Squirrel

Thank you all very much for responding!!!! I really appreciate the time each one of you took to answer my questions! I thought that most BSN schools had a separate nutrition course, but I was not sure of ADN or diploma programs. By the way, are there still diploma programs out there? There is so much research out there regarding nutrition and disease prevention, and I hope the lastest research is being incorporated into your courses. Once again, thank you all!

Hello students! I have been a nurse for awhile now, and am working on a Master's Degree in nutrition and will become a dietitian next year. I am trying to get a feel for how nutrition is taught in nursing schools these days. I graduated from an ADN program in 1987 and I did not have a specific course in nutrition, but nutrition concepts were given in my nursing courses. The specific questions I have are: 1. Do you have a specific course in nutrition that is required, and if so how many credits and what is the title? 2. If you do or do not, are you in an ADN, diploma, or BSN program? 3. Is your course taught through the school of nursing and taught by a nurse, or is it through a nutrition department and taught by a dietitian? 4. In your nutrition course, is medical nutrition therapy and/or nutrition support discussed? Thank you all very much, and good luck with school!

Mario: I forgot to mention a few things in my last post. At the bottom of the menu you will see foods listed as "free" (sugar free jello, iceburg lettuce). A free food has less than 20 Calories and less than 5 gm of CHO per serving, and patients usually can have up to 3 free food servings a day in addition to the servings from the food lists. After the number of servings from the exchange lists are figured out and distributed during the day (as was done on your menu), the patient can then choose from a variety of foods using the serving sizes from an exchange list. The patient needs to know what a serving size is and how to measure it, but does not need to worry about counting CHO, fat, and protein grams because this was already done by the dietitian when figuring out how many servings of each food list per day. No Calorie counting either! The exchange plan gives the patient more control over his diet with more variety. For example, 1 glazed doughnut counts as 2 CHO and 2 fat exchanges and the patient can eat a doughnut as long as it counts for 2 CHO and 2 fat exchanges in the daily menu.

Mario: I am just now looking at your menu you uploaded (by the way how did you do that?) This looks like something right out of my dietetic textbook! What it is saying is that the number of servings from each food list has already been determined for that patient: 3 servings from milk list, 3 from meat list, 8 from bread list, 2 from fruit list, 4 from vegetable list, and 5 from fat list. Where it says exchange plan is how the foods from the exchange lists are distributed during the day. For example, the patient will get a total of 3 servings of milk a day. These 3 servings are distributed as follows: 1 for breakfast, 1 for lunch, 1/2 for dinner, and 1/2 at bedtime. Does that make sense? This is what you need to know to plan the menu for the next day. Look at each meal and see how many servings of each exchange list you need. Breakfast: you need 1 serving from the milk list, none for meat, 2 from bread, 1 from fruit, no vegetable, and 1 from fat. The sample menu just gives you an example of a menu planned from the information stated above. For you to do this your instructor should have given you a list of what foods are included in each food list and what the serving sizes are. Again, be careful because the serving sizes are different for the exchange list and the food guide pyramid. Hope this helps!

Mario: I am not sure if this is what you are looking for, but I can give you a brief overview of what dietitians use when they counsel diabetic patients. The idea of the exchange list is to group similar foods into categories so the diabetic patient can have more of a selection and more control over his diet. The categories include the starch list, fruit list, milk list, vegetable list, meat list, and fat list. One serving from each list contains a certain amount of CHO, protein, fat, and calories. The serving size for each food is also listed so the patient will know how much of a certain food is considered a serving. Be careful because the serving sizes stated for the exchange lists may not be the same for the food guide pyramid. For example, one serving of fruit juice in the exchange list is 1/2 cup but the serving of fruit juice in the food guide pyramid is 3/4 cup. Each serving of food in the starch list contains 15 gm CHO, 3 gm protein, 1 gm fat, and 80 calories. Each serving in the fruit group has 15 gm CHO, no protein or fat, and 60 calories. If you need information from the other lists, I can post it for you. When you recommend a diet based on the exchange list, you first find out the Cal/day the patient needs such as 1800, then you figure out what percentage of Calories will come from protein, fat, and CHO. This will eventually lead you to how many grams of protein, fat, and CHO the patient will need each day. Then you work with the patient to figure out how these nutrients will be distributed during the day, and how many foods from the different lists will be included. For example, if a patient needs 60 gm of protein a day and does not like to eat meat to get the amount, he can choose more foods in the CHO or milk group. This can take alot of time to do and requires several calculations. If a patient likes to eat alot of fruit, then you should include more foods from the fruit list. If the patient will not drink milk, this needs to be considered before you recommend 2 servings from the milk list. I am not sure if this answers your question, as I am not sure how much information you need.

Hello everyone! I am wondering how all of you deal with family members, strangers, patients' families, and anyone else who asks you for health advice because you are a nurse? I've noticed that when some people find out you are a nurse, they automatically assume they are entitled to free health advice about their specific medical problems. Some also feel that they need to tell you about all of their problems, hospitalizations, and issues with the healthcare system. I get frustrated when family members ask me if I think their doctor is treating them properly and giving them the correct medications when I do not have a clue as to what the doctor is doing. I do not mind giving very general knowlege to people such as what consists of a low fat diet, which foods are high in saturated fat, and lifestyle modifications to prevent hypertension, but I will not give specific advice to people about any particular condition. I just tell them to contact their doctor with questions. I am interested in hearing how all of you handle this. Thanks in advance!

Thank you P_RN for the Colorado references. I am assuming that the nurses were charged because they changed the route from IM to IV without consulting the doctor. Does this mean that if they had given the medication IM and the child still died they would not have been criminally charged? Does anybody know if anymore cases like this out there? Thank you in advance!

Boy, this is very disturbing! I am not clear if the alleged drug use had something to do with the charge or if he would have been charged anyway. Does anybody remember a few years ago in Colorado there was a story about 2 nurses who were criminally charged with manslaughter after a baby died due to a med error? I do not know what the outcome was in that case. I hope this does not become a trend, as nurses have so much to worry about already (getting sued, getting abused by everybody, potential for diseases) on top of the fear of prison due to a med error.