UNIT 6 Flashcards
“Let food be thy medicine, and let medicine be thy food”
Greek physician Hippocrates
is the process of adopting long-term lifestyle modification to maintain a healthy body weight based on a person’s age, sex, and height.
Weight management
Methods of weight management include
eating a healthy diet and increasing physical activity levels.
It is preferred to the term ____ because it involves more than regulation of food intake or treatment of overweight people.
“dieting,”
Some health care professionals use the term _____ to cover all disorders related to weight.
“nutritional disorders”
includes education about healthy eating, as well as modifying the person’s food intake.
nutritional aspect of weight management programs
Purpose of Weight Management
- To help each patient achieve and stay at the best weight possible the context of overall health, occupation, and living situation.
- The prevention and treatment of diseases and disorders associated with obesity or eating disorders. These disorders include depression and other psychiatric disturbances, in addition to the physical problems associated with nutritional disorders.
Characteristics of Successful Weight Management Programs
- They present weight management as a lifetime commitment to healthful patterns of eating and exercise, rather than emphasize strict dieting alternating with carelessness about eating habits.
- They are tailored to each person’s age, general health, living situation, and other individual characteristics.
- They recognize that the emotional, psychological, and spiritual facet of human life is as important to maintaining a healthy lifestyle as the medical and nutritional facets.
are based on a diet that supplies enough vitamins and minerals; 50–63 grams of protein each day; an adequate intake of carbohydrates (100 g) and dietary fiber (20–30 g); and no more than 30% of each day’s calories from fat.
Most weight-management programs
Most weight-management programs are based on a diet that supplies enough vitamins and minerals; ____ of protein each day; an adequate intake of carbohydrates ______; and no more than _____of each day’s calories from fat.
Most weight-management programs are based on a diet that supplies enough vitamins and minerals; 50–63 grams of protein each day; an adequate intake of carbohydrates (100 g) and dietary fiber (20–30 g); and no more than 30% of each day’s calories from fat.
are intended to teach people how to make wise food choices and to encourage gradual weight loss.
Good weight-management diets
a person can choose among several items within a particular food group when following a menu plan.
food-exchange diet,
is important to successful weight management because many people, particularly those with eating disorders, do not understand how the body uses food. They may also be trying to manage their weight in unhealthy ways.
Nutritional counseling
refers to the clinical condition in which a person voluntarily eats very little food (self-imposed starvation). As a result, there is a large weight loss. The disorder is more common among teenage girls. The child develops psychological problems leading her to resent her obesity (which may be real or imagined) and embarks on a self-prescribed starvation diet. She continues to abstain from food even when she has achieved an ideal weight. After that, her health deteriorates.
Anorexia nervosa
Although the desire for food is present, the patient refuses to eat and drink. Occasionally the patient has an uncontrollable urge to gorge, which is followed by self-induced vomiting. Because of this, may lose 25%–35% of their body weight and become emaciated and wasted.
ANOREXIA
Electrolyte imbalances occur, and female anorexic patients develop hair over different parts of their body and cease to menstruate. Also, the present is decreased body metabolism, cold hands, and feet, decreased blood pressure, and decreased sensitivity to insulin.
ANOREXIA
Bone density is compromised, leading to stress fractures, especially in female athletes. The heart muscle becomes thin and weak, the immune system is impaired, anemia develops, insomnia is common, and both men and women lose their sex drives.
ANOREXIA
exhibit abnormal behavior such as frequent self-induced vomiting, excessive use of cathartics (laxatives), and over-exercise (hyperactivity).
ANOREXIA
A worsening mother-daughter relationship may set it off, or a sudden, highly emotional conflict between the patient and someone else may do so. Other possible causes are an abrupt failure in schoolwork and the emotional turmoil over the beginning or continuing a sexual relationship. These patients show a lack of feeling for hunger, satiety, tiredness, and sometimes even physical pain. They generally have a distorted image of their physical size.
ANOREXIA
Treatment for a patient with anorexia nervosa consists of
psychotherapy, behavior modification, drug therapy, and hospitalization for refeeding. The treatment objective of diet therapy and hospital feedings is to return the patient to a normal diet and an appropriate, healthy weight.
Most importantly, the attending nurse should monitor the patient’s eating behavior and pay full attention to the following feeding routines.
- Check that the foods served to comply with the meal plan.
- Pay attention to the patient’s hands constantly.
- Assume a friendly and supportive attitude so that the patient will not feel spied on.
