NUR 102: Nutrition And Diet Therapy-

STUDENT ACTIVITY SHEET Laboratory)

BS NURSING / SECOND YEAR
Session # 23

LESSON TITLE: DIETS FOR CARDIOVASCULAR

DISEASES (PART 1) Materials:
Book, pen, notebook, and PowerPoint
LEARNING OUTCOMES: presentation

Upon completion of this lesson, the nursing student can: References:

1. Discuss the different cardiovascular diseases.
2. Identify food allowed in the diet of an individual suffering
from cardiovascular diseases;
3. Plan meals for patients suffering from different
cardiovascular diseases; and
4. Prepare meals for patients suffering from different
cardiovascular diseases.
Laboratory Manual For Allied Health: Maria
Lourdes Cruz-Caudal (2019) Basic Nutrition and
Diet Therapy 2nd C&E Publishing, Inc.
https://www.webmd.com/heart-
disease/guide/diseases-cardiovascular#2

LESSON PREVIEW/ REVIEW (10 minutes)

True or False
Write the word True if the statement is correct and False if the statement is incorrect.

1. True Pancreatitis is inflammation of an organ in the abdomen called the pancreas.

2. False Acute pancreatitis is long-lasting inflammation and damage and cannot be cured.

3. True The liver, bladder, and pancreas are the accessory organs of digestion.

4. True The pancreas lies just behind the stomach between the duodenum and the spleen.

5. False Pallor or a yellowish coloring, is an obvious sign of liver disease or a blocked bile duct.

6. False Cirrhosis is an inflammation of the liver caused by alcoholism, the chemical action of drugs or toxic
substances, or viruses.

7. False Cholecystitis is a chronic, irreversible, degenerative disease most commonly caused by chronic
alcoholism

8. True Bladder disorders usually cause symptoms related to indigestion when eating fatty foods.

9. True The liver filters bilirubin and excretes it in bile.

10. True Excessive bilirubin leaks into tissues and causes a yellow color in the affected individual's skin
and sclera

CHECK FOR UNDERSTANDING (10 minutes)

You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to correct
answer and another one (1) point for the correct ratio. Superimpositions or erasures in you answer/ratio is not allowed.
You are given 15 minutes for this activity:

Multiple Choice

1. What is a myocardial infarction?

a. Heart failure c. Heart attack
b. Cardiac arrest d. All of the above
ANSWER: c. Heart attack
RATIO: A heart attack (myocardial infarction) happens when one or more areas of the heart muscle don't get enough
oxygen. This happens when blood flow to the heart muscle is blocked.

2. Risks for heart disease include …

a. High blood pressure and high cholesterol c. Smoking
b. Lack of exercise d. All of the above
ANSWER: d. All of the above
RATIO: Risk factors for heart disease include: Increasing age, Smoking, High blood cholesterol, High blood pressure,
Physical inactivity, Heredity, Obesity and being overweight.

3. A client with heart failure has been told to maintain a low sodium diet. A nurse who is teaching this client about
foods that are allowed includes which food item in a list provided to the client?
a. Pretzels. c. Whole wheat bread.
b. Tomato juice canned. d. Dried apricot.
ANSWER: d. Dried apricot
RATIO: Foods that are lower in sodium includes fruits and vegetables like dried apricot.

4. A patient is diagnosed with Congestive Heart Failure and must follow a specific diet. Which spices are okay for
the patient to use daily?
a. Onion Salt & Garlic Powder c. Ginger & Bay Leaves
b. Sea Salt & Pepper d. Garlic Sodium & Nutmeg
ANSWER: c. Ginger & Bay Leaves
RATIO: Patients with Congestive Heart Failure should avoid excessive sodium. Ginger & Bay Leaves are okay to use.

