Mosby items and derived items © 2005 by Mosby, Inc. Chapter 43 Nutrition.
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Transcript of Mosby items and derived items © 2005 by Mosby, Inc. Chapter 43 Nutrition.
Mosby items and derived items © 2005 by Mosby, Inc.
Chapter 43
Nutrition
Mosby items and derived items © 2005 by Mosby, Inc.
Elements of Energy and Nutrition
• Basal metabolic rate (BMR)
• Resting energy expenditure (REE)
• Nutrient density
• Nutrients: carbohydrates, proteins, fats, water, vitamins, minerals
Mosby items and derived items © 2005 by Mosby, Inc.
Carbohydrates
• Produce 4 kcal/g
• Main source of energy
• Saccharides: simple and complex carbohydrates, fiber
Mosby items and derived items © 2005 by Mosby, Inc.
Proteins
• Produce 4 kcal/g• Essential for growth, maintenance,
and repair of body tissue• Amino acids: essential and
nonessential• Complete and complementary
proteins• Nitrogen balance
Mosby items and derived items © 2005 by Mosby, Inc.
Fats (Lipids)
• Produce 9 kcal/g
• Triglycerides and fatty acids
• Saturated or unsaturated: monounsaturated or polyunsaturated fatty acids
• Essential or nonessential fatty acids
Mosby items and derived items © 2005 by Mosby, Inc.
Water
• Comprises 60% to 70% of body weight
• Cell function depends on a fluid environment
Mosby items and derived items © 2005 by Mosby, Inc.
Vitamins
• Essential to normal metabolism
• Fat-soluble: A, D, E, K
• Water-soluble: C and B complex
Mosby items and derived items © 2005 by Mosby, Inc.
Minerals
• Inorganic elements essential as catalysts in biochemical reactions
• Macrominerals
• Microminerals or trace elements
Mosby items and derived items © 2005 by Mosby, Inc.
Digestive System
• Anatomy and physiology– Digestion– Absorption– Metabolism and storage of nutrients– Elimination
Mosby items and derived items © 2005 by Mosby, Inc.
Dietary Guidelines
• Dietary referenced intakes (DRIs)
• Food guidelines: food guide pyramid
• Daily values
• Healthy People 2010
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Nutritional Needs throughout Growth and Development
• Infants through school-age– Breast-feeding– Formulas– Solid foods– Food habits
• Adolescents– Eating disorders– Activities
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Nutritional Needs throughout Growth and Development (cont'd)
• Young and middle adults– Pregnancy– Lactation
• Older adults
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Alternative Food Patterns
• Cultural and religious practices
• Vegetarian diets
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Assessment: Diet History
• Dietary intake and pattern• Symptoms• Allergies• Taste• Chewing and swallowing• Appetite• Elimination• Medications
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Assessment
• Anthropometry
• Body mass index (BMI)
• Ideal body weight (IBW)
• Laboratory tests
• Clinical observations
• Client expectations
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Nursing Diagnoses
• Risk for aspiration
• Constipation
• Diarrhea
• Imbalanced nutrition: less than/more than body requirements
• Feeding self-care deficit
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Planning
• Goals and outcomes– Client’s daily nutritional intake meets the
minimum DRIs– Client loses ½ pound per week
• Setting priorities
• Continuity of care
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Implementation: Health Promotion
• Client education
• Meal planning
• Food storage and preparation safety
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Implementation: Acute Care
• Advancing diets
• Promoting appetite
• Assisting clients with feeding
• Enteral feeding
• Parenteral nutrition
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Enteral Feeding
• Nasogastric, jejunal, gastric tubes
• Insertion and verification of placement
• Types and preparation of formulas
• Complications
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Parenteral Nutrition
• Initiation and management of insertion site
• Types of solutions
• Rate of infusion
• Prevention of complications
Mosby items and derived items © 2005 by Mosby, Inc.
Implementation: Restorative Care
• Medical nutrition therapy for specific illnesses, conditions, or injuries– GI diseases– Diabetes– Cardiovascular diseases– Cancer– HIV
Mosby items and derived items © 2005 by Mosby, Inc.
Evaluation
• Client care
• Client expectations