Nutrition and oral hydration Flashcards
Carbohydrates
Provide most of the body’s energy and fiber
4kcal/g
provide glucose
Should make up 45-65% of total daily Cal
Fats
Provide energy and vitamins
9kcal/g
No more than 35% of caloric intake should be from fat
Protein
Growth, maintenance
Repair body tissue
4 kcal/g
Vitamins
Necessary for metabolism
Water-soluble Vitamin C and B
Fat-soluble Vitamin A,D,E and K
Minerals
Biochemical reactions in the body
Ca, P, Na
Factors affecting nutrition
Cultural
Religious and cultural practices Guide food and preparation, choices
Factors affecting nutrition
Environmental factor
Sedentary lifestyle
Work schedule
Financial issue
Factors affecting nutrition
Physical factor
Disease and illness
Medication
Age
How to calculate BMI?
BMI=weight (kg) +height (m2)
25 to 29.9 over weight
30 obesity
Eating disorder
Anorexia
Significantly low body weight
Fear of being fat
Eating disorder
Bulimia nervosa
A cycle of being eating followed by purging
vomiting, using laxatives
Lack of control
Being eating and purging per week for at least 3 months
神経性過食症
Age factor
Newborns
High energy requirements
Breast milk or formula
Solid food starts at 4 to 6 months
No cow’s milk and honey for the first year
Age factor
Toddlers to preschoolers
Need increased protein
**from sources other than milk**
Calcium and phosphorus are important for bone
Nutrient density is more important than quantity
Age factor
School-age 6 to 12years
Need supervision to consume adequate protein and vitamins C and A
They love junk!! high carbohydrates, fats, and salt.
They grow at a slower rate, the decline in energy requirement
Age factor
Adolescents 12-20 years
Metabolic demands are high= need more energy
1/4 of dietary intake comes from snacks
Increasing water consumption is important!!
Age factor
Young to middle adult 20 to 65 years
Decrease need for most nutrients
Good oral health is important
Age factor
Older adults over 65 years
A slower metabolic rate requires fewer calories
Thirst sensations diminish, increasing the risk of dehydration
Need carbohydrates for fiber to enhance GI function
Assist providing aspiration
a) position when eat
b) position after eat
c) Avoid using what?
a) High fowler’s
b) Sem-fowler’s position
for at least 1hr after a meal
c) A straw
3 different kind of enteral access tubes
Nasogastric- for short term
Gastrostomy for longer than 6 weeks
Percutaneous endoscopic gastrostomy
Enteral access tubes
a) what to prepare?
b) Important to keep in mind is?
a) Cup of water and straw
Basin for gag
b) Understand the need for placement for diagnostic purposes
Nursing action for the enteral access
1: Auscultate for bowel sounds. palpate the abdomen
2: Assist high follower’s position
3: Testing pH should be 4 or less
4: Secure NG tube
Why regular mouth care is important for a pt having nasogastric feeds?
Reduced salivary flow
Dry mouth
What does Decompression mean?
Removal of gas or stomach contents
Prevent or relieve distention, nausea, and vomiting
Distention-膨張
What does Feeding mean?
Alternative to the oral route
Tube:Duo,Dobhoff
What does Lavage mean?
Washing out the stomach bleeding
What does Compression mean?
Using an internal balloon to apply pressure
Preventing GI or esophageal hemorrhage
Nursing intervention
Along with reviewing dietary habits, the nurse should?
Inspect the pt’ teeth, hair and skin to consider expecting finds
Medical history
History of digestion issues
Why NPO diet?
Schedule surgery
Schedule surgery
Diagnostic test
Medication
Sedation
Dysphagia 嚥下障害
Aspiration 誤嚥
What is the soft diet?
Easy to digest
Low in fiber
Without lots of seasoning
Well-cooked veggies
Low-fiber cereals
Creamy nut butters
What is pureed diet?
Soft and smooth
Do not need to be chewed
pureed mashed potatoes
pureed mashed meat
yogurt
pudding
A clear liquid diet?
Broth
Gelatin
Water
Foods that can be seen through
Completely melt at room temperature
Pt who has vomiting, nausea and diarrhea
Do not need to be digested
It should just for few days
Sedation?
Reduction of irritability or agitation by administration of sedative drugs
Why does low sodium intake is a key to heart disease?
High sodium food leads to hypertension=heart disease
No more than a teaspoon salt/per day
Diet for cardiovascular?
Controlling protein
controlling sodium
Eat low-fat high protein food
Renal diet?
Limited salt
Limited potassium
-Banana
-Grapefruit juice
-Tomatoes
-Orange
-Greens spinach, kale
Avoid table salt
Pt at risk for aspiration, it also risk for tube feed
Nursing intervantion?
Check the tube placement every 4 hours with a gastric pH check
Maintain the bed 30 to 45
After meal 45 for at least 1 hour
Indications difficulty breathing, Fever, cough
Stop feed and notify provider!!!
Chin-tuck position prevent what?
Aspiration
Pt at risk for aspiration, it also risks for tube feed
Nursing intervention?
Check the tube placement every 4 hours with a gastric pH check
Maintain the bed 30 to 45
After meal 45 for at least 1 hour
Indications difficulty breathing, Fever, cough
Stop feeding and notify the provider!!!
Nasogastric tube? (NG)
From nose to stomach
Provide nutrition and medication
Remove contents of the stomach(suction)
Gastrostomy tube? (GI)
Directly into the stomach by surgeon
A nurse about feed by NG tube found out pt gastric content ph 6.0. The nurse should do what?
a) Recheck the pH of the gastric contents.
b) Replace the NG tube
c) Flush the NG tube with 30 mL of water
a
Why?
above 6.0 indicate that the tube is not in the stomach.
The nurse should recheck and hold feeding.
What is the bloating?
A buildup of gas in the stomach and intestines
Digestive issue
What are macronutrients?
Include carbohydrates, proteins, and fats.
Anorexia nervosa
Significantly low body weight
Fear eating
BMI
Calculation
70kg/ 1.68x1.68
Ng tube
Post-procedure
The nurse can delegate
- measuring
- providing comfort
- oral care
When removing the tube, wear clean gloves
Why is the pt has feeding food?
They cannot intake orally, but their GI tract is functioning
Enteral feeding
Ongoing care
Ensure the formula is at room temperature
Auscultate bowel sounds
Check GI pH/ 0-4 OK
Enteral feeding
Continuous-drip feeding
Flush the tube every 4-6 hours
Monitor I&O
Monitor blood glucose every 6hr
Enteral feeding
Diarrhea 3 times/24hr?
Slow the rate
Consult if the pt take antibiotic/ ask for a different one
Enteral feeding
Nausea or vomiting
Slow the rate
Keep the bed head 30
Make sure the formula is at room temp
Check the tube’s patency(X-ray)
Slow the rate
Keep the bedhead 30
Make sure the formula is at room temp
Check the tube’s patency(X-ray)
Enteral feeding
Aspiration
Withhold the feeding
Turn the pt side
Suction the airway
Monitor vital sing for evaluated temp
Monitor for O2
NG tube
Double-lumen tube
(Salem Sump)
Best for decompression
NG tube
Small-bore
Single lumen tube
Dobhoff
Best for medication or nutrition
parenteral nutrition
Glucose levels!!
Monitor I&Qs
Daily weight
