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Chapter 14: Special Nutritional Considerations for Pulmonary Health

16 problems · 0 figures

Case Study 14.1.1 §14.1 source ↗

Read the following clinical scenario and then answer the questions that follow. This case study will evolve throughout the chapter.

Unlike many other American adolescents, Kai grew up eating fresh fruits and vegetables. His family had fruit trees in his yard, so he grew up picking fresh fruits from their source. His mother would obtain the rest of their food items from the local food market, with everything being grown locally. Kai’s mother would cook all their meals at home, and he would walk to school and play football to get plenty of exercise. No one in his family smoked, and they rarely ate outside of the home.

What lifestyle choices in Kai’s adolescence might lead the nurse to believe that Kai comprehends the benefits of good lifestyle choices?
  1. a.
    His family growing their own fruit
  2. b.
    His family’s history of eating fresh fruits and vegetables and his daily exercise
  3. c.
    His screen time
  4. d.
    His family not eating outside of the home

Answer

B. His family’s history of eating fresh fruits and vegetables and his daily exercise
The client grew up eating foods from their sources and cooking at home, and he participated in frequent exercise that provided him with a solid foundation in healthy lifestyle choices.

Case Study 14.1.2 §14.1 source ↗

Read the following clinical scenario and then answer the questions that follow. This case study will evolve throughout the chapter.

Unlike many other American adolescents, Kai grew up eating fresh fruits and vegetables. His family had fruit trees in his yard, so he grew up picking fresh fruits from their source. His mother would obtain the rest of their food items from the local food market, with everything being grown locally. Kai’s mother would cook all their meals at home, and he would walk to school and play football to get plenty of exercise. No one in his family smoked, and they rarely ate outside of the home.

What information from Kai’s past can the nurse incorporate into the dietary client’s education plan?
  1. a.
    Previous history of adolescent exercise and dietary selection
  2. b.
    Smoking cessation
  3. c.
    History of food sourcing
  4. d.
    History of being a football star

Answer

A. Previous history of adolescent exercise and dietary selection
The client grew up with the foundational knowledge of eating healthy food and exercising, so the nurse can use this information in the dietary education plan.

Case Study 14.1.3 §14.1 source ↗

Read the following clinical scenario and then answer the questions that follow. This case study is a follow-up to Case Study Part A.

When Kai moved out of his parent’s house at age 20, he found it difficult to get a job, so he started working with a local construction company at age 24. Kai began smoking when he was 25 while working on the construction sites. He stated, “Smoking used to help me decompress.” The local construction company required Kai to work long hours, making healthy food choices and exercise incorporation challenging. Kai found himself relying on fast food options and the hard work on the construction sites as his daily “exercise.” Kai moved through the ranks and is now a foreman, where he supervises the employees under him at the job sites. He sits more frequently than he used to and found himself putting on more weight, jumping from 255 lb to 280 lb.

What lifestyle choices occur during adulthood might lead Kai to an increased risk for respiratory disease later in life?
  1. a.
    Construction work, smoking, and eating fast foods
  2. b.
    Smoking, drinking alcohol, and exercising
  3. c.
    Eating fast foods, construction work, and drinking lots of water
  4. d.
    Smoking, construction work, and working long hours

Answer

A. Construction work, smoking, and eating fast foods
Construction work, smoking, and selecting fast food are risk factors for chronic respiratory disease.

Case Study 14.1.4 §14.1 source ↗

Read the following clinical scenario and then answer the questions that follow. This case study is a follow-up to Case Study Part A.

When Kai moved out of his parent’s house at age 20, he found it difficult to get a job, so he started working with a local construction company at age 24. Kai began smoking when he was 25 while working on the construction sites. He stated, “Smoking used to help me decompress.” The local construction company required Kai to work long hours, making healthy food choices and exercise incorporation challenging. Kai found himself relying on fast food options and the hard work on the construction sites as his daily “exercise.” Kai moved through the ranks and is now a foreman, where he supervises the employees under him at the job sites. He sits more frequently than he used to and found himself putting on more weight, jumping from 255 lb to 280 lb.

What lifestyle changes can Kai make early on to decrease his chance of developing a chronic respiratory disease?
  1. a.
    Working out
  2. b.
    Smoking cessation and eating better
  3. c.
    Different job
  4. d.
    Go back to school

Answer

B. Smoking cessation and eating better
Smoking cessation and eating better improves pulmonary health.

Case Study 14.2.5 §14.2 source ↗

Table 14.2 in the book ↗
Today’s Vital Signs Last Year’s Vital Signs and Exam Notes
Temperature: 97.6ºF
Blood pressure: 128/89 mm Hg
Heart rate: 99 beats/min
Respiratory rate: 28 breaths/min
Oxygen saturation: 89% on room air
(drops to 77% while walking)
Height: 6'0"
Weight: 268 lb
Temperature: 98.0ºF
Blood pressure: 126/82 mm Hg
Heart rate: 89 beats/min
Respiratory rate: 20 breaths/min
Oxygen saturation: 92% on room air
Height: 6'0"
Weight: 280 lb

The client presents with mild dry cough for 2 weeks. Client’s chest x-ray shows enlarged lung air pockets. The client does not have a history of respiratory conditions but stated he has smoked for 30 years. The client is a construction worker with a fluctuating dietary history. Recommendations for client include smoking cessation.

