DFS Approved Curriculum-Unit 61 Unit 6 Nutrition and Hydration Nurse Aide I Course.
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Transcript of DFS Approved Curriculum-Unit 61 Unit 6 Nutrition and Hydration Nurse Aide I Course.
DFS Approved Curriculum-Unit 6 1
Unit 6
Nutrition and HydrationNurse Aide I Course
DFS Approved Curriculum-Unit 6 2
Nutrition and HydrationIntroduction
This unit introduces the nurse aide to the basic principles of nutrition and emphasizes the functions of the major nutrients required for health.
DFS Approved Curriculum-Unit 6 3
Nutrition and HydrationIntroduction
(continued)
This unit covers the Food Guide Pyramid, the use of therapeutic diets, adaptive devices, alternative methods of feeding, providing water and nourishments, the procedure for feeding a resident, and the effects of good nutrition and poor nutrition.
DFS Approved Curriculum-Unit 6 4
Nutrition and HydrationIntroduction
(continued)
Knowledge of nutrition will enable the nurse aide to recognize the important relationship between food and good health.
DFS Approved Curriculum-Unit 6 5
DFS Approved Curriculum-Unit 6 6
6.0 Identify the general principles of basic nutrition.
6.1 Identify factors that influence dietary practices.
DFS Approved Curriculum-Unit 6 7
Good Nutrition
• Promotes physical and mental health
• Provides increased resistance to illness
• Produces added energy and vitality
DFS Approved Curriculum-Unit 6 8
Good Nutrition(continued)
• Aids in healing process• Assists one to feel and sleep better
DFS Approved Curriculum-Unit 6 9
Functions of Food
• Provides energy• Growth and repair
of tissue• Maintenance and
regulation of body processes
DFS Approved Curriculum-Unit 6 10
Factors Influencing Dietary Practices
• Personal preference• Appetite• Finance• Illness• Culture
DFS Approved Curriculum-Unit 6 11
6.1.1 Review cultural variations in diet.
DFS Approved Curriculum-Unit 6 12
Culture and Dietary Practices
• The diets of Chinese, Japanese, Koreans and people from Far East include rice and tea
• The diets of Spanish-speaking people include spicy dishes containing rice, beans and corn
DFS Approved Curriculum-Unit 6 13
Culture and Dietary Practices(continued)
• The Italian diet includes spaghetti, lasagna, and other pastas
• Scandinavians have a lot of fish in their diets
DFS Approved Curriculum-Unit 6 14
Culture and Dietary Practices(continued)
• Americans eat a lot of meat, fast foods, and processed foods
• Use of sauce and spices are culturally related
DFS Approved Curriculum-Unit 6 15
Culture and Food Preparation
Frying Baking
Smoking Roasting
Fresh/raw
DFS Approved Curriculum-Unit 6 16
6.1.2 List seven examples of foods avoided by some religious denominations.
DFS Approved Curriculum-Unit 6 17
Religion and Dietary Practices
• Days of fasting when all or certain foods are avoided.
• Christian Science - avoid coffee/tea and alcohol
• Roman Catholic - avoid food one hour before communion, observe special fast days
DFS Approved Curriculum-Unit 6 18
Religion and Dietary Practices(continued)
• Muslim/Moslem - avoid alcohol, pork products
• 7th Day Adventist - avoid coffee/tea, alcohol, pork and some meats, caffeine
DFS Approved Curriculum-Unit 6 19
Religion and Dietary Practices(continued)
• Baptists – some avoid coffee, tea and alcohol
• Greek Orthodox - fast days, but usually “forgiven” when ill
DFS Approved Curriculum-Unit 6 20
Religion and Dietary Practices(continued)
• Conservative Jewish faith–Prohibits shellfish, non-
kosher meats such as pork
–Requires special utensils for food preparation
DFS Approved Curriculum-Unit 6 21
Religion and Dietary Practices(continued)
• Conservative Jewish faith–Forbids cooking on
Sabbath–Forbids eating of
leavened bread during Passover
DFS Approved Curriculum-Unit 6 22
Religion and Dietary Practices(continued)
