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Chapter 6: Special Nutritional Considerations for Neurological Health

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Chapter 6: Special Nutritional Considerations for Neurological Health

14 problems · 0 figures

Case Study 6.1.1 §6.1 source ↗

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

A nurse working in an internal medicine clinic is assessing John Everett, a 77-year-old Black male. His daughter accompanies him for this routine exam. The nurse asks about John’s appetite and recent food intake. He reports that he eats “ok,” but his daughter says that he is not eating very well. The nurse reviews John’s record and notes that he has lost 10 lbs since his last visit. John lives alone, and his daughter is concerned he is not eating enough nutritious food.

Which of the following age-related findings is associated with older adults?
  1. a.
    Increased appetite
  2. b.
    Decreased muscle mass
  3. c.
    Increased caloric intake
  4. d.
    Decreased hydration requirements

Answer

B. Decreased muscle mass
Decreased muscle mass is associated with the aging process.

Case Study 6.1.2 §6.1 source ↗

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

A nurse working in an internal medicine clinic is assessing John Everett, a 77-year-old Black male. His daughter accompanies him for this routine exam. The nurse asks about John’s appetite and recent food intake. He reports that he eats “ok,” but his daughter says that he is not eating very well. The nurse reviews John’s record and notes that he has lost 10 lbs since his last visit. John lives alone, and his daughter is concerned he is not eating enough nutritious food.

Which of the following statements by the client indicates that he is at risk for impaired nutrient absorption?
  1. a.
    “I don’t drink much water.”
  2. b.
    “I eat canned vegetables.”
  3. c.
    “I take my blood pressure medicine with food.”
  4. d.
    “I eat a lot of snacks and small meals.”

Answer

A. “I don’t drink much water.”
Older adults are at high risk for dehydration which can affect the body’s ability to absorb nutrients.

Case Study 6.2.3 §6.2 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.

During John’s visit it becomes apparent that he is experiencing some cognitive decline. The health care provider is recommending further neurological evaluation for possible dementia. The provider is also concerned about the client’s weight loss and wants the nurse to work with John to improve his food intake.

Which of the following dietary recommendations should the nurse make to John?
  1. a.
    Limit all carbohydrate intake.
  2. b.
    Increase intake of complex carbohydrates.
  3. c.
    Switch to drinking diet beverages with artificial sweeteners.
  4. d.
    Limit fluid intake and focus on solid food intake.

Answer

B. Increase intake of complex carbohydrates.
Complex carbohydrates, such as those found in fresh fruit, vegetables, and high-fiber cereal grains, are recommended for the management of cognitive decline.

Case Study 6.2.4 §6.2 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.

During John’s visit it becomes apparent that he is experiencing some cognitive decline. The health care provider is recommending further neurological evaluation for possible dementia. The provider is also concerned about the client’s weight loss and wants the nurse to work with John to improve his food intake.

John’s daughter asks why he can’t just take a vitamin to meet his nutritional needs. Which of the following is the best response by the nurse?
  1. a.
    Vitamins and supplements are used as a last resort.
  2. b.
    Vitamins and supplements do not contain adequate amounts of needed nutrients.
  3. c.
    Taking vitamins and supplements may be confusing for the client and difficult to remember to take.
  4. d.
    Research shows that eating a nutrient-rich diet is the best source of micronutrients to support cognition.

Answer

D. Research shows that eating a nutrient-rich diet is the best source of micronutrients to support cognition.
Supplementing the diet with micronutrients has been shown to improve cognition in some studies of clients with Alzheimer’s disease, but the best health benefits have been verified with a varied multinutrient-rich diet rather than with supplements alone.

6-1 §6.RQ source ↗

The nurse is providing dietary instruction to a client who is in the first trimester of pregnancy. Consuming which of the following foods should the client prioritize to facilitate fetal neurological development?
  1. a.
    Apples and grapes
  2. b.
    Whole wheat bread
  3. c.
    Fruit juice
  4. d.
    Chicken and lentils

Answer

D. Chicken and lentils
Chicken and lentils are two sources of protein; 71 g of protein a day is often recommended during the first trimester of pregnancy to promote fetal neurological development.

6-2 §6.RQ source ↗

A 54-year-old client, recently diagnosed with multiple sclerosis, presents to the clinic for a follow-up appointment The client asks the nurse if there is any special diet that might help their symptoms. The nurse advises which diet as an option for the client to discuss with the neurologist?
  1. a.
    Mediterranean diet
  2. b.
    DASH diet
  3. c.
    Ketogenic diet
  4. d.
    Diabetic diet

Answer

C. Ketogenic diet
The ketogenic diet is low in carbohydrates, and carbohydrates are associated with increased symptoms among clients with MS. A ketogenic diet may improve their concentration, attention, and memory.