5. A patient was recently admitted for a Deep Vein Thrombosis and was started on Coumadin. During your
education with the patient you would instruct the patient to avoid what food?
a. Bananas c. Lettuce
b. Spinach d. Processed meats
ANSWER: b. Spinach
RATIO: Coumadin prevents clotting of the blood. Due to the high amount of vitamin k (vitamin k plays a role in clotting) in
green leafy vegetable, these foods should be limited.

AL Activity:

CASE: Person diagnosed with Congestive heart failure disease

1. Discuss the characteristics and dietary management of the person with Congestive Heart Failure disease condition

Congestive Heart Failure

 Characteristics: Heart failure, also called congestive heart failure, is characterized by the heart’s inability to
pump adequate blood, resulting in inadequate blood delivery and a buildup of fluids in the veins and tissues.
The heart enlarges or pumps faster or harder, but it may eventually weaken enough to fail completely. It often
affects a person’s food intake and level of physical activity. It causes chest pain, difficulty with digestion and
absorption, and swelling in the legs, ankles, and feet.

 Dietary management: A modest sodium restriction of 2000 milligrams or less daily to reduce the risk of fluid
retention, maintaining an adequate fiber intake, restricted or avoidance of consumption of alcoholic beverages,
and daily multivitamin-mineral supplementation.
2. Plan and prepare a therapeutic diet for a person with Congestive Heart Failure disease.

DIET MEAL PLAN FOR PATIENT WITH CONGESTIVE HEART FAILURE DISEASE

Breakfast
 1 cup cooked rolled oats sprinkled with 1 tablespoon chopped walnuts and 1 teaspoon cinnamon
 1 medium banana
 8 oz of skimmed milk
Lunch
 1 cup raw broccoli and cauliflower
 2 tablespoons low-fat cream cheese, plain or vegetable flavor (as a spread for crackers or vegetable dip)
 Fruit plate with ½ cup of fresh blueberries, ½ orange and 2 peach halves
 4 unsalted crackers
Dinner
 3 oz herb baked salmon
 ½ cup steamed spinach drizzled with fresh lemon juice
 8 sliced tomatoes
 4 slices of medium-sized apples
 1 glass of water
Snack
 4 low-sodium whole grain crackers
 ½ low sodium turkey sandwich on 2 slices of whole wheat bread
 1 cup low fat pudding
 NUR 102: Nutrition And Diet Therapy-
STUDENT ACTIVITY SHEET Laboratory)
BS NURSING / SECOND YEAR
Session # 24

LESSON TITLE: DIETS FOR CARDIOVASCULAR

DISEASES (PART 2)
LEARNING OUTCOMES:
Upon completion of this lesson, the nursing student can:
1. Discuss the different cardiovascular diseases.
2. Identify food allowed in the diet of an individual
suffering from cardiovascular diseases;
3. Plan meals for patients suffering from
different cardiovascular diseases; and
4. Prepare meals for patients suffering from
different cardiovascular diseases .
Materials:
Book, pen, notebook, and PowerPoint presentation
References:
Laboratory Manual For Allied Health: Maria
Lourdes Cruz-Caudal (2019) Basic Nutrition and
Diet Therapy 2nd C&E Publishing, Inc.
https://www.betterhealth.vic.gov.au/health/Conditi
onsAndTreatments/heart-disease-and-food

CHECK FOR UNDERSTANDING (10 minutes)

You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to correct
answer and another one (1) point for the correct ratio. Superimpositions or erasures in you answer/ratio is not allowed.
You are given 15 minutes for this activity:

Multiple Choice
1. You have a patient who just had a stroke and has garbled speech. What type of diet do you expect the patient to be
prescribed after a speech evaluation?
a. Soft diet c. Full liquid diet
b. Mechanically altered diet with thin liquids d. Mechanically altered diet with nectar thick liquids
ANSWER: d. Mechanically altered diet with nectar thick liquids
RATIO: When a patient has a stroke they are at risk for aspiration due to the decrease ability to swallow. Many times a
stroke with affect speech as well the patient‘s ability to utilize the swallowing muscles. Generally, when garbled speech is
noted in a stroke victim this is a sign there is a problem with the patient’s ability to use their swallowing muscles. A
mechanically altered diet with nectar thick liquid will usually be prescribed. However, a speech evaluation will determine
what is needed.

