Module 2 -b Flashcards
Influences on Nutrition (developmental)
Infants- most rapid rate of growth.
Nutritional Implications-Infants
Growth greater then any other cycle. Weight doubles (4-6 months), triples (1 yr). Length ^ 50%(1 yr). Solid foNutritional ods intro (6 months) Table food (1 yr)
Nutritional Implications-Toddlers
Do not need as many calories as infants. Self feeding by 2. Verbalize likes and dislikes. Food attitudes develop by - yrs of age.
Nutritional Implications-school aged
Dehydration potential because of forgetfullness to drink. Erratic growth patterns, appetite improves. Larger meals, less frequency. Digestive system matures.
Nutritional Implications-adolescents
Growth spurts, ^ nutrient needs (calorie,protein,calcium) ^ iron needs. Weight conscious, Girls-menstruation, Boys- ^ muscle mass. Teen pregnancy-increased risk for nutritional deficiency.
Nutritional Implications- adults
Physical activity is key
Nutritional Implications- Pregnant and Lactating
Nutrient needs increased. (needed for lactation) ^ Protein,Calories,Iron, Folic Acid (prevents congenital anomoly) , Calcium, Iodine. (Support growth of the fetus, supporting internal homeostasis)
Nutritional Implications-Elderly
Decrease in BMR and energy/activity. Decrease in periastalis, ans sensation in thirst. Soft,east to chew foods. ^ fiber/fluids, reduce constipation. Loss of taste buds and loss of interest in eating.
Influences on Nutrition
(Gender, state of health, alcohol abuse, meds) Male ^ muscle mass, caloric intake, vit B (metabolizes calories and protein) Females-^ ammounts of fatty tissue, higher need for Iron (menstruation). Chronic disease (diabetes) change vitamin requirements. Mental health- forget to eat.
Sociocultural/Psychological Facotrs
Economics, Psychological factors, cultural factors
Cultural aspects to nutrition (African America)
parents and grandparents- soul food
Cultural aspects to nutrition ( Mexican American)
corn and rice products
Cultural aspects to nutrition ( Asian American)
rice and veggies- no dairy
Cultural aspects to nutrition (Christianity)
no meat during Lent
Cultural aspects to nutrition (Judiaism)
shell fish are forbidden
Cultural aspects to nutrition (Islam)
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Cultural aspects to nutrition (Hinduism)
no beef- cows are sacred
Risk Factors for Poor Nutrition
Under/Over weight, Loss of 15% or more of body weight, 5 or more days with simple IV’s and NPO, Chemo, fevers, diarrhea, vomiting, burns.
Essential Elements of a Nutritional Assessment
DETERMINE- disease, eating poorly, tooth loss/mouth pain, economic hardship, reduced social contact, multiple meds, involuntary weight loss/gain, needs assistance with ADL, greater than 80 yrs old
Medical data
current illness, drug HX, ability to chew or swallow, appetite, allergies
Socioeconomic data
age gender lifestyle, occupation, religious affiliation, tabacco alcohol, income
BMI
Most precise for healthy body weight, ratio of height and weight. (weight in lbs/height in inches2 x 704.5 =BMI
BMI
18.8-24.9= ideal, 25-29.9= overweight, 30- greater= obesity
Clinical Observations
Study the power point/lecture
Biochemical data
lab testing to detect changes in there early stages
Hematocrit/hemoglobin/albumin
Inteventions to achieve goals
Determine eating habits, establish realisitc STG/LTG. education, consider developmental factors, discuss likes and dislikes, budget concerns, meaning of food, and consultation.
Activities to stimulate appettite
small/frequent meals, preferences, encouragement, attractive presentation, schedule procedures and meds, control pain and nausea, offer alternatives, good oral hygiene, free of odors and clutter, food can be easily reached, confortable position
Nutritional problems for older adults
Decrease chewing abilty, sense of smell,taste and thirst, decrese in periastalis in espohagus, reflux, decrease in gastric secretions, lower glucose tolerance, physical handicaps, polypharmacy, income.
Hospital diet (normal)
maintaining optimal nutrition w/out restrictions. 1400-2500 calorie
Hospital diet (clear liquid)
clear, room/body temp.
