NR 228 Discussion Questions Week 1 – 8

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 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 3 Discussion Question: Diet and Lab Values:

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.

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?

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.

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”!

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?

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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