2. Which is better for your heart health?

a. Avocado toast c. Peanut butter toast
b. Butter toast d. None of the above
ANSWER: a. Avocado toast
RATIO: 75% of an average-size avocado is made up of monounsaturated fats. According to the American Heart
Association, monounsaturated fats can help reduce bad cholesterol levels and lower the risk of heart disease. The Mayo
Clinic says that they may also help with blood sugar control. Therefore, choice A is the best option.

3. Which is better for your heart health?

a. Chicken c. Fish
 b. Pork d. Beef
ANSWER: c. Fish

RATIO: In general, red meats (beef, pork and lamb) have more saturated (bad) fat than chicken, fish and vegetable proteins
such as beans. Saturated and trans fats can raise your blood cholesterol and make heart disease worse. The unsaturated
fats in fish, such as salmon, actually have health benefits. Therefore, choice C is the best option.

4. Which is better for your heart health?

a. Coffee c. Cola
b. Tea d. All of the above
ANSWER: B. Tea
RATIO: Regular tea consumption can lead to fewer heart-related events, such as heart attacks and stroke. Coffee,
however, did not have such a beneficial effect. Diterpenes in coffee have been found to raise LDL, or bad cholesterol,
levels. While regular consumption of these ingredients in the high quantities you find in Coke (cola) and other processed
foods and drinks can lead to higher blood pressure, heart disease, diabetes, and obesity. Therefore, choice B is the best
option.

5. Which is better for your heart health?

a. Dark chocolate c. Milk chocolate
b. Either d. Neither
ANSWER: D. Neither
RATIO: Milk chocolate contains about 10 percent cocoa liquor – the paste made from ground, roasted, shelled and
fermented cocoa beans that contains both nonfat cocoa solids and cocoa butter. On the other hand, dark chocolate with 70
percent to 85 percent cacao contains about 600 calories and 24 grams of sugar which is important because the amount of
cocoa solids in dark chocolate indicates he amount of dietary flavonoids, which are antioxidants found in fruits, vegetables
and certain drinks. Research suggests consuming more dietary flavonoids is linked to a lower risk of coronary heart
disease. Researchers found that eating raw almonds, dark chocolate and cocoa helped lower "bad" LDL cholesterol in
people who are overweight or obese. But when investigators took the almonds away, dark chocolate and cocoa alone didn't
appear to aid heart health. In conclusion, while dark chocolate has more flavanols than other types of chocolate, the data to
suggest there is enough to have a health effect is thin at this point. Neither of the two has a huge impact and benefits on
one’s health.
 NUR 102: Nutrition And Diet Therapy-
STUDENT ACTIVITY SHEET Laboratory)
BS NURSING / SECOND YEAR
Session # 25

LESSON TITLE: DIETS FOR RENAL DISEASES (PART 1)

Materials:
LEARNING OUTCOMES: Book, pen, notebook, and PowerPoint
presentation
Upon completion of this lesson, the nursing student can:
References:
1. Discuss the different renal diseases. Laboratory Manual For Allied Health: Maria
2. Identify food allowed in the diet of an individual suffering Lourdes Cruz-Caudal (2019) Basic Nutrition and
from renal diseases; Diet Therapy 2nd C&E Publishing, Inc.
3. Plan meals for patients suffering from different renal
https://www.aarp.org/health/healthy-living/info-
diseases; and
2018/heart-healthy-foods-quiz.html#quest1
4. Prepare meals for patients suffering from different renal
diseases. https://www.healthline.com/health/kidney-
disease#treatment

LESSON PREVIEW/ REVIEW (10 minutes)

Choose what you know is best for you

Put a check in the box of your best answer. Defend or make a short explanation on your chosen answer.

