MODULE-IV.D-notes Flashcards
NUTRITION CARE INDICATORS
food and nutrient intake
growth and body
composition, food and nutrition related knowledge, attitudes, and behaviors; and food access
Laboratory values such as HgbA1c, hematocrit, serum cholesterol
Functional capabilities such as physical activity
Nutrition Care Evaluation
Measurement and evaluation of Nutrition Indicators
Nutrition care criteria:|
Nutrition prescription or goal
Reference Standard:
:pre-planned review and measurement of selected
nutrition care indicators of patient/client’s status relevant to
the defined needs, nutrition diagnosis, nutrition
intervention, and outcomes
Nutrition Monitoring
: the systematic comparison of current findings with the
previous status, nutrition intervention goals, effectiveness
of overall nutrition care, or a reference standard
Nutrition Evaluation
: the results of nutrition care that are directly related to the
nutrition diagnosis and the goals of the intervention plan
Nutrition Care Outcomes
: markers that can be measured and evaluated to
determine effectiveness of nutrition care.
Nutrition Care Indicators
:
. Gastrointestinal Changes
-stomach which negatively affect digestion andreducetheabsorption of nutrients
reducedstomachacid production or secretion
reduces the absorption of vitaminB-12 and iron
-B-12 deficiency is linked to cognitiveimpairment,whereas not enough iron leads to anemia
_
severe fatigue and loss of appetite
stomach emptying is slower
peristalsis – is also slower cause of constipation and bloating.
Reduced Metabolism
lose muscle mass due to reduced activity levels
metabolic rates decline proportionatelywiththedecline in muscle tissue
lower metabolism is weight gain in the form of fat - Type 2 diabetes and cardiovascular diseases
reduces the amount of water the body
can hold, as approximately 72 percent of total body water
is held within muscle tissue.
Perceptual Changes
higher risk of malnutrition
reduced cognitive
capacity
, deficiency
of certain nutrients– particularly vitamins B-6, B-9 and B- 12 – are associated with further cognitive impairment.
Reduced sense of smell and taste (less
appealing)
Less Saliva and Dentition Problems
reduced saliva production – called xerostomia
reduce breakdown of
nutrients such as starch and fat
. Loss of teeth
What are strategies that can address these changes?
1. Adapting to Dietary Changes
Eat healthy meals
-Protein
-Antioxidants
healthy weight. Seniors with a BMI between 25 and 32
have the lowest rates of mortality, and recover
better from illness and infection
Quit smoking and eliminate alcohol in the diet
. Exercise
sleep
Connect with others
- A therapeutic diet is a meal plan that controlstheintakeof certain foods or nutrients. It is part of thetreatment ofamedical condition and are normally prescribedbyaphysician and planned by a dietician.
SELECTED THERAPEUTIC DIETS
SELECTED THERAPEUTIC DIETS
. Low Calorie Diet
A low-calorie diet is typically between1000to1500 calories - weight loss
not appropriateforeveryone, especially athletes andbreastfeedingwomen.
Take in fewer calories than you burn(viadailyliving and deliberate exercise), to loseweight.
SELECTED THERAPEUTIC DIETS
.Diabetic Diet
treatment of diabetes (a metabolic diseasethataffects the endocrine systemof thebodyandtheuse of carbohydrates and fats).
. Diabetic Diet
glucose cannot be used which
raises the blood sugar level -
some of which will be excretedintheurine –
patient complains of frequent thirst–___
and
frequent urination – ___
and increase in appetite –
hyperglycemia
glycosuria
polydipsia,
polyuria,
polyphagia
. Diabetic Diet
Two Types are:
1) Juvenile Diabetes–occursatbirth through adolescence
2) Adult onset diabetes–occursprimarily among obesepeopleusually mild, stableandwellregulated with diet or withoralmedicatio
. Diabetic Diet
together foods that have roughly the same
amounts of calories, carbohydrate, fat and protein
into “Exchange” groups, so that one may be
exchanged for another.
