Nutrition Flashcards
Reduced-Calorie
Sugar-Free
Low-Fat
Natural
Organic
Low-Sodium
Calcium-Enriched
?
Are more practical tools you can use to educate patients and families
Food guides
?
Are a reference for nutrient intake thought to meet the nutritional needs of most healthy population groups
Standards
?
Are the chemical substances supplied by food that the body needs for growth, maintenance, and repair
Nutrients
What are the 6 classes of nutrients?
Carbohydrates Proteins Fats/Lipids Vitamins Minerals Water
?
These supply the body with energy
Macronutrients
?
These help manufacture, repair, and maintain cells
Micronutrients
The Energy Nutrients
Which 2 are the micronutrients?
Vitamins, minerals
The Energy Nutrients
Which 3 are the macronutrients?
Carbohydrates (CHO), protein, lipids
?
Primary source of energy for the body
Supply energy for muscle and organ function
Carbohydrates
What are simple carbohydrates?
Monosaccharides, disaccharides
What are complex carbohydrates?
Polysaccharides
?
Needed for tissue building, metabolism, immune system function, fluid balance, acid-base balance, and a secondary energy source
Protein
Proteins are composed of ___?
amino acids
__ amino acids are the building blocks of protein in the body
20
?
Are not produced by the body; must consume in what we eat
Essential amino acids
?
Are synthesized by the body
Non-essential amino acids
?
Has all amino acids necessary for protein synthesis
Complete protein
?
I&O are equal
More needed during pregnancy, illness, wound damage
Less in illness, injury, malnourishment
Nitrogen balance
?
Are insoluble in water
Fats/oils
Metabolized in ___ ?
Terms used interchangeably
Lipids/fats
Small intestine
Types of Lipids
Glycerides, sterols, phospholipids
Where are sterols synthesized?
In the liver
What are the 2 types of cholesterol?
LDL (low density lipoprotein)
HDL (high density lipoprotein)
Saturated, Unsaturated, and Trans-Fatty Acids
Saturated: hydrogen bonds are full
Trans-Fatty: are saturated fats; created in food processing
Function
- Supply essential nutrients; energy source
- Flavor & satiety
- Protects vital organs
Function cont’d
- Component of every cell membrane
- Support baseline metabolic rate
What are the 2 types of micronutrients?
Vitamins, minerals
Micronutrients: Vitamins
- Build & maintain healthy body tissues, support the immune system, & ensure healthy vision
- Important during periods of rapid growth & healing
Micronutrients: Vitamins cont’d
- Help in prevention of chronic illness & disease
- Must be consumed
Where are fat soluble vitamins stored?
In the liver & adipose tissue
What are the fat soluble vitamins?
A, D, E, K
What are the water soluble vitamins and how do we get rid of them?
C, B-complex (B6, B12)
Are readily excreted in the urine
Who Needs Increased Vitamin D?
- Low sun exposure
- Darker skin
- Osteoporosis (to absorb calcium)
Who Needs Increased Vitamin D? cont’d
- Irritable bowel syndrome (r/t ineffective absorption)
- Obese/gastric bypass
- Medications affecting Vit D absorption
Micronutrients: Minerals
- Found naturally in foods or made in supplements
Major minerals: need 100mg or MORE per day
Trace minerals: essential, but in lower concentrations
Micronutrients: Minerals cont’d
- Help to regulate fluid balance, nerve impulse transmissions, energy production, and disease prevention
- Excreted in feces
We need vitamins to be able to absorb minerals
Need Vitamin D for calcium
Need Vitamin C for iron
Water
Makes up HALF of total human body weight
Critical for human bodies
- Acts as a solvent, transport, lubricant & catalyst
- Assists w/temperature regulation & body structure
Water cont’d
Needs for water vary on environment, activity, age, health, & metabolic needs
?
Is water within each living cell
Intracellular fluid
?
Is water in the blood, lymphatic system, & GI tract
Extracellular fluid
Recommended ___L/day for women; ___L/day for men
2.7; 3.7
What is the recommended # of calories per day?
1600-2200 cal/day
?