1. Which is better for your heart health?

Greek yogurt
Regular yogurt

In my opinion, greek yogurt is better for my heart health since it has more protein and less sugar than the regular yogurt while
still having the high levels of vitamins and minerals, which is a good low-fat, nutrient-rich option.

2. Which is better for your heart health?

Red wine
White wine
Either
For me, I chose either of the alcoholic drinks stated above. Both impose a variety of nutritious benefits, with the red wine
containing powerful antioxidants, which are known as resveratrol that protect your blood vessels, may prevent blood clots.
and decreases bad cholesterol (LDL), while increasing the good cholesterol (HDL) and white wine also known to improve
heart health, may prevent heart diseases and also contain polyphenols too just like the red wine. According to Dr. Robert
Kloner, a chief science officer and director of cardiovascular research at Huntington Medical Research Institutes and a
professor of medicine at the University of Southern California, “It's unclear whether red wine is directly associated with this
benefit or whether other factors are at play.” Both drinks are neck-to-neck in calories, and so, both can be good for our health
References: Drinking red wine for heart health? Read this before you toast. American Heart Association. Retrieved from:
https://www.heart.org/en/news/2019/05/24/drinking-red-wine-for-heart-health-read-this-before-you-toast

3. Which is better for your heart health?

Soup
Salads

I’d go to salad for better heart health. Sure, soup has high liquid volume that calms hunger and easy to digest but it can
be high in sodium, fat and calories too that may have a drastic effect on people’s blood pressure and possibly low in fiber.
With salad, it offers a lot of variety of vegetables that one might choose to go with, and the fiber in vegetables promotes
feelings of fullness for few calories. So eating plenty of these nitrate-rich vegetables such as lettuce, spinach, and beets in
making salad, may actually lower the risk of dying of a stroke or heart attack. During digestion, your body converts nitrates
into nitric oxide and this compound relaxes and widens blood vessels, which helps lower blood pressure.

4. Which is better for your heart health?

Hamburger
Hot dog

I prefer hamburger over hot dog. According to Penny Kris-Etherton, PhD, RD, " Burgers can be part of a heart-healthy diet,"
"The key is portion control -- and the use of lean beef." Hamburgers pack way more nutrition into their patties compared to hot
dogs. Ground beef has more protein, more iron, more zinc, and far less sodium. It also contains vitamin B12 and selenium
(an antioxidant). They typically come with healthier, fresher topping options, such fresh lettuce, tomatoes, and onions, and if
your hosts chose lean ground beef, you'll get all of these benefits plus less fat.

References: Rose. (2020, August 21). Healthy Diet Burger. Retrieved from:
https://theguideways.blogspot.com/2020/07/healthy-diet-burger.html

5. Which is better for your heart health?

Potato chips
French fries

I’d choose French fries than potato chips. Aside from the fact that French fries has lower calories compared to potato chips,
one can actually make French fries a bit healthier by making it guilt-free or a homemade one, baking it in the oven with little
olive oil and spices, than potato chips that has high sodium content, contribute most to weight gain, loaded with saturated fat
and  is also linked to heart disease.

CHECK FOR UNDERSTANDING (10 minutes)

You will answer and rationalize this by yourself. This will be recorded as your quiz. One (1) point will be given to correct
answer and another one (1) point for the correct ratio. Superimpositions or erasures in you answer/ratio is not allowed. You
are given 15 minutes for this activity:

Multiple Choice

1. Medically speaking, which term refers to the kidney function?

a. Hepatic c. Renal
b. Dialysis d. Urinary
ANSWER: c. Renal
RATIO: "Renal" is the medical term that refers to kidney function. "Renal function" refers to the state of the kidneys, and how
well they filter blood.