The Food Exchange Lists
. DASH Diet
Stop Hypertension to treat high blood pressure
foods that contain high
amounts of potassium, magnesium, calcium and
fiber to help lower blood pressure
limit intake of sodium to 1,500 mg
a day for high blood pressure
wishing to lose weight and prevent the onset of
diabetes.
high amounts of fruits, vegetables
and whole grains, along with lean sources of
protein, low-fat dairy foods, nuts, seeds and
legumes.
Diet Therapy for Diseases of the Gastrointestinal Trac
. Peptic Ulcer
what-
treatment-
a condition in which painful sores or
ulcers develop in the lining of the lower esophagus, stomach or the first part of the small intestine (the
duodenum).
A bland diet is recommended
soft, low in dietary fiber, cooked rather
than raw, and not spicy with the ability to dilute, neutralize, or reduce the secretion of acid by the
stomach
Diet Therapy for Diseases of the Gastrointestinal Trac|
Diverticulosis and Diverticulitis
small, bulging pouches (diverticula) develop
in your digestive tract -
When one or more of these
pouches become inflamed or infected, the condition is
called diverticulitis
A diet of liquids in the acute phase and low
residue foods, then a well balanced high fiber
diet with more use of bran, whole grains and
cellulose foods are recommended.
. Malabsorption Syndrome (Celiac Sprue)
inability to absorb nutrients, vitamins, and minerals from
the intestinal tract (damaged by gluten) into the
bloodstream
Causes may include: Diseases affecting the
intestine itself, such as celiac disease. Absence or low
levels of certain digestive enzymes.
Gluten free diet
Healthyfatsare in foods like avocado, walnuts, coconut oil,ghee, and cold-pressed olive oil. Addeggs, andfish such as salmon, sardines andtuna
Avoidlactose-containing dairy products(milk, icecream, and cheese)
. Non-tropical Sprue
a rare digestive diseaseinwhichthe small intestine’s ability to absorb nutrients(gluten)isimpaired (malabsorption)
Excessivefat isexcretedin the stool (steatorrhea).
Gluten free diet – omit cereal grainscontainingwheat, rye, or oats fromthe diet. Substituewithrice and corn cereal.
Ulcerative Colitis
- an inflammatory bowel disease(IBD) that causes long-lasting inflammationandulcers(sores) in the digestive tract.
affectstheinnermost lining of the large intestine (colon) andrectumwhich causes profuse and bloody diarrhea, cramping,abdominal pain anorexia and weight loss.
Diet recommended high protein, highcalorie,with increased vitamin supplement lowresidue.For healing of colitis and restorationof nutrientdeficits.
Gastroesophageal Reflux (GERD)
occurswhenstomach acid frequently flows back intothetubeconnecting the mouth and stomach (esophagus).
Thisbackwash (acid reflux) can irritate theliningof theesophagus. Many people experience acid refluxfromtimeto time.
A diet rich in whole grains andfruitsandvegetables can help GERDsymptoms. Avoidfoods high in fat, large meals, andfoodsthatrelax the lower esophageal sphincter suchasalcohol, chocolates and high fat foods
. Hepatitis
inflammation of theliver. Virusescause most cases of hepatitis
Diet Therapy includes; enriched protein, moderate fat, high energy diet from 2500 to 4000
calories with minerals and vitamin supplement
The typeof hepatitisisnamed for the virus that causes it; for example, hepatitisA,hepatitis B or hepatitis C
Hepatitis A.
is a viral liver diseasethat cancausemild to severe illness. The hepatitis Avirus(HAV)is transmitted through ingestion of contaminatedfood and water or through direct contact withaninfectious person. Almost everyonerecoversfully from hepatitis A with a lifelongimmunity.
The typeof hepatitisisnamed for the virus that causes it; for example, hepatitisA,hepatitis B or hepatitis C
Hepatitis B
a vaccine-preventableliverinfection caused by the hepatitis Bvirus(HBV).Hepatitis B is spread when blood, semen,orother body fluids froma person infectedwiththevirus enters the body of someonewhoisnotinfected. This can happen throughsexualcontact; sharing needles, syringes, or otherdrug- injection equipment; or frommothertobaby at birth.
