Chapter 14 book notes Flashcards
Who can only give nutrition education or counseling?
-registered dietitian
Examples of nutrition interventions (4):
-nutrient/food delivery
-nutrition education
-nutrition counseling
-coordination of nutrition care
steps of nutrition care in nursing care plan (6):
-Assessment
-Nursing diagnoses (impaired swallowing, activity intolerance, etc.)
-planning outcome identification
-planning development of nursing strategies
-implementation
-evaluation
expected outcomes:
-patient-oriented goals that are derived from nursing diagnoses.
strategies the health practitioner can use to help patients modify their diets;
-nutrition education
-long term dietary intervention
-follow up care
Nutrition education helps patients learn about the:
-dietary factors that affect their particular medical condition
-this knowledge can motivate them to change their diet and lifestyle in order to help improve their health status.
A nutrition education program should be tailored to a person’s:
-age, level of literacy, and cultural background
What else should be considered in a nutrition education program?
-the patients learning style
The initial meeting of a nutrition education program should include an assessment of the person’s:
-understanding of the material and commitment to making changes.
Follow-up sessions can reveal whether the person has successfully:
-adopted the new dietary plan
When long-term changes are necessary, the care plan must take into account a person’s current:
-food choices, lifestyle, and degree of motivation.
What change is a process that occurs in stages during a long term dietary intervention? therefore more than one consultation is necessary
-behavior
Approaches that will help implementing long term dietary changes: (3)
-determining an individuals readiness for change
-emphasize what to eat, rather than what not to eat
-suggest only one or two changes at a time
Nutrition care can be evaluated by reviewing
-outcome measures of health status and
-determining the patient’s understanding and acceptance of the intervention.
regular diet:
- a diet that includes all foods and meets the nutrient needs of healthy people
modified diet:
-a diet that contains foods altered in texture, consistency, or nutrient content or that includes or omits specific foods;
-may also be called a therapeutic diet.
To estimate the energy needs of hospital patients, the clinician may measure or calculate:
-the resting metabolic rate (RMR) and then adjust the RMR value with a “stress factor” that accounts for the medical problem
To obtain more accurate RMR values, clinicians
sometimes use:
-indirect calorimetry
indirect calorimetry:
-a procedure that estimates energy expenditure by measuring oxygen consumption and carbon dioxide production.
A quick method for estimating energy needs is to multiply a person’s ?? t by a
factor considered appropriate for the medical condition
-body weight
For example, the recommended energy intake for critical-care patients often falls between ?? and ?? kilocalories per kilogram body weight per day;
a patient weighing 132 pounds (60 kilograms) may
therefore require between -1500-1800 kcalories per day
-25 to 30
In patients who are critically ill, energy needs may be higher than normal because
of:
-fever,
-mechanical ventilation,
-restlessness,
-presence of open wounds.
Diets that contain foods with altered texture and consistency may be advised for
individuals with…?
-chewing or swallowing difficulties.
Types of modified texture and consistency diet: (3)
-mechanically altered diets (soft & pureed foods)
-blenderized liquid diet (foods and fluid in liquid form)
-clear liquid diet (clear fluids/food that are liquid at room temp. and leave minimal residue in the colon).
Individuals who have difficulty chewing or swallowing
may benefit from what type of diet?
–mechanically altered diets.
Chewing difficulties usually result from
-dental problems
Impaired swallowing, (dysphagia), may result from:
-neurological disorders,
-surgical procedures involving the head and neck,
-physiological or anatomical abnormalities that restrict the movement of food within the throat or esophagus.
Dysphagia diets are highly ?? because swallowing problems
vary in severity and swallowing ability can fluctuate over time.
-individualized
A more restrictive diet of mechanically altered diet includes what type of foods? what about foods in a nonrestrictive diet?
-pureed food diet
-ground/minced food diet or moist soft textured foods
A blenderized diet is most often recommended following:
-oral or facial surgeries
Clear liquids, which require minimal digestion and
are easily tolerated by the gastrointestinal (GI) tract, are often recommended before some GI procedures (such as:
-GI examinations, after GI surgery, or after fasting or intravenous feeding.
clear liquid diet consists of clear fluids and foods that are liquid at
room temperature and leave little undigested material (called ??`)
in the colon
-residue
Examples of food in a clear liquid diet:
-clear or pulp free juices
-carbonated beverages
-fruit ice
-frozen juice bars
-hard candy
Although the clear liquid diet
provides??? , its nutrient and energy contents are
extremely limited
-fluid and electrolytes
If used for longer than a day or two, this diet should
be supplemented with
-low-residue formulas that provide required nutrient
Diets with modified nutrient or food content may be prescribed to correct :
-malnutrition,
-relieve disease symptoms,
-reduce the risk of developing complications
Types of modified nutrient or food content diets: (4)
-fat restricted diet
-low fiber diet (helps with intestinal disorders or reduce fetal output before surgery)
-low sodium diet
-high kcal, high protein diet
Fat restriction may be necessary for reducing the
symptoms of fat malabsorption (??, ???, and ??),
which often accompany diseases of the:
-diarrhea, bloating, and cramping
-liver, gallbladder, pancreas, and intestines
