Nutrition (Class 16)

A basic component of health and essential for normal growth/development, tissue maintenance, repair, cellular metabolism, and organ function

• Increase the number of breastfed infants

• Reduce obesity

• Increase the number of adults seeking medical care related to weight reduction

• Increase the amount of calcium. potassium, and vitamin D the population is getting

• Eliminate very low food security

• Reduce the number of adults with hypertension and high cholesterol

• Increase the proportion of schools in school-feeding programs

• Reduce the number of women of childbearing age that have iron deficiency

• Increase nutrition as an option as part of the employee health program

Energy needed at rest to maintain life-sustaining activities for a specific amount of time.

• Age

• Body Mass

• Gender

• Starving or Fasting

• Fever

• Menstruation

• Any Kind of Illness

• Activity Level

• Thyroid Function

• Main source of energy

• 4 Kcal/gram

• Glucose is necessary for brain, muscle, and blood cell production

• Simple vs. complex carbs

• Fiber

• Ex. Oats and Barley

• Essential for the growth, maintenance, and repair of body tissue.

• 4 kcal/gram

• Provides energy but because its essential role is to promote growth, maintenance, and repair it is spared and carbs are broken down first.

• Collagen, hormones, enzymes, immune cells, DNA, and RNA are all made of this.

  • Ex. Albumin and Insulin

• Must be provided by the diet

• Ex. Fish, poultry, milk, cheese, and eggs.

Contains all essential amino acids

Missing one or more of the nine indispensable amino acids and include grains, seeds, nuts, legumes, and vegetables.

Pairs of incomplete proteins that, when combined, supply the total amount of protein provided by complete protein sources. Ex. Rice and Beans.

True or False: Soy is the only plant source of a complete protein.

• 9 kcal/gram

• Carry out metabolic processes

• Most-calorie dense (hardest to rid due to energy required to breakdown)

• Saturated and unsaturated, Choelsterol and triglycerides

• Ex. Meats, butter, and dairy products

• Solid at room temperature

• Increase levels of LDL cholesterol

• Clogs the arteries

• “Bad cholesterol”

• Vegetable oils

• Liquid at room temperature

• Increase levels of HDL cholesterol

• “Good Cholesterol”

• Grabs LDL and escorts it to the liver where it is broken down and eventually removed from the body.

• Critical because cell function depends on a fluid environment.

• Makes up 60-70% of total body weight.

• Organic substances that are essential to normal metabolism.

• Fat soluble (DAKE) high risk of toxicity (hypervitaminosis)

• Water soluble (BC)

• Inorganic elements essential to the body as catalysts in biochemical reactions.

• Silicon, vanadium, nickel, tin, cadmium, arsenic, aluminum, and boron are trace elements.

Minerals that humans need more than 100 mg of

The building of more complex biochemical substances by synthesis of nutrients. Occurs when an individual adds lean muscle through diet and exercise.

The breakdown of biochemical substances into simpler substances and occurs during physiological states of negative nitrogen balance.

Present evidence-based criteria for an acceptable range of amounts of vitamins and nutrients for each gender and age-group.

Recommended amount of a nutrient that appears sufficient to maintain a specific body function for 50% of the population based on age and gender.

Represents average needs of 98% of the population, not the exact needs of the individuals.

Suggested intake for individuals based on observed or experimentally determined estimates of nutrient intakes

Highest level that likely possess no risk of adverse health events.

• Pork

• Alcohol

• Ramadan fasting sunrise to sunset for a moth

• Ritualized methods of animal slaughter required for meat ingestion

• Some denominations (Ex. Baptists) allow minimal or no alcohol.

• Some meatless days may be observed during the calendar year, commonly during Lent.

• Pork

• Predatory fowl

• Shellfish (eat only with scales)

• Rare meats

• Blood (Ex. blood sausage)

• Mixing of milk or dairy products with meat dishes

• Must adhere to kosher food preparation methods

• 24 hour fasting on Yom Kippur, a day of atonement.

• No leavened bread eaten during Passover (8 days)

• No cooking on the Sabbath from sundown Friday to sundown Saturday

• Alcohol

• Tobacco

• Caffeine such as in teas, coffees, and sodas

• Pork

• Shellfish

• Fish

• Alcohol

• Caffeine

• Vegetarian or Ovolactovegetarian diets encouraged

Consumption of a diet consisting predominantly of plant foods

Avoid meat, fish, and poultry but eat eggs and milk.

Avoid meats and eggs but drink milk

Consume only plant foods, no animal derived products.

The systematic method of measuring the size and makeup of the body by taking height and weight.