The typeof hepatitisisnamed for the virus that causes it; for example, hepatitisA,hepatitis B or hepatitis C
Hepatitis C
Hepatitis C is spread through contact with blood from an infected
person. Today, most people become infected
with the hepatitis C virus by sharing needles or
other equipment used to prepare and inject
drugs
The typeof hepatitisisnamed for the virus that causes it; for example, hepatitisA,hepatitis B or hepatitis C
Hepatitis D
also known as the hepatitis delta
virus, is an infection that causes the liver to
become inflamed. This swelling can impair liver
function and cause long- term liver problems,
including liver scarring and cancer. The condition
is caused by the hepatitis D virus (HDV).
Diet enriched protein, moderate fat, high energy diet from 2500 to 4000 calories with minerals and vitamin supplement
Cirrhosis of the liver
- Cirrhosis is the severe scarring
of the liver and poor liver function seen at the terminal
stages of chronic liver disease
The scarring is most often
caused by long-term exposure to toxins such as alcohol or
viral infections
Patients are often depleted of protein and
complications of ascites (accumulation of fluids in the
peritoneal cavity).
Diet Therapy includes – Na restricted diet, high
protein to compensate for the depletion. Alcohol
is strictly forbidden.
. Cholecystitis
- is inflammation of the gallbladder. It
usually occurs when drainage from the gallbladder
becomes blocked (often from a gallstone).
It may be acute
(come on suddenly) and cause severe pain in the upper
abdomen
Diet Therapy: Low fat diet – avoid rich pastries, chocolates, nuts, fatty fried gas forming foods, spices and high residue food.
. Pancreatitis -
is inflammation in the pancreas due to a
decreased production of the digestive enzymes
Diet Therapy – during acute attacks NPO
for 48 hours then low fat, low elemental
formulas when enteral feeding is
appropriate
. Acute Renal failure
– a sudden decline of kidney
function or abrupt loss of kidney function
Low Protein, essential amino acid- controlled potassium, high carbohydrate
diet (for energy) to sustain patients with
uremia and alleviate symptoms.
- Cancer
– a group of dissimilar diseases categorized
by unconstrained replication of cells. Seen as an atypical
growth of cells resulting in a mass that invades and
destroys normal tissues.
Any substance that is an agent
involved in the promotion of cancer or its propagation is
called a carcinogen.
Highcalorie,high protein orally or via tubefeedingsandor Total parenteral Nutrition
Cancer
There are two types of tumor:
)Benign tumor
- is a mass of cells (tumor) that lacks
the ability to either invade neighboring tissue or
metastasize (spread throughout the body). When
removed, benign tumors usually do not grow back, whereas malignant tumors sometimes do.
Cancer
There are two types of tumor:
Malignant tumor
- are cancerous and can spread
cancer cells throughout one’s body through the
blood or lymphatic system, a process known as metastasis
. Acquired Immune Deficiency Syndrome(AIDS)
disease of the immune systemdue to infectionwithHIV.
HIV destroys the CD4 T lymphocytes (CD4cells) of theimmune system, leaving the body vulnerabletolifethreatening infections and cancers
Eating a diet high in vegetables, fruits,whole grains, and legumes. Choosing lean, low-fat sourcesof protein. Limiting sweets, soft drinks, andfoodswithadded sugar. Including proteins, carbohydrates, andalittle good fat in all meals andsnacks
RECORDING AND REPORTINGOFNUTRITIONSTATUS - Quality documentation for nutrition monitoringandevaluation includes’ the following:
- Date and time
- Indicators measured, results, and themethodforobtaining the measurement
- Criteria to which the indicator is compared(nutritionprescription/goal or a reference standard)
- Factors facilitating or hampering progress5. Other positive or negative outcomes
- Future plans for nutrition care, nutritionmonitoring,and
