PCT Nutrition, Diets, and I&O Monitoring 2 — Questions and Answers
Question 1: A patient on a clear liquid diet may consume which of the following?
- Milk and cream soups
- Gelatin, broth, and apple juice (Correct answer)
- Scrambled eggs and toast
- Mashed potatoes and gravy
Correct answer: Gelatin, broth, and apple juice
Clear liquids include transparent fluids that leave no residue: broth, gelatin, clear juices (apple, cranberry), tea, and popsicles.
A clear liquid diet provides hydration and minimal nutrition while placing minimal demand on the GI tract. Permitted items include clear broth, gelatin (Jello), apple/cranberry juice, clear sodas, tea, coffee (without cream), popsicles, and hard candy. Milk, juice with pulp, and anything opaque are excluded. This diet is typically temporary (pre-surgery or post-procedure).
Question 2: When recording intake and output (I&O), which item should be counted as fluid intake?
- A baked potato
- Ice chips (recorded at half their volume) (Correct answer)
- A slice of bread
- A hard-boiled egg
Correct answer: Ice chips (recorded at half their volume)
Ice chips are measured as intake at approximately half their frozen volume since they melt to roughly half the amount of liquid.
I&O tracking includes all fluids taken in and eliminated. Intake includes oral fluids, IV fluids, tube feedings, and ice chips (recorded at 50% of volume since ice melts to half). A 240 mL cup of ice chips equals approximately 120 mL of fluid intake. Foods that are liquid at room temperature (gelatin, ice cream, popsicles) are also counted.
Question 3: A diabetic diet primarily focuses on controlling intake of:
- Protein and fat only
- Carbohydrates to manage blood sugar levels (Correct answer)
- Sodium to prevent hypertension
- Calcium to prevent bone loss
Correct answer: Carbohydrates to manage blood sugar levels
Diabetic diets focus on carbohydrate control because carbohydrates directly affect blood glucose levels.
Carbohydrates are broken down into glucose, directly impacting blood sugar. Diabetic diets use carbohydrate counting or consistent carbohydrate intake to maintain stable blood glucose. The diet also emphasizes complex carbohydrates over simple sugars, adequate fiber, lean proteins, and healthy fats. The PCT should monitor and record what the patient eats and report uneaten portions.
Question 4: Normal adult urine output is approximately:
- 100-200 mL per day
- 30 mL per hour or about 720 mL per day minimum (Correct answer)
- 2,000-3,000 mL per hour
- 50 mL per shift
Correct answer: 30 mL per hour or about 720 mL per day minimum
Adequate urine output is at least 30 mL per hour (approximately 720 mL per day), with less indicating possible dehydration or kidney dysfunction.
Normal urine output is 0.5-1 mL/kg/hour, or approximately 30-60 mL/hour for an average adult (720-1,440 mL/day). Output below 30 mL/hour (oliguria) may indicate dehydration, hypotension, or kidney failure. Output below 100 mL/day (anuria) is a medical emergency. The PCT must accurately measure and record all output and report abnormalities immediately.
Question 5: A patient on a sodium-restricted diet should avoid which food?
- Fresh fruit
- Canned soup (Correct answer)
- Steamed vegetables without added salt
- Grilled chicken breast
Correct answer: Canned soup
Canned soups are notoriously high in sodium, often containing 800-1,200 mg per serving, making them inappropriate for sodium-restricted diets.
Sodium-restricted diets (typically 1,500-2,000 mg/day) require avoiding high-sodium foods: canned soups and vegetables, processed meats (bacon, ham, deli meats), soy sauce, pickles, chips, and fast food. Fresh fruits, vegetables, and unseasoned meats are naturally low in sodium. The PCT should check food labels and report when patients receive or consume restricted foods.
Question 6: What should the PCT do when a patient on I&O monitoring vomits?
- Record the approximate amount as output (Correct answer)
- Ignore it since vomiting is not part of I&O
- Only record it if the physician specifically orders it
- Subtract it from the patient's intake total
Correct answer: Record the approximate amount as output
Emesis (vomit) is recorded as output because it represents fluid leaving the body, which affects the overall fluid balance calculation.
All fluid losses must be recorded as output: urine, emesis, diarrhea, wound drainage, nasogastric tube output, and any other measurable fluid loss. The PCT estimates and records the volume of emesis, notes its characteristics (color, presence of blood or food), and reports to the nurse. Accurate I&O is critical for assessing fluid balance and guiding treatment.
PCT Nutrition, Diets, and I&O Monitoring 2
A patient on a clear liquid diet may consume which of the following?