- Prevent food disposal by keeping any container (such as a facial tissue box, a wastebasket, or a flower pot) away from the patient during the meal and checking the meal tray after the patient has finished eating. The patient may hide food under napkins or smear it under the bed, on the window sill, and so forth.
- Permit a maximum of one hour for eating a meal.
- If possible, the patient should wear a pocketless hospital gown while eating.
- Insist that the patient rest for 1 ⁄2 to one hour after a meal and does not leave the bed, since she may induce vomiting.
- Recovery is a long and difficult process that may last from six months to one year or more.
Nursing Implications ANOREXIA
- All team members must be consistent and caring in their handling of the feeding routines.
- Patients may not manipulate or dictate food intake.
- Feeding periods must be closely supervised.
- Bathroom privileges must be denied for at least 30 minutes after a meal to prevent self-induced vomiting.
- Major sleep disturbances that occur early in treatment cease as the patient gains weight.
- Avoid all conversation related to food or weight gain while the patient is hospitalized, except as it relates to an agreed-upon contract.
- Nutrition education for patients and families can begin when the patient is discharged.
- Psychological counseling takes precedence over nutritional counseling.
Huge amounts of food (up to 5000 kcal in a single sitting, eaten rapidly) are consumed. This is followed by feelings of guilt and shame at the loss of control. In response to these feelings and the need to purge the body of this vast intake of food, the person practices self-induced vomiting; uses laxatives, diuretics, or diet pills, and/or engages in strenuous exercise. The effect of these behaviors on the body is very damaging. The effect on the psyche is also damaging, leading to loss of self-esteem and depression. Persons with ___ usually keep it a guilt-ridden secret until their symptoms become apparent.
BULIMIA NERVOSA
Some of the physical symptoms of bulimia include:
- Blood-shot eyes and broken blood vessels on the face. Decayed teeth and eroded enamel on the teeth from self-induced vomiting. There may also be bruises on the hand that is used to induce the vomiting.
- Sore throat, swollen salivary glands, and infrequently, esophageal tears or ruptures of the gastric mucosa
- Intestinal problems from overuse of laxatives.
- Although fatigue is common, as is the cessation of menses, the weight fluctuates. Clients are not usually underweight or, if they are, they will cycle back to their previous weight, and sometimes weigh more than they did previously.
This disorder, newly classified by the American Psychiatric Association, is commonly called “compulsive overeating
CHRONIC DIETING SYNDROME
It is a reaction to psychological stressors, such as anxiety and emotional problems, or a need for comfort. A great deal of compulsive overeating follows very restrictive dieting practices in an attempt to reach an unnatural and unrealistic weight goal. When failure occurs, rebound eating follows. This creates the characteristic weight cycling. Each time a cycle occurs the Basal Metabolic Rate (BMR) drops, and in the next dieting cycle, the weight comes off more slowly than before. Lean body mass is also lost with each cycling, and it is not regained with the refeeding. Body composition is altered.
CHRONIC DIETING SYNDROME
Management of Bulimia and Compulsive Overeating
The approach is individualized to the client, and psychological treatment will be a priority. Clients may receive antidepressant drug therapy along with counseling. Nutrition education and counseling receive high priority. Behavior modification is helpful. Support groups and/or one-on-one counseling in combination with other therapies and follow-up care are needed. The strategies for nutrition management should include written material such as diet plans and behavioral techniques.
play a large part in longevity, but recent research indicates that regular exercise, fitness, especially cardiovascular fitness, and reduction of stress lead to extended life spans.
Genetic factors
The key elements to physical fitness include
frequency of activity, duration of the activity, the intensity of activity, and type of activity
The first step in beginning a quest for physical fitness involves
program selection
can calculate the functional capacity of the cardiovascular system, a measurement important to exercise program selection.
Exercise testing
. is to determine the predicted heart rate without causing chest pain.
The goal in such testing
must be suited to both health considerations and goals.
The ideal physical fitness program
session is characterized by a warm-up period, an endurance phase, occasional competition, and finally a cooling-down period. Typically, the session will last up to an hour in total.
physical fitness training
exercise must continue after the goal is attained to prevent loss of what has been achieved.
For flexibility and strength programs,
includes good dietary habits that provide optimal nutrition and adequate calories, a diet low in fat but high in energy foods, such as complex carbohydrates.
An effective program
are crucial to good health, and good nutrition is crucial to strong bones.
Strong bones
By around 18 or 19 years old, we’ve reached about ___ of our peak bone mass.
95%
But by age 30, we stop making any more ____
“bone deposits”.
