high-risk pregnancy? Explain your answer. Evaluate her prepregnancy weight and weight gain thus far. How much total weight should she gain? Explain your answer. Is her attitude about supplements appropriate? What would you tell her about supplements? Explain. Category B Based on the 2,400-calorie meal pattern, what foods should Sarah eat more of? What food is she eating more than the recommended amounts? How would you suggest she modify her intake to minimize heartburn? What would you tell her about weight gain during pregnancy? What strategies would you suggest to her after her baby is born that would help her regain her healthy weight? Devise a 1-day menu for her that provides all the food she needs in the recommended amounts and alleviates her heartburn. 7) What are the differences between enteral nutrition and total parenteral nutrition? How do the implications of each method concern the nurse? 8) My daughter spent three weeks in an eating disorder medical stabilization unit in Phoenix, Arizona, for restrictive purging anorexia. She deteriorated physically as she intractably vomited everything she was encouraged to eat. She was refusing fluids as well. She fainted frequently with a resting heart rate between 35 and 45; they told me they could not help her. They would not place a life-sustaining NG-tube for fear of aspiration from her vomiting. After my daughter spent almost two weeks in another hospital in Sacramento, vomiting NG-tubes out 7 or 8 times, the very desperate decision was made to surgically place a gastrostomy tube for life-saving nutrition. I was terrified at this aggressive measure, but I was also aware of the fact that my daughter was slipping away. The G-tube was placed and nutrition was given completely via the G-tube for 4 days. Guess what? It broke the cycle of vomiting. She began to eat 100 percent without vomiting. The tube was used for a total of 5 days. Next, we began the hard work of refeeding together, FBT style. With the support of the doctors, nurses, aides, clerks, and therapists, we nursed my daughter back to physical stability. After almost 6 weeks, her G-tube was removed. She is weight restored and is fighting for her life now. She continues eating 100 percent of her three meals and her snack, and she shares more and more about how her anxiety rules her life. What are your thoughts on the treatment approach taken with the patient? What are the pros and cons of this approach? Explain. As a follow-up to this treatment, you are assigned to work with the patient and her family. What behavior modification techniques would you use and why? Use evidence from one scholarly source other than your textbook to support your answer. Use APA format to cite your source. 9) Compare and contrast the effects of insulin and oral medications for type 1 and type 2 diabetics. What patient education is necessary? 13) Compare and contrast the types and levels of proteins necessary for renal patients with nephrotic syndrome, acute kidney disease, and chronic kidney disease. 10) Explain options to improve oral intake for cancer and HIV/AIDS patients.

Nutrition
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Briefly respond to each item with a APA format and APA citation with reference. May put it on one word document.

1) What is the difference between fat-soluble and water-soluble vitamins in deficiency and toxicity levels? How do deficiencies and toxicities occur for each?

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2) Tonya is 5' 3" tall, weighs 151 pounds, and is 38 years old. Her waist circumference is 37". Her life is busy but sedentary. She simply does not have the time or energy to stay with an exercise program after working all day as receptionists and caring for her two socially active children. She would like to lose about 20 pounds but knows dieting doesnt work for herall the diets she has tried in the past have left her hungry and feeling deprived. Losing weight has taken on greater importance since her doctor told her that both her blood pressure and glucose levels are at borderline high levels.

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What is her BMI? Assess her weight based on BMI.
Estimate her total calorie requirements using the rule-of-thumb method of calculating BMR and adding calories for a sedentary lifestyle. How does it compare to the level of calories recommended in Table 7.3 of your text for a woman her age with a sedentary lifestyle? Which calorie level do you think is most accurate? Why?
How many calories would she need to eat to lose 1 pound of weight per week if her activity level stays the same? Two pounds per week? Is a 2-pound weight loss per week a reasonable goal?
To help her avoid feeling hungry while eating fewer calories, what foods would you recommend she consume more of? She knows she should drink fewer soft drinks. What advice would you give her to help her do that?