<18.5 BMI

25-29.9 BMI

18.5-24.9 BMI

30-34.9 BMI

35< BMI

• Albumin

• Prealbumin

• Transferrin

• Retinol Binding Protein

• Total Iron Binding Capacity

• Hemoglobin

• Hemorrhage

• Fluid Balance

• Liver Function

• Kidney Function

• Underlying Disease

• Drainage From Wounds

• Steroid Medications

• Age

• Trauma

• Stress Burns

• Easily fatigued

• Cachectic

• Underweight or overweight

• Flaccid muscles

• Anorexia

• Thin and brittle hair and nails

• Edema

• Hair loss

• Pallor

• Keep a patient’s environment free of odors

• Provide oral hygiene as needed to remove unpleasant tastes

• Offering smaller, more frequent meals

• Encourage visitors to eat with a patient

Clear fat-free broth, bouillon, coffee, tea, carbonated beverages, clear fruit juices, gelatin, fruit ices, and popsicles.

Same as clear liquid, with addition of smooth-textured dairy products (Ex. ice cream), strained or blended cream soups, custards, refined cooked cereals, vegetable juice, pureed vegetables, all fruit juices, sherbets, puddings, frozen yogurts.

As for clear and full liquid, with addition of scrambled eggs; pureed meats, vegetables, and fruits; mashed potatoes and gravy.

As for clear and full liquid and pureed, with addition of all cream soups, ground or finely diced meats, flaked dish, cottage cheese, cheese, rice, potatoes, pancakes, light breads, cooked vegetables, cooked or canned fruits, bananas, soups, peanut butter, eggs (not fried.)

Addition of low-fiber, easily digested foods such as pastas, casseroles, moist tender meats, and canned cooked fruits and vegetables; desserts, cakes, and cookies without nuts or coconut.

Addition of fresh uncooked fruits, steamed vegetables, bran, oatmeal, and dried fruits.

No more than 4-g (no added salt); vary from no added salt to severe sodium restriction which requires selective food purchases.

300 mg/day cholesterol, in keeping with American Heart Association guidelines for serum lipid reduction.

Nutrition recommendations by the American Diabetes Association; focus on total energy, nutrient and food distribution; include a balanced intake of carbs, fats, and proteins; varied caloric recommendations to accommodate patient’s metabolic demands.

Eliminates wheat, oats, rye, barley, and their derivatives.

No restrictions unless specified.

• Difficulty swallowing

• High risk for aspiration

• Coughing during eating

• Change in voice tone or quality after swallowing

• Abnormal movements of the mouth, tongue, or lips

• Slow, weak, imprecise, or uncoordinated speech

• Abnormal gag reflex

• Delayed swallowing or pocketing

• Drooling

• Aspiration pneumonia

• Dehydration

• Decreased nutritional status and weight loss

• Leads to disability or decreased functional status

• Increased mortality

• NG-Tube

• G/J-Tube

True or False: Enteral feedings are only given to patients with a functional GI tract.

Providing EN by a feeding pump over 24 hours per day.

Providing EN by a feeding pump in less than a 24-hours time period (Pauses for several hours)

Providing EN over 20-60 minutes every 4-6 hours with or without a feeding pump.

EN over a very short period of time at specified time interval by gravity or with a syringe.

• Check placement of tube before administering feeding

• Check residual before each feeding or every 4-6 hours (continuous)

• Assess for bowel sounds each shift

• Maintain integrity of feeding system

• Clean or replace feeding apparatus every 24 hours

Physiological response of the patient when feedings are emptied rapidly into the small intestines from the stomach. Signs and Symptoms are distention, cramping, dizziness, and weakness.

True or False: Under 200 residual is good and over 250 is bad.

• A form of specialized nutritional support provided intravenously

• Who are unable to digest or absorb EN benefit

• Basic formula is a combination of crystalline amino acids, hypertonic dextrose, electrolytes, vitamins, and trace elements.

• Administered through a central line, is a 2-in-1 formula in which administration of fat emulsions occurs separately from the protein and dextrose solution.

• Blood glucose monitoring: hypo, hyperglycemia

• Vital signs

• Respiratory assessment

• Catheter-sterile techniques

• Tubing change

• S/S of infection

• Electrolyte imbalances

1. Aspiration

2. Diarrhea

3. Constipation

4. Tube occlusion

5. Tube displacement

6. Cramping/vomiting

7. Delayed gastric emptying

8. Electrolyte imbalances

9. Fluid Overload

10. Dehydration

1. Electrolyte Imbalance

2. Hypercapnia

3. Hyperglycemia

4. Hypoglycemia

5. HHNS

6. Infection/Sepsis

7. CVC complications