Chapter 26 Nutrition Powerpoint PDF

Chapter 26 Concepts of Basic Nutrition and Cultural Considerations ATI Fundamentals Chapter 39 ATI Nutrition Chapter 1 Copyright © 2...

Chapter 26 Concepts of Basic Nutrition and Cultural Considerations ATI Fundamentals Chapter 39 ATI Nutrition Chapter 1 Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.  Overview of the Gastrointestinal System (p.467) Structures involved in the digestive system Mouth Teeth Accessory organs Tongue Pharynx Salivary gland Esophagus Liver Stomach Small intestine Gallbladder Large intestine Pancreas Anus  Functions of the Organs of Digestion Mouth: Contains tongue and (32) permanent teeth and receives secretions from the salivary glands Tongue composed of mostly skeletal muscle; the most movable organ of the mouth Receives food and breaks it down into smaller pieces; mixes food with saliva and starts the digestive process Parotid glands: Largest salivary glands, One on each side (anterior and inferior to the ear) Secrete saliva into the mouth and Begins digestion of starches Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.  Functions of the Organs of Digestion Pharynx Connects the nasal and oral cavities to the esophagus; food is forced into the pharynx by the tongue Esophagus Muscular tube approximately 20 cm long Propels food into the stomach from the pharynx using muscular contraction Lining secretes mucus Slid e4 Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.  Functions of the Organs of Digestion Stomach Located in the upper-left quadrant of the abdomen; has a capacity of approximately 1.5 L Has two sphincters, prevent gastric acid from moving back up esophagus Is a temporary storage place for food Mixes food with digestive juices (gastric acids) Changes food into a semiliquid state Begins the digestion of proteins Absorbs vitamin B12 Slid e5 Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.  Functions of the Organs of Digestion Small intestine: (duodenum, jejunum, ileum): mixes food with secretions from liver and pancreas; finishes digestion; absorbs nutrients Large intestine: (ascending, transverse, descending, and sigmoid colon; rectum; anus; cecum): absorbs fluid and electrolytes; eliminates waste products Liver and gallbladder: concentrate, store, and secrete bile into the duodenum when stimulated by fatty foods Pancreas: secretes digestive juices; produces insulin Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.  Changes in the Digestive System that Occur with Aging Dental carries and Decreased sphincter tooth loss tone Decrease ability to Increase reflux risk chew Decreased gastric Decreased gag reflex secretions Increase aspiration May interfere with risk digestion Decreased sense of Decreased peristalsis taste Increased constipation  Metabolism Process in which large molecules are broken down into smaller molecules Makes energy available to body Enables absorbed nutrients to enter bloodstream following digestion Digestion converts food into chemical substances such as proteins and simple sugars to be used by the body for energy production and cellular metabolism Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.  Dietary Guidelines USDA MyPlate Emphasizes fruits, vegetables, whole grains, and fat- free or low-fat milk and milk products Includes lean meats, poultry, fish, beans, eggs, and nuts Is low in saturated fats, trans fats, cholesterol, sodium, and added sugars A variety of foods from each group is needed to achieve a healthy diet See also the AHA 2015 Diet and Lifestyle Recommendations  Protein Constant supply essential Food Sources: for rebuilding and Animal: contain all 9 essential replacing body tissues amino Acids Plays a role in hormone Red meat, eggs, milk and production, fluid milk products, poultry, balance, antibody fish production, and Complete, or high-quality transportation of proteins nutrients Plant: Composed of amino acids Grains, legumes, and 9 essential & 11 most vegetables nonessential Incomplete, or low- quality proteins  Protein Dietary Reference Intakes Average DRI is 46 to 56 g of protein per day for the healthy adult Combination of meat and plant sources Protein intake should be 10% to 15% of the total daily calories May vary depending on activity level, state of health, and availability of protein food sources. Individuals who are very active or very ill should have an increase in protein intake.  Protein Deficiency Marasmus Severe Starvation- A form of protein energy and nutrient malnutrition Occurring chiefly in the first year of life, characterized by growth retardation and wasting of subcutaneous fat and muscle Kwashiorkor: A condition occurring in infants and young children soon after weaning from breast milk Severe protein deficiency, even when adequate intake of other nutrients occurs.  Protein Excess Stressful to the liver and kidneys for those with no need for increase Kidneys must rid the body of excess waste products Liver function is strained with the excess load of protein to metabolize Can lead to excess fat in the diet Leads to obesity, heart disease, and certain types of cancer Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.  