Introduction To Nutrition And Metabolism Flashcards
What is nutrition
The process by which the body ingest, absorbs , transports, uses and eliminates nutrition
What are nutrients
Biochemical substances used by the body for growth, development, activity and reproduction, health maintenance and recovery of from illness or injury
What does macronutrients do
Supply energy to build tissue
Micronutrients
Regulate and control body process
Examples of macronutrients
Carbohydrates
Fats
Lipids
Protein
Micronutrient
Vitamin
Minerals
Water
What is metabolism
The process of biochemical reactions occurring in the cells to produce energy, repair and facilitate growth in the cells in order to maintain life
Basal metabolic rate
Energy required to fuel the involuntary activities of the body at rest after 12 hours
Who tend to have have a higher BMI
Men
Equation for BMI
Men: 10x weight(kg) + 6.25 x height (cm) -5 x age (years) +5
Female: 10x weight(kg) + 6.25 x height (cm) -5 x age (years) -161
Factors that increase BMR
Growth, infection, fever
Emotional tension
Extreme environmental temp
Muscle waistline
Elevated hormone
Factors that decrease BMR
Aging
Prolonged fasting
Sleep
Body mass index
Provides an estimate of body fat
Ratio of weight in kilo to height in meters square
Can be used for initial assessment
What can be used for initial assessment for nutritional status
BMI
BMI formula
703 x wright (lbs) / height (in) ^2
What BMI underweight
Less than 18.5
Normal bmi
18.5-24.9
Overweight bmi
25.0 to 29.9
Obesity class 1 BMI
30.0 to 34.9
Obesity class 2
35.0 to 39.9
Extreme obesity bmi
40 and above
Carbohydrates
Consist of starch and sugars
Primary h function is to supply energy
Most abundant and least expensive
Sugars classified as simple or complex sugars
Proteins
Required for the formation if all body structures and vital component of every living cell
Complete proteins contain sufficient essential amino acid to support growth
Incomplete protein
Recommended 10-30%
Vitamins
Needed for metabolism of carbs, protein and fat
Water soluble vitamin
Fat soluble
Water soluble vitamin
Vitamin c
B complex vitamin
Fat soluble vitamins
A, d, e,k
Complete proteins are essential for what
Support growth
Fat
Contain moisture of saturated and unsaturated fatty acid
Most concentrated source of energy
What are the requirements of a normal nutrition and metabolism
Healthy lifestyle: adequate sleep, exercise and nutrition
Normal weight
No exposure to known carcinogen
Simple sugar
Table sugar
Syrup
Complex sugar
Whole grains
Beans
Vegetables
Saturated fat
Butter and red meat
Unsaturated fat
Oils
Almonds
Avocado
How many hours of sleep
7-9
Normal nutritional status
Adequate calorie and diet intake
Adequate muscle strength and movement
Within normal limits (height, weight, bmi)
Adequate energy levels to complete ALD
Cooperative and alert
Normal bowel sounds
Normal urine output
Normal stool
Normal metabolism status
WNL: hr, bp, temp, temp, blood glucose levels
Heights, weight, bmi
Adequate input and output
Adequate muscle strength and movement
Adequate energy to complete Adl
Factors that affect nutrition and metabolism
Physiologic and physical factors
Social determinants of health
Culture
Developmental considerations
Infants and adolescents needs an increase in nutrition needs
Age related changed in metabolism and body composition: develop poor nutrition habits
Fewer calories required in adulthood because if decrease BMR: older adults
Nutritional assessments tool
Food intake
Decreased food intake : anorexia
Increased food intake : obesity
Altered nutrition
Abnormal BMI, age, growth development
Tired, weak
Insufficient calorie/nutritional intake
Muscle waisting
Hyperactive/ hypoactuve bowel sounds
Abnormal bowel pattern or appearance
Altered metabolism
Hypo/hyper bp
Hyp/hyper blood glucose
Tired weak
Muscle waisting
Abnormal hormone levels
Abnormal sleep patterns
Nursing diagnosis
Impaired nutritional status
Impaired swallowing
Body weight problem: under or overweight
Malnutrition
Altered ability to chew
Loss of smell and taste senses
Older adults sample nursing diagnosis
Altered ability to chew
Loss of smell and taste senses
What history should u be taking
Dietary
Medical
Socioeconomic
Physical assessment
Clinical dataHair, skin, nails, mucus membranes
Lab data
Hemoglobin
Albumin
Protein status
Vitamin
What is. Marker for malnutrition
Albumin levels
What should you assess for impaired nutrition status
Usual dietary intake
Food allergies on intolerance
Food preparation and storage
Types of dietary practices
Eating disorders patterns
Nursing interventions
Develop nutrition care plan
Teaching nutrition information
Monitor nutritional status
Stimulating appetite
Assisting with eating
Providing oral nutrition
Proving long term nutritional status
How can you monitor a patient nutrition status
Assessment/observation of food and supplement intake in relation to identified outcomes
• Documentation of appetite and initiating appropriate interventions when the patient does not eat
• Collaborating with the health care team to implement supplements if the patient’s intake is low or the patient has
increased nutritional requirements
• Collaborating with the health care team to initiate a nutritional consult
• Assess the patient’s tolerance of the prescribed diet
• Monitor the patient’s weight
• Monitor progression of nothing by mouth (NPO) status and prescribed restrictive diets
• Monitor the patient’s understanding of nutritional information and engagement
• Monitor the patient’s progress in meeting goals identified in the plan of care for nutrition
Nurses are often involved in the process of diet progression. The decision to advance a patient’s diet is based on the return of GI function, the absence of symptoms related to a particular disease process,
How do you stimulate a patients appetite
Serve small, frequent meals to avoid overwhelming the person with large amounts of food.