Is the energy required for heart, liver, and brain to function
Direct measurement (done by researchers) Indirect measurement
Basal Metabolic Rate (BMR)
Factors that affect BMR
Body composition, growth periods, body temperature
Prolonged physical exertion
Disease processes
Environment
Nutritional Considerations: Young & Middle Adult
- Unhealthy habits from childhood & adolescence begin to take a more notable effect on the body
- BMR decreases in middle adulthood, leading to increased weight gain
Nutritional Considerations: Young & Middle Adult
Increased need of ___, ___, ___, and ___
Calcium, Vitamin D, folic acid, iron
Nutritional Considerations: Older Adult
- Fewer calories needed for energy, so smaller quantities of most foods
- Ability to taste & smell decrease w/age
- Encourage to increase intake of milks, yogurts, & cheeses
Nutritional Considerations: Older Adult cont’d
- Encourage to limit breads & cereals
- Encourage complex carbohydrates (i.e. polysaccharides) like fiber to promote bowel function
- Frail Elderly Syndrome
Nutrition-Related Lifestyle Changes
- Dietary patterns (type & quality of foods)
- Stress relief
- Work environment
- Tobacco use (Vit C ↓ faster in users)
- Oral contraceptive use (↓ Vit B & C)
Nutrition-Related Lifestyle Changes cont’d
- Cooking methods
- In water soluble, 1/2 vitamins lost in cooking water when boiling food
- Also when keeping foods warm >2 hrs
- Alcohol
- Leads to obesity
- Dec rate of fat metabolism
- Impairs nutrient storage in body
- Caffeine (May lead to bone loss but there are also positive effects)
Ethnic, Cultural, & Religious Influences on Nutrition
- Language barriers
- Food choices
- Food preservation concerns
- Religious practices
Ethnic, Cultural, & Religious Influences on Nutrition cont’d
- Obesity rates are higher in some ethnic/cultural groups
- Cultural beliefs, perceptions, & attitudes about weight
Do note that many traditional diets within cultures are healthful & should not be discouraged
Illness & Injury Effects on Nutrition
- Traumatic injuries: i.e. burns; increased protein & Vitamin C
- Long-term insufficient caloric intake: i.e. cancer; protein-calorie malnutrition (muscle wasting)
- Alcoholism: poor appetite, interferes w/vitamin functions
Illness & Injury Effects on Nutrition cont’d
- Cognitive function: forgetful as to what, when, or whether they have eaten, i.e. dementia
- Limitations in the ability to obtain & prepare food (socioeconomic status, affordability, physical impairment [broken arm])
- Chewing & swallowing: eat soft foods only or avoid food
- Bariatric surgery: alters digestion
Medication Effects on Nutrition
- Can directly decrease appetite
- Side effects can interfere w/eating & absorption of nutrients
- Almost all oral medications have a potential to cause nausea & vomiting
Medication Effects on Nutrition cont’d
- Can alter metabolism (inc/dec nutrient excretion)
- Can affect specific nutrients (i.e. OTC aspirin can ↓ folate levels)
Diets
- Regular/house - no special needs
- NPO
- Modified consistency - trouble swallowing, chewing
- Vegetarian/vegan - no animal byproducts
- Calorie-restricted - for weight loss
Diets cont’d
- Sodium-restricted - HTN, high BP, fluid balance issues
- Fat-restricted - elevated cholesterol, triglycerides
- Diabetic - manage carbs, calories
Diets cont’d
- Renal - manage fluid/electrolyte balance
- Protein-controlled - manage liver/kidney disease
- Ketogenic - treat epilepsy, neurologic disorders
Diets cont’d
- Antigen-avoidance - i.e. gluten-free for Celiac disease
- Calorie-protein push - heal wounds, promote growth, maintain/increase weight
Applying the Nursing Process: Nutrition
Applying the Nursing Process: Nutrition cont’d
Assessment
- Screening (1st) vs Focused (2nd)
- Dietary History
- 24-Hour recall, food frequency questionnaire, food record
- Assess body composition
- Circumferences, BMI
Assessment cont’d
- Physical examination findings
- Laboratory values
- Blood glucose, serum protein levels
Mini Nutritional Assessment (Elderly)
What is the “normal” BMI range?
18.5 - 24.9
General Appearance as an Indicator of Nutritional Status
Lutz’s Nutrition and Diet Therapy Table 1-5, p. 14
- Demeanor
- Weight
- Hair
- Eyes
- Lips
- Tongue
- Teeth
- Gums
- Skin
- Nails
- Mobility
Diagnosis
Nutrition as the Problem
- Obesity
- Overweight
- Underweight
- Malnutrition
- Frail Elderly Syndrome
Diagnosis
Nutrition as the Etiology (r/t factor)
- Constipation (i.e. r/t low fiber intake)
- Diarrhea
- Risk for Impaired Skin Integrity
- Impaired Skin Contact (i.e. r/t self esteem assoc w/obesity)
Planning Outcomes
- To promote health and reduce chronic disease that is associated with diet and weight
Healthy People 2020 → Healthy People 2030
Example: “Client will lose 1 pound per week until ideal weight of 130 pounds is attained.”
Interventions and Implementation
- Teach clients about meeting vitamin & mineral needs through diet or supplementation
- Supplements do not replace the need to eat a nutritious diet
- Read nutritional labels carefully
- Review research assoc w/supplementation
Interventions and Implementation cont’d
- Treat side effects that can impact nutritional status
- Make referrals for those w/limitations (i.e. to a dietician, nutritionist, and/or healthcare provider)
?
Is the delivery of liquid nutrition into the upper intestinal tract via a tube
- May be used in addition to or in place of oral intake
- Short or long-term therapy
Risks
> Aspiration (into lungs; consider pt positioning)
> Bacterial growth
> n/v/d
Enteral nutrition
?
Is delivery of nutrition intravenously into a large, central vein
- Used for clients who cannot receive nourishment via the GI tract
- Risks include: infection, septic shock, blood clots, liver dysfunction, GB disease
- Lipid emulsions
Parenteral nutrition
Parenteral nutrition cont’d
Before administering parenteral nutrition, it is vital that x-ray confirms that the tip of the intravenous catheter is in the lower portion of superior vena cava, adjacent to the right atrium