Hospital diet (full liquid)
Milk, sherbert, cream of wheat
Hospital diet (soft)
low fiber, low seasoning (surgery, GI)
Hospital diet (mechanical soft)
mashed potatoes, (modified texture)
Hospital diet (other modified)
purreed, blenderized, liquid diet (oral Sx, swallowing diff)
Enteral Feedings
Bolus tube feeding (NG, PEG) check tube placement, HOB ^ 30 degrees, check residual, change tube every 24 hrs. flush, oral hygeine
GI Tubes
decompress/drain the stomach. (most likely). irrigate with saline, flush with water.
Protein (Albumin)
CHON- Growth and tissue maintenance. (3.5-5.0 g/dl) Signs of deficiency is edema, retarded growth muscle wasting, damage to mental development.
Carbohydrates
CHO- provides energy. Most abundant, least expensive source of calories
Fat (Lipids)
COOH- Most concentrated source of energy. High fat diets increase the risk for heart disease and obesity. Saturated fat from animals.
Vitamins (water soluble)
Vit C and B complex, usually not stored, excess secreted, daily intake neccessary
Vitamins (fat soluble)
Vitamins A, D, E, K, absorbed with fat in to lymphatic circulation, deficiencies occur, stores excess, daily intake not imperative, toxicities
Vitamin C- water
Wound healing, improves iron absorbtion, formation of RBC’s in bone marrow
Vitamin B1- water
energy metabolism, normal nervous system functioning
Vitamin B2- water
Metabolism
Vitamin B6- water
Amino acid metabolism, blood formation, maintenance, maintain nervous tissue
Vitamin B12- water
RNA/DNA synthesis, metabolism, blood formation
Niacin - water
metabolism
Folic Acid- water
RNA/DNA synthesis, forms mature RBC
Vitamin A- fat
visual acuity in dim light, bone, skin, and mucous membranes
Vitamin D- fat
Calcium and Phosphorus metabolism, normal skeletal development
Vitamin E- fat
stability and integrity of membranes, spares Vit A
Vitamin K- fat
Helps produce Prothrombin (coagulation)
Minerals
inorganic elements found in all body fluids and tissues in the form of salts or combined with organic compounds
Functions and Sources of Macrominerals & electrolytes
Calcium, Phosphorus, Magnesium, Sodium, Potassium, Chlorine
Macromineral - Calcium
8.4-10.2 mg/dL- issues w/ clotting, bone forming, nerve transmission, muscle contraction
Macromineral - Phosphorus
2.5-4.5 mg/dL- acid-base balance, energy metabolism
Macromineral - Magnesium
1.8-2.4 mg/dL- smooth muscle relaxation
Macromineral - Sodium
135-145 mEq/L- major extracellular fluid cation, water balance, acid base balance
Macromineral - Potassium
3.5-5 mEq/L- CARDIAC FUNCTION, fluid balance, major intracellular fluid cation, acid-base balance
Macromineral - Chlorine
98-106 mmo L/L- Major anion extra/intracellular fluid , gastric activity, acid-base balance
Micromineral- Iron
hemoglobbin formation, and O2 transport
Micromineral- Iodine
component of thyroid hormone
Micromineral- Zinc
tissue growth, healing and development
Functions and sources of Electrolytes
Sodium, Potassium, Chlorine
Fluid Volume disturbances
Deficit(resulting in)- weight loss, skin turgor, thick mucous, dry oral membranes, urine output, postural hypotension, pale cool skin, ^ Hematocrit (40-50) and specific gravity. Clinical symptoms and lab results.
Fluid Volume disturbances
Excess(resulting in)- weight gain, peripheral edema, distended neck veins, moist crackles, polyuria, low Hematocrit/specific gravity of urine, fluid collection in cavities. CHF
Nursing interventions for fluid intake
explain, STG, LG amounts earlier in the day, variety, bedside fluids, appr. temp, clean and easy to use cups, support.
Nursing interventions for fluid restrictions
explain, space fluid intervals, set goals, ice chips, small glasses, frequent oral care, avoid dry/salt/gum, diversions.
Fluid balance for the elderly
altered sense of thirst( offer fluid, replace fluid, preferences, assistive devices) Loss of Nephrons and low renal bld flow. (record output, urine appearance and specific gravity, and LABS)
Assessment parameters for fluid imbalances
Daily weights, I and O’s, edema, VS-low BP, low electrolytes, fatigue, etc…