Nutrition Flashcards
factors influencing nutrition
environmental factors:
- what is readily available (is going to be more inexpensive than something not readily available, produce is lower priced when local and there are farmer’s markets)
- lifestyle: active (make better meal choices) vs. sedentary
- work schedules: ex: truck driver isn’t going to eat salads bc that needs 2 hands, nurses eat fast which may contribute to overeating (bc don’t realize full whereas slower eaters taking time realize they’re full)
- cost: healthier food is more expensive at stores and fast food, so going to go with less expensive food
- lack of exercise opportunities: ability to feel safe when walking in neighborhood vs. don’t feel safe, or no good places to walk
developmental needs:
- infants/toddlers/school-age (school-age are picky eaters, only want certain things)
- adolescents: demand for calories increases a lot, hormones change and this is when highest risk for eating disorders
- young and middle adults: young calorie demand increases, need for supplemental intake may increase (calcium, iron, vitamin deficiencies), when pregnancy occurs so caloric demand increases ?
- older adults
older adults
- slow metabolic rate
- changes in oral health
– dentures, change what they eat based on if they can chew, easy to eat
– thirst sensation decreases so don’t realize thirsty, at high risk for dehyrdation - age-related GI changes: peristalsis slows down, doesn’t happen as actively
- chronic illness: can affect body, ex: diabetes, end stage renal disease, cancer
- ADLs: functional level decreases, can’t drive anymore, can’t move around or have that freedom as usual
- adverse effects of medications: taking lots of meds has a GI effect, ex: dry mouth, impaired sense of smell and taste, GI bleeding
- cognitive impairment: forget to eat, ex: dementia, depression (at high risk, seen loved ones die) makes them overeat or not want to eat
cultural aspects of nutrition
- eating habits: tied to social and cultural norms, ex: eat dinner together every night
- harmony of hot/cold, wet/dry: if cold, want warm foods, if dry, want wet foods like soup
- some ethnicities are at greater risk for nutrition/GI related issues
– Korean: more likely to be lactose intolerant
– Middle Eastern and Indian: GI stuff, stomach acid overproduction
– African descent: more likely to have colon cancer
nursing process
- assessment: early recognition, malnourishment and complications
- screening: dietician, gastroenterologist
- diet and health history: intake and preference (important for peds, want to give kids foods that they will actually eat + include sensitivities), symptom, allergies, medications
- physical signs and symptoms: refer to box 45.4, p. 1114, teeth and gums, reduces saliva production, atrophy of oral mucosal epithelial cells, increases taste threshold, decreased thirst sensation, reduced gag reflex, decreased esophageal and colonic peristalsis
health promotion
- myplate.com
- meal planning
- healthy substitutions
(taking into consideration when sending ppl home if they’ll be able to make meals for themselves, or have someone there to help them, if they may need meal planning to assist them)
food safety
- botulism:
– comes from home canning, honey, ham, sausage, shellfish
– mild discomfort to death, nausea, vomiting, paralysis - e. coli:
– comes from undercooked meat
– cramps, nausea, vomiting, renal failure - listeria:
– comes from soft cheese, hot dogs, lunch meat, unpasteurized milk, seafood
– diarrhea, fever, meningitis (inflammation around brain and spinal cord), endocarditis (inflammation of sac that protects heart) - clostridium enteritis:
– comes from meat
– mild diarrhea, vomiting - salmonella:
– comes from milk, custard, eggs, shellfish, chicken
– diarrhea, vomiting - shigella:
– comes from milk, seafood, salads
– cramps, diarrhea to fatal dysentery - staph:
– comes from custard, cream, ice cream
– cramps, vomiting
food safety
- clean: hands, food, surfaces
- separate: wash hands and utensils between use
- cook: ensure proper temperatures
- chill: proper refrigeration, leftovers for only 2 days (if meal prepping for over 2-5 days like 2 weeks, freeze it instead of just refrigerating)
acute care
- advancing diets:
– require doctor’s order (to say now you can have food, after surgery when NPO)
– nutrition plays a role in immunity - promoting appetite:
– oral hygiene: providing opportunity to brush teeth, some ppl can’t eat until they brush their teeth (their preference)
(esp. for those with resp. stuff, keeping mouth clean is important so bacteria doesn’t travel from mouth to lungs)
– mealtimes: taking food into isolation when someone has left it on the isolation cart
– assisting with meals
hospital diets
- NPO: nothing by mouth
- clear liquid: broths, popsicles made of fruit, water
- full liquid: can add cream, cream of chicken, ice cream
- dysphagia: pureed food
- mechanical soft: stroke patients, dysphagia on thin liquids, add thickener to liquids
- soft/low residue: easily digestible, low in fiber
- high fiber: high in fresh fruits, vegetables
- low sodium: low salt, low processed foods that include salts
more hospital diets
- low cholesterol: low in fat, low lipids
- diabetic: balancing carbs, fats, proteins
- gluten free
- heart healthy: common hospital diet, combo low sodium, low cholesterol diet
- renal: those in renal dysfunction, body can’t process certain electrolytes like phosphate, magnesium
- regular
restorative and continuing care
- GI diseases
- diabetes mellitus: esp. new diagnosis
- cardiovascular disease: heart healthy, giving meal ideas, grocery lists
- cancer and cancer treatment: metabolic need increases, need more calories than they think, won’t want to eat bc loss of taste and smell during treatment, can give meds to increase appetite
- HIV/AIDS: prone to body wasting, high metabolic demand, high risk for food and water infection, breakdown in immune system
(outside of the hospital, educate those with these things)
