Nutrition PDF

NUTRITION LEARNING OBJECTIVES: A1. Explain the concepts and principles related to medication administration and the basic Physiological needs of the patient pertaining to nutrition. I.Nutrition: It is the study of how food nourishes the body. It encompasses the study...

NUTRITION LEARNING OBJECTIVES: A1. Explain the concepts and principles related to medication administration and the basic Physiological needs of the patient pertaining to nutrition. I.Nutrition: It is the study of how food nourishes the body. It encompasses the study of how nutrients and how they are handled by the body as well as the impact of human behavior and environment on the process of nourishment. II.Nutrients: Are specific biochemical substances used by the body for growth, development, activity, reproduction, lactation, health maintenance and recovery from illness or injury. ❖ Essential nutrients – must be provided in the diet or through supplements, supply energy and build tissue 1. Macronutrients: A. Water B. Carbohydrates C. Fats D. Protein Fundamental of Nursing theory 2 Prepared by: Dr. Rahaf Akel Rajjoub 1  2. Micronutrients: – required in much smaller amounts to regulate and control body processes A. Vitamins B. Minerals C. Required in milligrams or micrograms D. Minerals and vitamin required in hundreds of grams ✓ Which nutrients supply energy? CARBOHYDRATES PROTEIN FAT (1g) (1g) (1g) 4 calorie 4 calorie 9calorie III.Body Mass and body weight Ideal body weight (IBW): optimal weight recommended for optimal health. If a person’s energy intake does not equal energy expenditure, weight will fluctuate ❖ Body mass index (BMI) ▪ considered more reliable indicator by health professionals. ▪ More preferred methods to establish ideal body weight for adults and children and measurement of waist circumference for adults only. Fundamental of Nursing theory 2 Prepared by: Dr. Rahaf Akel Rajjoub 2  IV. Factors Influencing Nutrition: A. Physiologic and physical factors (a) Stage of development: Periods of intense growth and development such as during infancy, adolescence, pregnancy and lactation cause in increase in nutrition needs. (b) State of health Alternation in nutrient requirements that results from illness and trauma varies with the intensity and duration of stress Ex: someone that is sick, their taste buds are diminishes the food tastes bad and start vomiting Fundamental of Nursing theory 2 Prepared by: Dr. Rahaf Akel Rajjoub 3  ▪ Trauma (major surgery, burns, crush injuries followed by hormonal changes. ▪ Mental health problems such as depression and confusion can cause a patient to forget to eat or lack the motivation to eat leading to malnutrition. (c) Medications Some meds change taste buds Change the PH of GI tract Increase GI motility Damage intestinal mucosa Bind with nutrients rendering them unavailable to the body B. Physical, sociocultural and psychosocial factors influencing food choices: Economics Culture and religion: Many religions don’t allow certain food products Tradition and food ideology Education Social status V. Nutritional Assessment: 1) Dietary history o Dietary assessment o Medical assessment o Socioeconomic assessment Fundamental of Nursing theory 2 Prepared by: Dr. Rahaf Akel Rajjoub 4  2) Physical assessments o Focus of skin, hair, nails, eyes and mucosa o Substantiate with lab tests and dietary data 3) Laboratory data o Serum proteins (prealbumin, total protein) o Hemoglobin & hematocrit o BUN and creatinine o Low albumin = high risk for skin breakdown, albumin synthesis declines with age it’s an age process rather than nutritional risk. 4) Nutritional status factors o Usual dietary intake o Food allergies or intolerances o Food preparation and storage o Eating disorder patterns. VI. Dietary guidelines USDA o Shift to plant-based foods o Reduce foods with added sugars, fats o Exercise regularly o Consume foods daily with vitamin D, calcium, potassium and fiber: - Vitamin D – synthesizes calcium obtained from sun - Fiber is needed for bowel movements Fundamental of Nursing theory 2 Prepared by: Dr. Rahaf Akel Rajjoub 5  o eat variety of vegetables especially dark-green and red and orange vegetables, and beans/peas. o Consume at least half of all grains as whole grains o Select an eating pattern that meets nutrient needs over time at an appropriate calorie level o Follow food recommendations when preparing and eating foods to reduce the risk of foodborne illness. VII. Altered nutrition A. Malnutrition B. Overnutrition/ Undernutrition. C. Overweight, obese (is defined as body weight 20% or more above ideal weight or having BMI of 30 or more. VIII. Nursing interventions 1) Screening patients at home for nutritional risk 2) Observing intake and appetite 3) Evaluating the patient’s tolerance 4) Assisting patient with eating 5) Administering enteral and parenteral feedings 6) Consulting with dietitian and physician 7) Addressing potential for drug-nutrient reactions 8) Obtaining more food or snack for the patient if appropriate 9) Monitoring food brought in by visitors. 10) Participating in nutrition education efforts. Fundamental of Nursing theory 2 Prepared by: Dr. Rahaf Akel Rajjoub 6  11)Monitoring nutritional status: Anthropometric data: measurements are used to determine body dimensions. In children anthropometric measurements are used to assess growth rate, in adults they can give indirect measurements of body protein and fat stores. IX. Special diets: 1) Nothing by Mouth (Non-Per Os [NPO]) 1. Restricted oral food and fluid intake. 2. Generally ordered before surgery, procedures, or tests to minimize the risk of aspiration. 2) Soft Diet: 1. Easily chewed, swallowed, and digested foods; promotes the mechanical digestion of food. 2. Includes all foods on a full liquid diet plus soft, chopped, and shredded foods. 3. Ordered for patients with difficulty chewing because of problems with the teeth, gums, jaw, or improperly fitted dentures and those who are weak. 3) Pureed Diet Consists of foods that are processed in a blender or food processor so that the consistency is thicker than full liquids but can be served in scooped mounds on a plate. 4) American diabetic association (ADA) Balanced meals based on total calories and carb counting (45-60 grams/meal). Fundamental of Nursing theory 2 Prepared by: Dr. Rahaf Akel Rajjoub 7  5) Renal Low protein, increase carbs, decrease Na, decrease k, controlled fluid intake 6) Enteral and Parenteral nutrition: Important Note: Nurses must be proficient in caring for patients with enteral feedings because of the risks associated with this type of therapy. Enteral nutrition Parenteral nutrition It is the delivery of liquid 1. Total parenteral nutrition (TPN) or IV hyper formula into the GI tract via a alimentation. tube that bypasses the mouth, a. Hypertonic, so injected only into high-flow central veins. esophagus and, depending on b. Used in clients with severe malnutrition, severe the type of tube, sometimes burns, bowel disease disorders, acute renal the stomach. failure, hepatic failure, metastatic cancer, major Enteral feedings are designed surgeries (NPO 5 days). for patients who have a c. Carries risk of infection and fluid/electrolyte functioning GI system but imbalances. have an inability to chew and d. Requires surgical aseptic technique, frequent lab monitoring for TPN modification swallow food, have a high 2. Peripheral parenteral nutrition (PPN) metabolic need, or lack the a. Less concentrated solution, can provide lipids stamina to eat. but associated with phlebitis. b. Used more to prevent than to correct nutritional imbalance. Fundamental of Nursing theory 2 Prepared by: Dr. Rahaf Akel Rajjoub 8 Fundamental of Nursing theory 2 Prepared by: Dr. Rahaf Akel Rajjoub 9