• Conservative Jewish faith–Forbids serving milk
and milk products with meat
–Strict rules regarding sequence in which milk products and meat may be consumed
DFS Approved Curriculum-Unit 6 23
6.1.3 Review the major classification of nutrients and their function in the body.
DFS Approved Curriculum-Unit 6 24
Nutrients
• Nutrients are essential• Four classifications of nutrients
1. Fats - provide energy, help body use certain vitamins, conserve body heat and protect organs from injury
2. Proteins – build and repair tissue
DFS Approved Curriculum-Unit 6 25
Nutrients
(continued) • Four classifications of nutrients
(continued)3. Carbohydrates - provide energy
and fiber that help in bowel elimination
4. Vitamins and minerals - ingested through food and are necessary for carrying out and maintaining specific body functions
DFS Approved Curriculum-Unit 6 26
Nutrients(continued)
• Fats, proteins and carbohydrates measured in calories
DFS Approved Curriculum-Unit 6 27
Nutrients(continued)
• Water - solvent for nutrients and metabolic waste products–Found in all body tissue–Essential for digestion of food–Makes up most of blood plasma–6 to 8 glasses necessary per day–Has no caloric value
DFS Approved Curriculum-Unit 6 28
6.1.4 Describe six factors that influence caloric needs.
DFS Approved Curriculum-Unit 6 29
Factors That Influence Caloric Need
• Age• Sex• Size and activity level• Climate• State of health• Amount of sleep
obtained
DFS Approved Curriculum-Unit 6 30
6.1.5 Cite nine age-related changes/factors that affect the resident’s nutritional status.
DFS Approved Curriculum-Unit 6 31
Age Related Changes/Factors Affecting Nutrition
• Need for fewer calories• Vitamin and mineral
requirements change• Drugs that affect how nutrients
are absorbed and used• Teeth/dentures affect ability to
chew food
DFS Approved Curriculum-Unit 6 32
Age Related Changes/Factors Affecting Nutrition
(continued)
• Diminished sense of taste and smell
• Assistance required with eating• Decreased saliva and gastric juices
production• Discomfort caused by constipation• Decreased appetite and thirst
DFS Approved Curriculum-Unit 6 33
6.1.6 Recognize the signs of good nutrition.
DFS Approved Curriculum-Unit 6 34
Signs Of Good Nutrition
• Healthy, shiny looking hair• Clean skin and bright eyes• A well-developed, healthy
body• An alert facial expression• An even, pleasant
disposition
DFS Approved Curriculum-Unit 6 35
Signs Of Good Nutrition(continued)
• Restful sleep patterns• Healthy appetite• Regular elimination
habits• Appropriate body
weight
DFS Approved Curriculum-Unit 6 36
6.1.7 Identify seven results of poor nutrition.
DFS Approved Curriculum-Unit 6 37
Results of Poor Nutrition
• Hair and eyes appear dull
• Irregular bowel habits
• Weight changes• Osteoporosis and
other diseases
DFS Approved Curriculum-Unit 6 38
Results of Poor Nutrition(continued)
• Lack of interest - mental slowdown
• Skin color and appearance poor
DFS Approved Curriculum-Unit 6 39
Results of Poor Nutrition(continued)
• Anemia leading to:–tired feeling–shortness of breath– increased pulse–problems with
digestion
–pale skin–poor sleep
patterns–headaches
DFS Approved Curriculum-Unit 6 40
DFS Approved Curriculum-Unit 6 41
6.2 Discuss the six basic food groups from the Food Guide Pyramid that contribute to balanced nutrition.
DFS Approved Curriculum-Unit 6 42
Dietary Guide For Americans
• Guidelines are the foundation of the Food Guide Pyramid and include nine key recommendations.
• Key recommendation #1: Consume nutrient-dense foods and beverages within calories needed for age, sex and activity level.
DFS Approved Curriculum-Unit 6 43
Dietary Guide For Americans
• Key recommendation #2: To maintain health body weight, balance calories consumed with calories expended.
• Key recommendation #3: Engage regularly in a variety of physical activities and reduce sedentary activities.
