Chapter 44 Nutrition Flashcards
Food security is critical for
all members of a household: amount and resources
Food holds what
symbolic meaning.
Medical nutrition therapy uses
nutrition therapy and counseling to manage disease
Diseases that need nutrition managing:
Type 1 diabetes mellitus
Hypertension
Inflammatory bowel disease
Enteral nutrition (EN); parenteral nutrition (PN)
Why might a Hindu woman refuse to eat her hospital-provided meal?
She was served a dish with beef.
Healthy People 2020; Health for All (WHO):
Guidelines for dietary change recommend reduced fat, saturated fat, sodium, refined sugar, and cholesterol, and increased intake of complex carbohydrates and fiber.
Carbohydrates:
complex and simple saccharides main source of energy
Proteins:
- Amino acids
- Necessary for nitrogen balance
- Essential for tissue maintenance
Fats:
saturated, polyunsaturated, mono, and calorie-dense
Water:
All cell function depends on a fluid environement
60-70%
Vitamins:
Essential for metabolism
Water-soluble (A,D,E,K) or fat soluble (B,C)
Minerals:
Catalysts for enzymatic reactions
Macrominerals; trace elements
Digestion:
begins in the mouth and ends in the small and large intestines
Absorption:
Intestine is the primary area of absorption
Metabolism and storage of nutrients:
consist of anabolic and catabolic reactions
Elimination:
Chyme is moved through peristalsis and is changed into feces
Keep total fat intake between:
20-35% of total calories
Dietary reference intakes (DRIs):
Acceptable range of quantities of vitamins and minerals for each gender and age group
Daily values
Needed protein, vitamins, fats, cholesterol, carbohydrates, fiber, sodium, and potassium
MyPlate Food Guidance System
Five food groups:
Mostly veggies and then other portion fruit
More grains than protein
A small portion should be dairy
Factors influencing nutrition:
- Environmental factors
2. Developmental needs
Environmental factors:
restaurants, cost of food
Developmental needs:
- Infants through school age: Breastfeeding, formula, solid foods
- Adolescents: body image
- Young and middle adults
- Older adults: vitamins
Alternative Food Patterns can based on:
religion, cultural background, ethics, health beliefs, and preference
Vegetarian diet consists predominantly of plant foods:
- Ovolactovegetarian (avoids meat, fish, and poultry, but eats eggs and milk)
- Lactovegetarian (drinks milk but avoids eggs)
- Vegan
- Fruitarian (consumes fruit, nuts, honey, and olive oil)
A zen macrobiotic diet is a
diet in which an attempt is made to balance the yin and yang elements of food
Screening a patient is a quick method of identifying malnutrition or risk of malnutrition using sample tools:
Height Weight Weight change Primary diagnosis Comorbidities Screening tools
Anthropometry is a
measurement system of the size and makeup of the body.
IBW:
An ideal body weight provides an estimate of what a person should weigh.
Assessment also includes:
lab and biochemical tests
physical examination
dysphagia
Normal range for BMI:
18.5 to 24.9
overweight= 25-30
How would the nurse counsel a 48-year-old woman who has a BMI of 26 kg/m2?
Refer her to a nutritionist.
Dietary and health history
Health status; age; cultural background; religious food patterns; socioeconomic status; personal food preferences; psychological factors; use of alcohol or illegal drugs; use of vitamin, mineral, or herbal supplements; prescription or over-the-counter (OTC) drugs; and the patient’s general nutrition knowledge
Causes of dysphagia:
Myogenic: Aging, muscular dystrophy
Neurogenic
Obstructive
Other: GI resection
Which of the following patients is at risk for a nutritional problem?
A. A 25-year-old woman on a diet of all clear liquids for the past week.
Good cholesterol =
under 200 mg/dL
Health promotion for Nutrition:
- Education
- Early identification of potential or actual problems
- Meal planning
- Weight loss plans
- Food safety
More Acute care
in Nutrition:
- Risk factors in acutely ill patient
- Advancing diets = Gradual progression of dietary intake
- Promoting appetite
- Assisting with oral feedings
When a patient needs help with eating, it is important to
protect his or her safety, independence, and dignity.
Assisting an Adult Patient With Oral Nutrition:Diets may be
therapeutic or modified, or may involve supplements
Assisting with oral nutrition requires
time, patience, knowledge, and understanding
Delegation and Collaboration:
The task of assisting a patient with oral nutrition can be delegated to NAP
The nurse directs NAP by:
- Explaining any specific swallowing strategies/techniques
2. Reviewing when to stop feeding and the need to report incidences
Dysphagia evaluation
Goal:
- to ensure that the patient will be able to safely swallow oral fluids and foods
- Screening is minimally invasive
When assessment shows risk for dysphagia and aspiration, refer for a more
comprehensive examination
Dysphagia management:
- Dietary modification by altering consistency of foods and liquids
- SLP/RD central to management
- Program individualized based on which phase of swallowing is affected
National Dysphagia Diet (NDD) Stages:
NDD1
NDD2
NDD3
Regular
NDD1:
dysphagia pureed
NDD2:
dysphagia mechanically altered
NDD3:
dysphagia advanced
Consequences of dysphagia:
Physiologic consequences may include
decreased appetite, weight loss, dehydration, malnutrition, and pneumonia
Consequences of dysphagia:
Emotional responses may include
altered body image, embarrassment, social isolation, and depression
The nurse is teaching a program on healthy nutrition at the senior community center. Which points should be included in the program for older adults?
- Avoid grapefruit juice, which impair drug absorption
- Take a multivitamin that includes vitamin D for bone health
- Cheese and eggs are good sources of protein
The nurse is caring for a patient experiencing dysphagia. Which interventions help decrease the risk of aspiration during feeding?
- Sit the patient upright in a chair
- Place food in the strong side of the mouth
- Feed the patient slowly, allowing time to chew and swallow
The nurse teaches a patient who has had surgery to increase which nutrient to help with tissue repair?
Protein