6-3 §6.RQ source ↗

A client is prescribed phenytoin for epilepsy. Which of the following nutritional deficiencies is the client at risk for?
  1. a.
    Vitamin D deficiency
  2. b.
    Iron deficiency
  3. c.
    Hypoglycemia
  4. d.
    Hypercalcemia

Answer

A. Vitamin D deficiency
Clients taking phenytoin are at risk for vitamin D and biotin deficiencies.

6-4 §6.RQ source ↗

A 15-year-old client has decided to try a vegetarian diet. Which of the following nutritional deficiencies is this client at risk for developing?
  1. a.
    Vitamin C
  2. b.
    Omega-3 fatty acids
  3. c.
    Calcium
  4. d.
    Potassium

Answer

B. Omega-3 fatty acids
Nutritional deficiencies, especially of the omega-3 fatty acids, iron, zinc, and B12, are more common among vegetarians and vegans.

6-5 §6.RQ source ↗

The patient care technician is assisting a client with Parkinson’s disease during mealtime and reports the client began to drool and cough while eating. Which action is the most appropriate from the nurse?
  1. a.
    Perform a bedside swallow evaluation.
  2. b.
    Tell the patient care technician to watch the client carefully for the rest of the meal.
  3. c.
    Show the patient care technician how to suction the mouth orally.
  4. d.
    Place a nutrition consult for tomorrow morning to initiate tube feedings.

Answer

A. Perform a bedside swallow evaluation.
Drooling and coughing are symptoms of dysphagia, and the client will require a dysphagia screening.

6-6 §6.RQ source ↗

The nurse is educating a client’s family about the addition of polyphenols to the client’s diet. Which foods should be recommended by the nurse?
  1. a.
    Chicken
  2. b.
    Fish
  3. c.
    Whole-fat milk
  4. d.
    Spinach

Answer

D. Spinach
Polyphenols obtained from fresh fruits and vegetables have been shown to improve neurological function and slow cognitive decline in clients with degenerative conditions including Alzheimer’s disease.

6-7 §6.RQ source ↗

A client diagnosed with epilepsy asks the nurse if nutritional changes could potentially help control their seizures. Which diet would the nurse tell the client about?
  1. a.
    DASH diet
  2. b.
    Ketogenic diet
  3. c.
    Mediterranean diet
  4. d.
    Vegetarian diet

Answer

B. Ketogenic diet
Ketogenic diets can reduce seizures that have not previously responded to drug therapy.

6-8 §6.RQ source ↗

The nurse is educating a client who is breastfeeding about maternal dietary habits that can promote the infant’s health. Which of the following statements by the client indicates the need for additional instruction?
  1. a.
    “I will be sure to eat some leafy green vegetables.”
  2. b.
    “I will drink plenty of fluids throughout the day.”
  3. c.
    “I need to eat fewer carbohydrates.”
  4. d.
    “I need to eat 300–400 extra calories each day.”

Answer

C. “I need to eat fewer carbohydrates.”
Lactating mothers should not restrict carbohydrate intake. They need to eat fruits, vegetables, and complex carbohydrates including whole-grain foods, such as cereals, breads, pastas, and oatmeal.

6-9 §6.RQ source ↗

A diet rich in flavonoids, which are found in tea, red wine, certain fruits, and vegetables is often recommended in neurodegenerative conditions, due to which of the following benefit of flavonoids?
  1. a.
    Antioxidant effect
  2. b.
    They cross the placental barrier.
  3. c.
    They cross the blood-brain barrier.
  4. d.
    Anticoagulant effect

Answer

A. Antioxidant effect
Flavonoids inhibit growth of pathogens in the gut microbiome and have a strong antioxidant effect.

6-10 §6.RQ source ↗

The nurse is providing discharge instructions to a client who has been prescribed an antidepressant. What nutritional recommendations are appropriate for this client?
  1. a.
    Drink a glass of orange juice when taking your medication.
  2. b.
    Eat a high-fiber meal when taking your medication.
  3. c.
    Switch to a high-carbohydrate diet to decrease the risk for weight loss.
  4. d.
    Follow a balanced diet to decrease the risk for weight gain.

Answer

D. Follow a balanced diet to decrease the risk for weight gain.
Follow a balanced diet to decrease the risk for weight gain. Taking antidepressants is associated with weight gain.

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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.