DFS Approved Curriculum-Unit 6 44
Dietary Guide For Americans
• Key recommendation #4: Encourage the following:–Choose variety of fruits and
vegetables daily.–Half of daily grains should come from
whole grains.–Consume 3 cups fat-free or low fat
milk or equivalent milk products daily.
DFS Approved Curriculum-Unit 6 45
Dietary Guide For Americans
• Key recommendation #5: Consume foods and beverages that are low in saturated fats, trans fats and cholesterol.
• Key recommendation #6: For carbohydrates: Choose fiber-rich foods, vegetables and grains often. Reduce intake of sugar- and starch-containing foods.
DFS Approved Curriculum-Unit 6 46
Dietary Guide For Americans
• Key recommendation #7: Consume less than a teaspoon of salt per day.
• Key recommendation #8: Consume alcoholic beverages in moderation if alcohol intake is permitted.
• Key recommendation #9: Prepare foods in a safe manner to avoid microbial foodborne illness.
DFS Approved Curriculum-Unit 6 47
Six Basic Food Groups From the Food Pyramid Guide
GRAINS Vegetables Fruits MilkMeat &Beans
DFS Approved Curriculum-Unit 6 48
Food Pyramid GuideGrain Group
(breads, cereal, rice, pasta)
• Provides–carbohydrates–minerals–fiber
DFS Approved Curriculum-Unit 6 49
Food Pyramid GuideGrain Group
(breads, cereal, rice, pasta)(continued)
• 1 ounce equivalent is about 1 slice of bread, about 1 cup of breakfast cereal or ½ cup cooked rice, cereal or pasta.
DFS Approved Curriculum-Unit 6 50
Food Pyramid GuideGrain Group
(breads, cereal, rice, pasta)(continued)
• Daily:–6 ounce equivalents
for males over 60–5 ounce equivalents
for females over 60
DFS Approved Curriculum-Unit 6 51
Food Guide Pyramid Vegetable Group
• Provides:–vitamins–minerals–fiber (roughage)
• Easier to chew if cooked, chopped or diced
DFS Approved Curriculum-Unit 6 52
Food Guide PyramidVegetable Group
(continued)
• Chose from all five vegetable subgroups:–dark green–orange– legumes–starchy–other vegetables
DFS Approved Curriculum-Unit 6 53
Food Guide PyramidVegetable Group
(continued)
• Daily:–2½ cups for males over 60–2 cups for females over 60
DFS Approved Curriculum-Unit 6 54
Food Pyramid GuideFruit Group
• Provides–vitamins–minerals–fiber
• Chose fresh, frozen, canned or dried fruits
DFS Approved Curriculum-Unit 6 55
Food Pyramid GuideFruit Group
(continued)
• Daily:–2 cups daily for males over 60–1½ cups daily for females over 60
DFS Approved Curriculum-Unit 6 56
Food Pyramid GuideMilk, Yogurt and Other Milk Products
• Provides–proteins–vitamins (A)–minerals (calcium)–carbohydrates–Fat
• Choose low-fat or fat-free milk and milk products
DFS Approved Curriculum-Unit 6 57
Food Pyramid GuideMilk, Yogurt, Cheese Group
(continued)
• Daily: –3 cups for males over 60–3 cups for females over 60
DFS Approved Curriculum-Unit 6 58
Food Pyramid GuideMeat, Poultry, Fish and Beans Group
• Provides–protein–fats–vitamins–Minerals–1 ounce of meat, poultry or fish is
about ¼ cup cooked beans, 1 egg, 1 tablespoon of peanut butter or ½ ounce nuts or seeds
DFS Approved Curriculum-Unit 6 59
Food Pyramid GuideMeat, Poultry, Fish and Beans Group
(continued)
• Daily:–5½ ounce equivalents daily for
males over 60–5 ounce equivalents daily for
females over 60
DFS Approved Curriculum-Unit 6 60
Food Pyramid GuideOil Group = fats that are liquid at
room temperature• Provides essential
fatty acids• High in calories• Use sparingly• Keep total fat intake
between 20% to 35% of calories
DFS Approved Curriculum-Unit 6 61
Food Pyramid GuideOil Group = fats that are liquid at
room temperature• Most fats consumed should be
polyunsaturated and monounsaturated.