2. Common non-specific symptoms of chronic kidney disease include:

a. Increased urination at night c. Loss of appetite
b. Swelling of hands and feet d. All of the above
ANSWER: d. All of the above
RATIO: Kidney disease can have many different signs and symptoms that are non-specific, meaning, these same symptoms
could also be signs of dysfunction in another body organ. Some non-specific symptoms of renal disease include: Frequent
urge to urinate, Fatigue, Blood in the urine, swelling in the ankles and feet, Loss of appetite, foamy urine and muscle
cramps.

3. People on dialysis should maintain diets high in .

a. Protein c. Fiber
b. Fats d. Carbohydrates
ANSWER: a. Protein
RATIO: People on dialysis should maintain diets high in protein. High-quality protein produces less waste for removal during
dialysis. Good sources for protein include meat, poultry, fish, and eggs.

4. Patients with kidney diseases must manage fluid intake because fluid...
 a. Retention can cause swelling and weight gain c. Affects blood pressure
b. Overload can result in heart trouble d. All of the above
ANSWER: d. All of the above
RATIO: Healthy kidneys work to remove excess fluid from your body and they do so regularly. A person on dialysis can
have fluid buildup between treatments. Excess fluid can cause swelling and weight gain, elevated blood pressure, and a
buildup of fluid in the lungs that makes it more difficult to breathe. Excess fluid also means the heart has to work harder.
Patients on dialysis must carefully control fluid intake, and that includes fluid from foods such as fruits and vegetables. Salt
should also be reduced or avoided, as it can make you thirsty, causing a greater fluid intake.

5. You are seeing a patient on hemodialysis for a monthly lab review. During the review, you notice that his albumin
level is 2.6 g/dL. He says he eats one meal per day and would like advice on what meats and meat alternatives to
prepare. Which proteins are among those you would advise your patient to eat?
c. Chicken, fish, beef, eggs, soybeans, quinoa c. Potatoes, rice, breads, and pasta
d. Legumes d. Sesame seeds, pumpkin seeds, almonds, walnuts
ANSWER: A. Chicken, fish, beef, eggs, soybeans, quinoa
RATIO: Since the patient is on hemodialysis and appears to have an advice on what meats or meat alternatives should he
prepare, nurses should encourage a patient on hemodialysis with albumin of 2.6 g/dl to take chicken, fish, beef, eggs,
soybeans and quinoa to achieve the required prescribed protein requirement. Therefore, choice A is the best option.

AL Activity:
CASE: : Glomerulonephritis

1. Discuss the characteristics and dietary management of a person diagnosed with Glomerulonephritis condition.

Glomerulonephritis
Characteristics: Inflamed tiny filters in the kidneys (glomeruli).  If the glomeruli are damaged, the kidneys will stop
working properly, and can go into further complications like kidney failure.
Signs and Symptoms:People diagnosed with this condition often shows signs and symptoms such as pink or
cola-colored urine from red blood cells in your urine (hematuria), Foamy urine due to excess protein (proteinuria),
High blood pressure (hypertension), Fluid retention (edema) with swelling evident in your face, hands, feet and
abdomen.
Dietary management: Eat a healthy diet that is low in sodium, saturated fat, trans fats, cholesterol, and refined
sugars, limited consumption of protein and phosphorus; Multivitamin/mineral supplementation specifically,
calcium supplements to reduce risk of bone loss, fluid restriction, eat more fresh vegetables or canned vegetables
with no added sodium or low sodium and fruits.

2. Plan and prepare a therapeutic diet for a person with Glomerulonephritis condition.
DIET MEAL PLAN FOR PATIENT WITH GLOMERULONEPHRITIS
Breakfast
 2 slices white toast
 1 glass of skimmed milk
 1 medium apple
Lunch
 1 small bowl of sodium free Tuscan vegetable soup
 6 oz tomato without added salt
 ½ cup fresh strawberries
Dinner
 1 pita pocket with 3 oz chicken
 ½ cup Acorn squash baked with pineapple
 4 frozen cranberries
Snack
 1 Toast/bread with margarine and 1 oz hard Cheddar Cheese