Vegetari an Diets Well planned vegetarian diets may offer health benefits Lacto-ovo-vegetarian: Dairy products, eggs, & plant foods included in the diet Lactovegetarian: Eggs excluded; dairy products & plant foods included Vegan: All animal food sources are excluded, including honey May have a diet deficient in Vitamin B6, vitamin B12, iron, zinc, riboflavin, and vitamin D  Carbohydrates The body’s main source of energy Should make up 50% to 60% of the daily diet Regulate protein and fat metabolism, fight infection, and promote growth of body tissues Three main types: Simple, Complex, and Fiber Slid e 15 Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.  Simple Carbohydrate s Simple carbohydrates (monosaccharides) Glucose is the metabolized form of sugar found in the body and is found in: Table sugar (sucrose), the major sweetener found in foods Fruit sugar (fructose), high fructose corn syrup added to many foods Milk sugar (lactose) (disaccharides) Quickly absorbed into the bloodstream Cause a quick rise in serum glucose  Complex Carbohydrate s Complex carbohydrates (polysaccharides) Oatmeal, Whole grain Breads, pasta, cereals, and rice Broken down into simple sugars for use by the body Provide a more consistent serum glucose level than simple sugars provide Slid Recommended that 85% to 95% of e 17 consumed carbohydrates are complex Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.  FIBER Carbohydrates Fiber The portion of the carbohydrate that cannot be broken down during digestion Passes through the intestine undigested Increases bulk in the stool and aids in elimination May decrease absorption of fat (cholesterol) Delays absorption of some carbs- beneficial to diabetic pts. Recommended intake 21 to 38 g/day Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved. Food Sources: Fiber Fruits Apples, bananas, oranges, grapefruits Cantaloupe, strawberries Vegetables Green beans, broccoli, cauliflower, celery Corn, potato (with skin), sweet potato Grains and cereals Whole wheat Breads, All Bran, oatmeal, Shredded Wheat Legumes (cooked) Beans: kidney, pinto, lima; black-eyed peas  Fats (Lipids) An essential nutrient Supplies a concentrated form of energy Made up of fatty acids & glycerol: Called triglycerides Adds flavor to foods and contributes to texture Dissolves and transports fat-soluble vitamins and fat-soluble phytonutrients (carotenoids) Insulates and controls body temperature Makes food smell appetizing Cushions and protects body organs Facilitates transmission of nerve impulses Gives feeling of fullness after eating  Fats: Saturated vs. Unsaturated Fatty acids are classified as saturated or unsaturated Fatty liquids at room temperature are called oils Most oils are unsaturated fat: Corn oil, safflower oil, canola oil Omega-3 fatty acids: most unsaturated form of fatty acid Found in salmon, halibut, sardines, tuna, canola oil, soybean oil, chicken, eggs, and walnuts  Fats: Cholesterol Cholesterol is a component of fat and linked to heart disease and hardening of the arteries. Found in animal products and oils such as palm and coconut Blood studies associated with fats: HDL- High density lipids (Good or HAPPY lipids) Want these high Helps remove cholesterol from arteries LDL- Low density lipids (LOWSY lipid) Want these low Main source of build up in arteries Triglycerides- fats found in the blood, if high at increased risk for heart disease  Vitamins Essential nutrients that must be taken in through food sources or supplements Water-soluble vitamins Easily absorbed into the bloodstream for use by the body Vitamin C & B-complex Fat-soluble vitamins Absorbed in the small intestine the same as other fats by action of bile in the duodenum and stored in the liver A, D, E, and K Slid e 23 Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.  Minerals *Know minerals in red Inorganic substances found in animals and plants Essential for metabolism, cellular function, proper nerve and muscle function Mineral actions interrelated: a deficiency in one will affect the action of another Major minerals Calcium, magnesium, sodium, potassium, phosphorus, sulfur, chloride High Sodium Foods (Table 26.5, p. 469) Trace minerals Iron, copper, iodine, manganese, cobalt, zinc, molybdenum, selenium, fluoride, chromium Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.  Water Water is the most essential of all nutrients Water requirement is 1 mL/calorie of intake Used in every body process, from digestion to absorption to elimination or secretion; large amount must be stored in the body General rule: intake needs to be equal to recorded output plus 500 mL: Example: intake= output (ml) + 500 ml So, if patient has an output of 1, 000 ml, they need to be at least taking in 1, 500ml of fluid to maintain fluid balance. Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.  