Read the following clinical scenario and then answer the questions that follow. This case study is a follow-up to Case Study Parts A and B.

Kai is in the clinic today for difficulty breathing upon walking. His current vital signs are listed on the left side of the following table. Kai states that he has smoked for 30 years and frequently eats fast food because his job demands long hours and he does not have time for grocery shopping. You notice a cough; Kai states he does not know when it began exactly. He has noted a decrease in his weight, and he has a hard time working the long days his job demands because he becomes short of breath. You look at his chart, shown on the right side of the following table, which includes his vital signs and exam notes from his visit last year.

Based on the documented visit history, which of the following issues requires follow-up by the nurse during today’s visit?
  1. a.
    Smoking
  2. b.
    Hydration status
  3. c.
    Dietary recommendations
  4. d.
    Workplace safety

Answer

C. Dietary recommendations
The client’s note from last year indicates altered respiratory function and a low-quality diet, and since nutritional counseling was not addressed during that visit, the nurse should instruct the client during this visit.

Case Study 14.2.6 §14.2 source ↗

Table 14.2 in the book ↗
Today’s Vital Signs Last Year’s Vital Signs and Exam Notes
Temperature: 97.6ºF
Blood pressure: 128/89 mm Hg
Heart rate: 99 beats/min
Respiratory rate: 28 breaths/min
Oxygen saturation: 89% on room air
(drops to 77% while walking)
Height: 6'0"
Weight: 268 lb
Temperature: 98.0ºF
Blood pressure: 126/82 mm Hg
Heart rate: 89 beats/min
Respiratory rate: 20 breaths/min
Oxygen saturation: 92% on room air
Height: 6'0"
Weight: 280 lb

The client presents with mild dry cough for 2 weeks. Client’s chest x-ray shows enlarged lung air pockets. The client does not have a history of respiratory conditions but stated he has smoked for 30 years. The client is a construction worker with a fluctuating dietary history. Recommendations for client include smoking cessation.

Read the following clinical scenario and then answer the questions that follow. This case study is a follow-up to Case Study Parts A and B.

Kai is in the clinic today for difficulty breathing upon walking. His current vital signs are listed on the left side of the following table. Kai states that he has smoked for 30 years and frequently eats fast food because his job demands long hours and he does not have time for grocery shopping. You notice a cough; Kai states he does not know when it began exactly. He has noted a decrease in his weight, and he has a hard time working the long days his job demands because he becomes short of breath. You look at his chart, shown on the right side of the following table, which includes his vital signs and exam notes from his visit last year.

The nurse is constructing a teaching plan for Kai to address potential complications of COPD. Which of the following conditions will the nurse include in the plan?
  1. a.
    Asthma
  2. b.
    Respiratory syncytial virus
  3. c.
    Pulmonary fibrosis
  4. d.
    Pneumonia

Answer

D. Pneumonia
Pneumonia is a potential complication as the mucosal lining thickens and cough pressure declines in clients with COPD.

14-1 §14.RQ source ↗

Based on physiological changes that occur during pregnancy, which nutrients should the nurse encourage a client to eat to support the pulmonary system and fetal development during pregnancy?
  1. a.
    Carbohydrates
  2. b.
    Vitamin C
  3. c.
    Proteins
  4. d.
    Vitamin B

Answer

C. Proteins
Pregnant women should consume a balanced diet that includes protein to support the physiological changes of the mother and the growth of the fetus.

14-2 §14.RQ source ↗

Nutritional factors play a role in the development and function of the pulmonary system during infancy. Which nutrient is essential for the development of the pulmonary system?
  1. a.
    Iron
  2. b.
    Protein
  3. c.
    Vitamin C
  4. d.
    Omega-3 fatty acids

Answer

D. Omega-3 fatty acids
Omega-3 fatty acids are essential to the development and function of the pulmonary system during infancy.

14-3 §14.RQ source ↗

The nurse is caring for a pregnant client who has nutritional deficits. How should the nurse describe the potential fetal effects from maternal malnourishment?
  1. a.
    The fetus will experience lower blood glucose levels.
  2. b.
    The fetus will develop a slower-than-normal heart rate.
  3. c.
    The fetus may develop cognitive and behavioral delays.
  4. d.
    The fetus may experience hormone imbalances.

Answer

C. The fetus may develop cognitive and behavioral delays.
Cognitive and behavioral defects may occur in the fetus whose mother is malnourished.

