Chapter 15: Nutrition and Malnutrition

Chapter 15: Nutrition

• Nutrition is the process where the body utilizes food for its functions.
• Malnutrition is a condition that arises from a deficiency of essential nutrients in the diet.

Who is at Risk for Malnutrition?

• Malnutrition is prevalent among individuals in impoverished and developing nations.
• Older adults who are socially isolated or on fixed incomes are at risk of malnutrition in the United States.
• Homeless people, children with low socioeconomic status, and pregnant teenagers can suffer malnutrition.
• People with substance abuse issues like alcoholism, and clients with eating disorders such as anorexia and bulimia nervosa are also at risk.

Human Nutritional Needs

• Calories are the measurement of the energy value of food.
• Proteins comprise amino acids and are essential for building, maintaining, and repairing body tissues.
• Carbohydrates serve as the body's primary and rapid energy source.
• Fats represents a concentrated source of energy.
  • Saturated fats
  • Unsaturated fats

Question 1

• False: High-density lipoprotein (HDL) is not referred to as "bad cholesterol."

Human Nutritional Needs - Continued

• Minerals are noncaloric substances that regulate chemical processes.
• Vitamins are chemical substances necessary for normal growth, health maintenance, and body functioning.
  • Water-soluble vitamins are eliminated with body fluids.
  • Fat-soluble vitamins are stored in the body as reserves.

Question 2

• False: Vitamin B complex and Vitamin C are not fat-soluble vitamins.

Question 3

• Vitamin A can be toxic to the body at high levels.

MyPlate

• Amounts from various food group categories can be individualized according to a person’s age, gender, and activity level.
• Grains: 30%
• Vegetables: 30%
• Fruits: 20%
• Proteins: 20%
• Include low/non-fat milk and other dairy products.

Nutritional Labeling

• Nutritional labeling serves disease prevention guidelines.
• It provides the amount of nutrition per serving, using household measurements.
• The percentage of Daily Value (DV) standards per serving is listed.
• Labels also include vitamin and mineral content per serving.
• The federal Nutrition Labeling and Education Act requires compliance with standard definitions for health-related claims on food labels.

Influences on Eating Habits

• Food preferences are acquired during childhood.
• Established patterns for meals also influence dietary choices.
• Attitudes towards nutrition play a significant role.
• A persons knowledge of nutrition is important.
• Income level can affect access to nutritious foods.
• Time available for food preparation influences dietary habits.
• The number of people in the household affects food choices and quantities.
• Access to food markets determines the availability of certain foods.
• Religious beliefs impact dietary practices, e.g., abstaining from meat in Hinduism and Buddhism.
• Judaism and Islam restrict pork consumption, with further restrictions during fasting.

Protein Complementation

• Complete proteins contain all essential amino acids and are typically found in animal sources; examples include fish, chicken, turkey, beef, pork, eggs, milk, yogurt, and cheese.
• Incomplete proteins contain some essential amino acids and are primarily found in plant sources; examples include lentils, peas, beans, quinoa, mixed nuts, and seeds.
• Protein complementation involves combining plant sources of protein to acquire all essential amino acids from non-animal sources.

Nutritional Status Assessment Activity

• A practical assessment technique for health professionals involves gathering subjective data like a client's diet history to understand their eating habits and related factors.
• Examples of data that might be collected are appetite levels, unintentional weight changes (10% loss/gain in 6 months), and meal frequency.
• Objective data includes anthropometric measurements, body size, composition, and body mass index (BMI). Body measurements include midarm, abdominal circumference and triceps skinfold.
• Assessing physical appearance, oral structures, skin, hair, flexibility, strength, attention, and concentration are important physical assessments.
• The laboratory data, which includes hemoglobin and hematocrit levels, glucose levels, serum albumin and transferrin levels, cholesterol, triglyceride, and lipoprotein profiles, are very important.

Question 4

• Vitamin deficiencies result in various symptoms that nurses can observe.

Management of Problems Interfering with Nutrition

• Obesity
• Emaciation
• Anorexia
• Nausea
• Vomiting
• Stomach gas

Nursing Interventions to Resolve Nutritional Problems

• Nursing interventions are aimed at resolving a number of nutritional problems
• Imbalanced nutrition: less than body requirements can be addressed.
• Imbalanced nutrition: more than body requirements also needs resolution.
• Deficient knowledge about nutrition is part of the problem.
• Requires attention to self-care deficit or feeding.
• Impaired swallowing represents a risk of aspiration.

Management of Client Nutrition

• Nursing responsibilities during client care:
  • Ordering and canceling diets.
  • Serving and collecting meal trays.
  • Helping clients eat.
  • Recording the percentage of food that clients eat.
  • The knowledge of the client’s diet type prescribed, the purpose, and characteristics will help.

Standard and Therapeutic Diet Activity

• Use the next two slides to fill in the blanks on the standard and therapeutic diet worksheet.
• Use the internet to research on credible sites if you are unsure.
• Work with your classmates!

Common Hospital Diets

• Regular or general diets have no restrictions.
• Light diets avoid fried, fatty, gas-forming, and raw foods.
• Soft diets include foods with soft textures that are low in residue, easily digestible, and have limited seasoning compared to a light diet.
• Mechanical soft diets are similar to light diets but used for people with chewing challenges, offering cooked fruits, veggies, and ground meats.
• Full liquid diets provide fruit and vegetable juices, creamed or blended soups, milk, ice cream, yogurt, pudding, milkshakes, gelatin, custards, and cooked cereals.
• Clear liquid diets include water, broth, fruit juices, gelatin, popsicles, clear soft drinks, tea, and coffee.
• Special therapeutic diets provide foods prepared to meet specific needs, like those low in sodium, fat, calories or fiber.

Common Special Diets

• Cardiac diets aim to reduce cardiovascular disease risk with heart-healthy, anti-inflammatory foods.

  • Includes a variety of vegetables and fruits.
  • Limits sugars and salts.
  • Recommends whole grains.
  • Suggests plant-based protein (legumes, nuts, seeds).
    • Lean meats and low-fat or fat-free dairy only if including animal products.
  • Encourages using olive oil for cooking and limiting processed foods.

• The goal of diabetic diets is to manage blood sugar levels through balanced eating.

  • Fill half the plate with non-starchy vegetables.
  • Fill one quarter with a lean protein.
  • Fill one quarter with carbohydrate foods higher in carbs like grains and starchy vegetables.
  • Diabetics should consume non-starchy vegetables because they are already getting complex carbs from grains.

Feeding Strategies

• Techniques for:
  • Clients with dysphagia
  • Clients with visual impairment
  • Clients with dementia

Question 5

• True: Clients with dysphagia have difficulty swallowing.

Older Adults

• Older adults evaluation of nutritional status is important.
• Diminished senses of smell and taste.
• Require fewer calories, therefore nutritional supplements should be evaluated.
• Benefits of exercise are important.
• Watch out for oral and dental problems.
• Look for chronic conditions; food–drug interactions; dysphagia; socioeconomic barriers; psychosocial impairments.

Let’s Practice!

• Each group will receive a diet. Complete a menu for your patient.
• Each student should upload a menu with team member's names on top.