• Solicit food preferences and encourage favorite foods from home or prepared when at home, if possible.
• Provide encouragement and a pleasant eating environment.
• Be sure that any prepared food looks attractive.
• Schedule procedures and medications at times when they are least likely to interfere with appetite.
• Control pain, nausea, or depression with medications.
• Offer alternatives for items that a person cannot or will not eat.
• Encourage or provide good oral hygiene. Ensure that the patient’s dentures are well-fitting and in place, if
applicable.
• Remove clutter from the eating area.
• Keep eating area free from irritating odors.
• Arrange food tray so that a person can easily reach food.
• Provide a comfortable position.
• Ask about any rituals during mealtimes at home and include them if possible.
• If patients are absent from their rooms during mealtime, order a late food tray or keep food warm until they return.
• Do not disturb mealtime; don’t interrupt patients for nonurgent procedures during mealtime.
Assisting with eating with visual impaired
Explain placement of foods on plates and food tray. Relating items on plate to the location on a clock face may be helpful.
• Provide special plate guards, utensils, double handles, and compartmentalized plates.
• Place foods and dishes in similar locations at each meal.
• Use straws for beverages, if not contraindicated by the presence of dysphagia.
• Provide supervision as needed.
Special consideration with patients who have dysphasia
Special Considerations and Interventions for Feeding Patients With Dysphagia
Provide at least a 30-minute rest period prior to mealtime. A rested person will likely have less difficulty swallowing.
Sit the patient upright, preferably in a chair. If bedrest is mandatory, elevate the head of the bed to a 90-degree angle. Maintain upright position for 30 minutes after the meal.
Provide mouth care immediately before meals to enhance the sense of taste.
Avoid rushed or forced feeding.
Provide small, frequent meals to help maximize intake.
Adjust the rate of feeding and size of bites to the patient’s tolerance. Allow patient to control the eating process if possible.
Collaborate to obtain a speech therapy consult for swallowing evaluation.
Initiate a nutrition consult for appropriate diet modification such as chopping, mincing, or pureeing of foods and liquid consistency (thin, nectar-thick, honeylike, spoon-thick).
Keep in mind that some patients may find thickened liquids unpalatable and thus drink insufficient fluids.
Reduce or eliminate distractions at mealtime so that the patient can focus attention on swallowing; discourage chatting during the meal.
Alternate solids and liquids.
Assess for signs of aspiration during eating: sudden appearance of severe coughing; choking; cyanosis; voice change, hoarseness, and/or gurgling after swallowing; frequent throat clearing after meals; or regurgitation through the nose or mouth.
Inspect oral cavity for retained food.
Avoid or minimize the use of sedatives and hypnotics since these agents may impair the cough reflex and swallowing
Nursing goals and outcome
Patient will maintain weight in desired goal
Patient will recognize factors that are contributing to bring under or overweight
Patient will identify appropriate nutritional needs
Patient will consume adequate nutrition
Patient will verbalize appropriate management of nutrition at home
Short term nutritional support
Nasogastric or nasointestinal tube
Confirming placement of ng tube
Radiographic exam
Measure aspirate ph and assessment of aspirate
Measure tube length and marking
Monitor co2
Confirm nasal intestinal placement : x ray
Long term nutritional support
Enterostomal tube
Enterostomal tube
Placed through opening created into the stomach or jejunum
Gastronomy (g tube)
The preferred route to deliver external nutrition in patient who are comatose
Patient in coma feeding
G tube
