Nutritional Care, Therapeutic Diets, and Enteral/Parenteral Nutrition | Chapter 11 from Saunders Comprehensive Review for the NCLEX-PN Examination (7th Edition)
Nutritional Care, Therapeutic Diets, and Enteral/Parenteral Nutrition | Chapter 11 from Saunders Comprehensive Review for the NCLEX-PN Examination (7th Edition)

Welcome to Chapter 11 of the Saunders Comprehensive Review for the NCLEX-PN Examination (7th Edition) by Linda Anne Silvestri and Angela E. Silvestri. Nutrition is a cornerstone of holistic nursing care, and this chapter prepares you to assess, educate, and care for clients with diverse and complex dietary needs. From macronutrients to specialized feeding methods, it covers every nutritional component vital for NCLEX-PN success and safe practice.
Watch the comprehensive video summary below, and subscribe to Last Minute Lecture for more NCLEX-PN chapter reviews and nursing care tips:
Essential Nutrients: Macronutrients, Vitamins, Minerals, and Electrolytes
- Carbohydrates: Main energy source (4 kcal/g), found in grains, fruits, and vegetables.
- Proteins: Required for growth, repair, immune function (4 kcal/g); animal and plant sources.
- Fats: Energy storage, cell structure (9 kcal/g); include saturated, unsaturated, and trans fats.
- Vitamins: Fat-soluble (A, D, E, K) and water-soluble (B-complex, C)—each with unique roles and deficiency symptoms.
- Minerals: Calcium, iron, potassium, sodium, magnesium, and others—critical for physiologic processes.
- Electrolytes: Help regulate fluid balance, nerve function, and muscle contraction.
Healthy Eating Guidelines and MyPlate
- MyPlate divides daily intake into fruits, vegetables, grains, proteins, and dairy to promote balanced nutrition.
- Encourage variety and portion control for chronic disease prevention and optimal health.
Therapeutic Diets: Indications and Nursing Considerations
- Clear and Full Liquid: GI rest, pre/post-surgery, or acute illness.
- Mechanical Soft/Soft: Chewing or swallowing difficulties.
- Low/High Fiber: GI disease management and bowel regulation.
- Cardiac, Fat-Restricted, Sodium-Restricted: Heart disease and hypertension.
- Renal, Potassium-Modified, Protein-Restricted: Kidney disease and fluid/electrolyte balance.
- High-Calorie/High-Protein: Malnutrition, wound healing, or severe illness.
- Carbohydrate-Consistent: Diabetes management.
- Low-Purine: Gout management.
Individualize diets for chronic conditions such as diabetes, heart failure, renal disease, and GI disorders.
Vegetarian and Vegan Diets: Risks and Recommendations
- Vegetarian: Excludes animal flesh; may include dairy and eggs (lacto-ovo).
- Vegan: Excludes all animal products—risk for deficiencies in B12, iron, calcium, and omega-3s. Supplementation or careful planning required.
Enteral and Parenteral Nutrition: Safe Administration and Monitoring
- Enteral Nutrition: Tube feeding via NG, gastrostomy, or jejunostomy tubes—monitor for aspiration, correct placement, and intolerance.
- Parenteral Nutrition (PN/TPN): Intravenous feeding for clients unable to tolerate oral or enteral intake—monitor for infection, glucose imbalance, and electrolyte disturbances.
- Follow protocols for lipid infusion, filter use, and preventing refeeding syndrome.
Home care education is vital for patients and families managing tube feedings or TPN outside the hospital.
Nursing Considerations and NCLEX Practice
- Monitor labs: albumin, prealbumin, glucose, electrolytes, and triglycerides for nutrition status and therapy complications.
- Assess for food allergies, intolerances, cultural and religious dietary restrictions.
- Educate clients on hydration, dietary modifications, and the importance of nutrition in healing and chronic disease management.
Review NCLEX-style questions and apply knowledge to clinical scenarios for real-world preparation.
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Conclusion: Providing Safe, Effective Nutritional Care
Chapter 11 of Saunders Comprehensive Review for the NCLEX-PN Examination (7th Edition) empowers nursing students to deliver safe, individualized nutritional care—from dietary assessment to therapeutic diet management and advanced feeding interventions. Use these guidelines to promote optimal client health and prepare for NCLEX-PN nutrition questions with confidence.
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