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3) Explain supplement regulations. Choose a supplement (from your own home or online) and imagine you are educating your patient who states that she takes the supplement. What should she understand about the items on the label, the packaging, supplement regulations or lack thereof, and interactions or side effects? Attach a picture of the supplement label and packaging you are discussing. Cite at least one scholarly source other than your text using APA. Do not choose a supplement that has already been explained.

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4) Locate an article that explores issues related to culture and religion in healthcare settings. Provide a summary of the article along with a link to the article. What concerns are raised? How are conflicts resolved or not resolved? How does the information you learned in the article shape your views on culture and religion in health care? Choose an article that comes from a credible source. The source does not necessarily need to be scholarly for this discussion; you may use news stories.

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5) Describe some of the diet and health connections between a child and a senior citizen? Provide examples.

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6) (You need to respond to one question from A, and one question from B, based on the information) Sarah is 28 years old and 7 months pregnant with her third child. Her other children are 2-12 and 1-12 years old. She had uncomplicated pregnancies and deliveries. Sarah is 5' 6" tall; she weighed 142 pounds at the beginning of this pregnancy, which made her pre-pregnancy BMI 23. She has gained 24 pounds so far. Prior to her first pregnancy, her BMI was 20 (124 pounds). She is unhappy about her weight gain, but the stress of having two young children and being a stay-at-home mom made losing weight impossible.

She went online for her MyPlate plan, which recommends she consume 2,400 calories per day. She doesn't think she eats that much because she seems to have constant heartburn. She takes a prenatal supplement, so she feels confident that even if her intake is not perfect, she is getting all the nutrients she needs through her supplement.

Category A
Does she have any risk factors for a high-risk pregnancy? Explain your answer.
Evaluate her prepregnancy weight and weight gain thus far. How much total weight should she gain? Explain your answer.
Is her attitude about supplements appropriate? What would you tell her about supplements? Explain.

Category B
Based on the 2,400-calorie meal pattern, what foods should Sarah eat more of? What food is she eating more than the recommended amounts? How would you suggest she modify her intake to minimize heartburn?
What would you tell her about weight gain during pregnancy? What strategies would you suggest to her after her baby is born that would help her regain her healthy weight?
Devise a 1-day menu for her that provides all the food she needs in the recommended amounts and alleviates her heartburn.

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7) What are the differences between enteral nutrition and total parenteral nutrition? How do the implications of each method concern the nurse?
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8) My daughter spent three weeks in an eating disorder medical stabilization unit in Phoenix, Arizona, for restrictive purging anorexia. She deteriorated physically as she intractably vomited everything she was encouraged to eat. She was refusing fluids as well. She fainted frequently with a resting heart rate between 35 and 45; they told me they could not help her. They would not place a life-sustaining NG-tube for fear of aspiration from her vomiting.
After my daughter spent almost two weeks in another hospital in Sacramento, vomiting NG-tubes out 7 or 8 times, the very desperate decision was made to surgically place a gastrostomy tube for life-saving nutrition. I was terrified at this aggressive measure, but I was also aware of the fact that my daughter was slipping away. The G-tube was placed and nutrition was given completely via the G-tube for 4 days.
Guess what? It broke the cycle of vomiting. She began to eat 100 percent without vomiting. The tube was used for a total of 5 days. Next, we began the hard work of refeeding together, FBT style. With the support of the doctors, nurses, aides, clerks, and therapists, we nursed my daughter back to physical stability. After almost 6 weeks, her G-tube was removed. She is weight restored and is fighting for her life now. She continues eating 100 percent of her three meals and her snack, and she shares more and more about how her anxiety rules her life.
What are your thoughts on the treatment approach taken with the patient? What are the pros and cons of this approach? Explain.
As a follow-up to this treatment, you are assigned to work with the patient and her family. What behavior modification techniques would you use and why?
Use evidence from one scholarly source other than your textbook to support your answer. Use APA format to cite your source.
-------------

9) Compare and contrast the effects of insulin and oral medications for type 1 and type 2 diabetics. What patient education is necessary?
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10) Compare and contrast the types and levels of proteins necessary for renal patients with nephrotic syndrome, acute kidney disease, and chronic kidney disease.
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11) Explain options to improve oral intake for cancer and HIV/AIDS patients.