Factors Influencing Nutrition Age: infants, toddlers, preschool, school-age, adolescents, adults, older adults Illness (need increases) Emotional status (over eat or under eat) Economic status (limited income, healthy choices) Religion: Islam, Judaism, Seventh-Day Adventist Culture: African American, Hispanic, Asian Individuals more likely to consume foods that are familiar Food Safety Wash fruits and vegetables Cook ground beef and chicken thoroughly Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.  Cultural Influences on Nutrition African American Typical foods in the traditional African American diet include a variety of greens, dry beans, cornbread, sweet potatoes, pork, catfish, and chicken Preferences often contribute to high fat, sugar, and salt content in the traditional African American diet Hispanic American Diet is high in carbohydrates such as beans, rice, corn, and tortillas The diet can be high in fat because of the use of lard in the preparation of fried foods Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.  Cultural Influences on Nutrition Asian American Diet is high in carbohydrates and vegetables and low in meat and fish The use of monosodium glutamate (MSG) to enhance flavor has decreased but dishes may still have a high sodium and high fat content Middle Eastern American Preferences include fermented dairy products such as yogurt, meats, grains in the form of wheat or rice at each meal, fresh fruits, and vegetables Some foods may be specially prepared if the individual practices the Muslim religion Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.  Nutrition Counseling Dietary counseling should include modification of the culture’s traditional diet to accomplish a healthier composition and preparation while maintaining the diet’s basic components Patients should be taught how meals can be made healthier by preparing food with less fat and Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.  Nutritional Needs Through the Life Span: Infants Should double birth weight by 6 months and triple weight by 1 year Breast milk recommended AAP recommends breast milk for first full year Formulas Modified form of cow’s milk, made more digestible with added carbohydrate and fat content Solids introduced in diet at 4 to 6 months, not before Introduce gradually one at a time. (allows for allergy identification) Rice or oatmeal is a good initial choice. No Egg or fish 1st year because of potential allergic reactions Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.  Nutritional Needs Through the Life Span: Toddlers /Preschool Ages 2 to 5 years Consume less milk and increase intake of solids Provide small servings Offer foods that are easy to chew Avoid combination foods Toddlers prefer single-item foods that do not touch each other on the plate Try colorful foods (e.g., peas, carrots) Provide a pleasant environment at mealtimes Provide plates and utensils in a size that can be easily handled by a small child Use dishes that are colorful and/or contain pictures of favorite characters Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.  Nutritional Needs Through the Life Span: School-Age Children May desire sweet, non-nutritive foods such as soda, candy, cake, and ice cream Provide well-balanced breakfast before school Provide nutritious after-school snacks High-calorie, high-sodium preferences may predispose to obesity Becoming a health issue during the school age Slid years e 32 Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.  Nutritional Needs Through the Life Span: Adolescents Tend to consume many fast foods During growth spurt the body requires more calories as well as nutrients Adolescent females require increased levels of iron after the menstrual cycle begins Adolescents are very aware of appearance Slid e 33 and concern can lead to eating disorders Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.  Nutritional Needs Through the Life Span: Adulthood Adults are focused on work, child rearing, family, etc. Rely on fast foods and convenience foods Obesity and hypertension prevalent Have increased fat and sodium intake Have increased sugar intake Lack exercise Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.  Nutritional Needs Through the Life Span: Older Adults Most at risk for inadequate nutrition May need to decrease calories if activity level is decreased – nutrient requirements don’t change Physical limitations make food preparation more difficult Arrange for companionship during meals Some older adults have limited incomes and must limit food choices Cognitive decline Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.  Nutrition: Assessment Determine factors impacting nutrition (diagnosis, surgery, etc.) Medical, family, and social history Physical examination Determine BMI (Fig 26.5, p. 485)- more reliable than weight alone Recommended BMI is 18.5 to 24.9 Lab studies Sli de 36 Nutrition: Implementation Assist patients with meal tray set up, feeding when needed. Provide pleasant environment, free of odors Position patient upright Verify correct diet order for the correct patient Serve hot food hot and cold food cold Provide enteral or total parenteral nutrition Patient education: therapeutic diet