• Make most fat sources from fish, nuts and vegetable oils.
• Limit solid fats like butter, stick margarine, shortening and lard.
DFS Approved Curriculum-Unit 6 62
DFS Approved Curriculum-Unit 6 63
6.3 Define a therapeutic diet and recognize the need for alterations in a regular diet.
6.3.1 List five purposes of a therapeutic diet.
DFS Approved Curriculum-Unit 6 64
Purposes of Therapeutic Diets
• Add or eliminate calories to cause a change in body weight
• Assist with digestion of food by taking foods out of diet that irritate digestive system
• Restrict salt intake to prevent or decrease edema
DFS Approved Curriculum-Unit 6 65
Purposes of Therapeutic Diets(continued)
• Help body organs to maintain and/or regain normal function
• Treat metabolic disorders by regulating amount of food
DFS Approved Curriculum-Unit 6 66
6.3.2 Discuss the types of therapeutic diets that the physician might order for a resident.
DFS Approved Curriculum-Unit 6 67
Types of Therapeutic Diets
• Clear liquid• Full liquid• Bland• Low residue• Controlled carbohydrate
(Diabetic)• Low fat/low cholesterol
DFS Approved Curriculum-Unit 6 68
Types of Therapeutic Diets(continued)
• High fiber • Low calorie• High calorie• Sodium restricted• High protein• Mechanical soft, chopped, pureed
DFS Approved Curriculum-Unit 6 69
Types of Therapeutic Diets(continued)
Residents may have difficulty accepting special diets.
DFS Approved Curriculum-Unit 6 70
DFS Approved Curriculum-Unit 6 71
6.4 Recognize adaptive devices used to assist residents with eating.
DFS Approved Curriculum-Unit 6 72
Adaptive Devices
• Food Guards• Divided Plates• Built-up handled utensils• Easy grip mugs/glasses
Residents have to be taught how to use these devices.
DFS Approved Curriculum-Unit 6 73
DFS Approved Curriculum-Unit 6 74
6.5 Discuss alternate methods of feeding.
DFS Approved Curriculum-Unit 6 75
Parenteral Fluids(Intravenous Infusion)
• Fluids administered through vein. Little nutritional value
• Responsibility of licensed nurse
DFS Approved Curriculum-Unit 6 76
Parenteral Fluids(Intravenous Infusion)
(continued)
• Observations to report–Near-empty bottle/bag–Change in drip rate–Pain at needle site, and/or redness
and/or swelling, if observable–Loose, non-intact, or damp
dressing
DFS Approved Curriculum-Unit 6 77
Enteral Feeding
Residents unable to take nutrients by mouth
• Depressed• Comatose• Swallowing problem (stroke,
Alzheimer’s or other medical conditions)
• Disorders of digestive tract
DFS Approved Curriculum-Unit 6 78
Enteral Feeding(continued)
Liquid formula administered through tube by licensed nurse/NAII
• Nose to stomach - nasogastric tube
• Directly into stomach - gastrostomy tube
DFS Approved Curriculum-Unit 6 79
Nurse Aide Responsibilities in Alternative Nutrition
• Ensure that there is no tension or pulling on tube
• Keep resident’s nose clean and free of mucus
• Check that tube is securely taped to nose
• Perform frequent oral care with nasogastric tube
DFS Approved Curriculum-Unit 6 80
Nurse Aide Responsibilities in Alternative Nutrition
(continued)
• Fasten tube with pin to shoulder area of clothing to prevent straining or tension on tube
• Report non-intact dressing around tube site
DFS Approved Curriculum-Unit 6 81
Nurse Aide Responsibilities in Alternative Nutrition
(continued)