14-4 §14.RQ source ↗

The nurse is working with a client who was recently diagnosed with asthma and is using a bronchodilator inhaler. Which of the following foods should the nurse instruct the client to minimize or avoid?
  1. a.
    Steak
  2. b.
    Coffee
  3. c.
    Grapefruit
  4. d.
    Kale

Answer

B. Coffee
Foods containing caffeine, like coffee, can potentiate the effects of the bronchodilator leading to tremors, nervousness, anxiety, and heart palpitation.

14-5 §14.RQ source ↗

The nurse is providing prenatal diet instruction for a pregnant client. Which nutrients should the nurse encourage the client to consume to promote explain proper fetal lung function and development?
  1. a.
    Proteins, vitamins A, D, and E, and omega-3 fatty acids
  2. b.
    Carbohydrates and vitamins A, D, and E
  3. c.
    Proteins and iron
  4. d.
    Fats, vitamins B12 and B6, and calcium

Answer

A. Proteins, vitamins A, D, and E, and omega-3 fatty acids
A pregnant client needs protein, vitamins A, D, E, and omega-3 fatty acids for proper lung function and development of the fetus.

14-6 §14.RQ source ↗

The nurse is providing discharge teaching for a client with respiratory alterations. Which of the following statements regarding the effects of nutrition on the immune system and lung health should be included in the plan?
  1. a.
    Good nutrition is important, although it does not prevent acute respiratory tract infections.
  2. b.
    Nutrition only affects lung tissue repair, not the immune system.
  3. c.
    Improper nutritional intake alters the immune system but does not impact lung health.
  4. d.
    Nutrition plays a role in supporting the immune system to prevent and treat infection and repair lung tissue.

Answer

D. Nutrition plays a role in supporting the immune system to prevent and treat infection and repair lung tissue.
Nutrition plays a role in supporting the immune system, which prevents and treats infections while also repairing lung tissue.

14-7 §14.RQ source ↗

The nurse is instructing the parent of a child recently diagnosed with asthma. Which of the following foods should the nurse instruct the parent to include with the child’s meals to decrease the risk for an asthma exacerbation?
  1. a.
    Salmon or other fatty fish
  2. b.
    A lean protein such as chicken
  3. c.
    At least one serving of fruits and vegetables
  4. d.
    A serving of red meat

Answer

C. At least one serving of fruits and vegetables
Consuming fruits and vegetable is linked to a decreased risk for developing asthma and a decreased risk for experiencing asthma symptoms such as wheezing.

14-8 §14.RQ source ↗

The nurse is counseling a client experiencing worsening COPD symptoms on diet strategies to minimize the impacts of the disease. Which dietary component is associated with worsening airway inflammation and lung function limitations?
  1. a.
    Saturated fats
  2. b.
    Carbohydrates
  3. c.
    Vitamins
  4. d.
    Unsaturated fats

Answer

A. Saturated fats
A diet high in saturated fats has been linked with worsening airway inflammation and lung function.

14-9 §14.RQ source ↗

What is the goal of an anti-inflammatory diet for clients with RTI and pneumonia?
  1. a.
    To limit the immune system’s response
  2. b.
    To increase the immune system’s response
  3. c.
    To decrease lung function and reduce coughing
  4. d.
    To minimize the duration of and decrease the risk for infections

Answer

D. To minimize the duration of and decrease the risk for infections
The main goal of an anti-inflammatory diet is to minimize the duration of and decrease the risk for infection. An anti-inflammatory diet supports the immune system and lung function and decreases oxidation.

14-10 §14.RQ source ↗

The nurse is instructing a client on long-term oxygen therapy at home on the role of nutrition in managing the client’s condition. Which of the following statements by the client indicates the client understands the instruction?
  1. a.
    “I know my GI tract is not getting as much oxygen as it used to, so I need to make sure I get enough vitamins and minerals in my body.”
  2. b.
    “I need to eat whatever I feel like I can – calories are the most important thing.”
  3. c.
    “I need to eat as much protein as possible.”
  4. d.
    “I need to try to avoid foods high in calcium as these can affect my condition.”

Answer

A. “I know my GI tract is not getting as much oxygen as it used to, so I need to make sure I get enough vitamins and minerals in my body.”
Long-term oxygen therapy in COPD clients causes nutritional deficiencies, because low oxygenation to the gastrointestinal tract decreases its ability to function and absorb nutrients.

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Problems and answers are adapted from Nutrition for Nurses by Emerald Charity Bilbrew, Jody Vogelzang and Kelli Whittington, OpenStax, and are used under the CC BY-NC-SA 4.0 licence. Access for free at https://openstax.org/books/nutrition/pages/1-introduction. Illustrations: Copyright Rice University, OpenStax, under CC BY-NC-SA 4.0 license. This adaptation is released under the same licence, is non-commercial, and is neither affiliated with nor endorsed by OpenStax or Rice University.