• Report any signs or symptoms related to aspiration or GI problems
• Mitts may be ordered to prevent resident from dislodging tube
DFS Approved Curriculum-Unit 6 82
DFS Approved Curriculum-Unit 6 83
6.6 Identify the responsibilities of the nurse aide in preparing residents for meals.
6.6.1 Serve prepared food as instructed.
DFS Approved Curriculum-Unit 6 84
Preparing Residents for Meals
• Meals enjoyable, social experience• Provide pleasant environment
–Clean area–Odor-free area–Adequate lighting
• Flowers/decorations and music add interest to dining area
DFS Approved Curriculum-Unit 6 85
Preparing Residents for Meals(continued)
• All residents clean and dressed for meals
• Hair combed• Oral care provided• Encourage to use
bathroom or urinal/bedpan• Cleanse and dry
incontinent residents
DFS Approved Curriculum-Unit 6 86
Preparing Residents for Meals(continued)
• Face and hands washed• Provide for comfort
–Raise head of bed–Position in chair–Transport to dining
area• Provide clothing
protector if appropriate
DFS Approved Curriculum-Unit 6 87
Preparing Residents for Meals(continued)
• Check to be certain resident receives right tray and has correct diet
• Food should be attractively served and placed within reach
• Check tray to see that everything needed is there
DFS Approved Curriculum-Unit 6 88
Preparing Residents for Meals(continued)
• Assist resident as needed with:–cutting meat–pouring liquids–buttering bread–opening containers
DFS Approved Curriculum-Unit 6 89
Preparing Residents for Meals(continued)
• Blind residents made aware of food placement according to face of clock
• Stroke residents approached from non-effected side
DFS Approved Curriculum-Unit 6 90
Preparing Residents for Meals(continued)
• Residents should be encouraged to do as much as possible for themselves
• Provide time for resident to complete meal
• Display pleasant, patient attitude
DFS Approved Curriculum-Unit 6 91
Preparing Residents for Meals(continued)
• Remove tray when meal finished
• Report unconsumed food to supervisor
• Record fluid intake if ordered
• Assist to position of comfort
DFS Approved Curriculum-Unit 6 92
Preparing Residents for Meals(continued)
• Call signal and supplies positioned within reach
• Area should be left clean and tidy• Hands washed before and after
care of each resident
DFS Approved Curriculum-Unit 6 93
DFS Approved Curriculum-Unit 6 94
6.7 Demonstrate the procedure for assisting with dining/feeding resident who cannot feed self.
DFS Approved Curriculum-Unit 6 95
DFS Approved Curriculum-Unit 6 96
6.8 Discuss the various types of supplementary nourishments.
DFS Approved Curriculum-Unit 6 97
Types of Nourishments
• Milk• Juice• Gelatin• Custard, ice cream, sherbet• Crackers• Nutritional supplementation
products (e.g., Ensure, etc.)
DFS Approved Curriculum-Unit 6 98
Supplementary Nourishments
• Usually served:–Midmorning–Mid-afternoon–Bedtime
DFS Approved Curriculum-Unit 6 99
Supplementary Nourishments(continued)
• Ordered by physician• Serve as directed by
supervisor• Provide necessary
eating utensils, straw and/or napkin
DFS Approved Curriculum-Unit 6 100
DFS Approved Curriculum-Unit 6 101
6.10 Demonstrate the procedure for serving supplementary nourishments.
DFS Approved Curriculum-Unit 6 102
DFS Approved Curriculum-Unit 6 103
6.11 Identify the special fluid orders that the physician could write.
DFS Approved Curriculum-Unit 6 104
Providing Fresh Drinking Water
• Fresh water should be provided periodically throughout day
• Encourage to drink 6-8 glasses daily if appropriate
DFS Approved Curriculum-Unit 6 105
Providing Fresh Drinking Water(continued)
• Note residents who have special fluid orders–N.P.O.–Fluid restrictions:
•Schedule 24-hour intake•Remind resident
DFS Approved Curriculum-Unit 6 106
Providing Fresh Drinking Water(continued)
• Note residents who have special fluid orders–Force fluids
•Offer fluids in small quantities•Offer fluids (resident preference) without being asked
•Remind resident of importance of fluids in bodily functions
–No ice
DFS Approved Curriculum-Unit 6 107
DFS Approved Curriculum-Unit 6 108
6.11 Demonstrate the procedure for providing fresh drinking water.
DFS Approved Curriculum-Unit 6 109