nutrition

digestion involves what

the esophagus, stomach, liver, gallbladder, pancreas, small intestine, large intestine, rectum, and anus

esophagus

muscles propel food down to the stomach

stomach

holds and digests food using acids and enzymes

liver

filters toxins from the blood and produces bile that breaks down carbs, proteins, and fats

gallbladder

stores the bile produced by the lier and releases it when needed

pancreas

produces insulin that helps with the metabolism of sugar

small intestine

breaks down food and absorbs most of the nutrients

large intestine

removes water and electrolytes from food particles for the body's use while turning the rest into feces

rectum

temporary storage area for feces

anus

expels feces

food security

when people have reliable access to sufficient, affordable, nutritious food to support a healthy life

why is food security important?

requires a multi faceted approach, including sustainable farming practices, reducing food waste, improving supply chains, and investing in resilient food systems

basal metabolic rate/ BMR

also called basal energy expenditure

the amount of energy used in a 24 hr for involuntary activities of the body- maintaining temp, heartbeat, circulation, and respirations

resting metabolic rate RMR

also called resting energy expenditure

refers to the calories needed for involuntary activities of the body at rest

BMR

energy needed to keep the lights on

RMR -

energy needed if someone is inside just sitting and relaxing

carbohydrates

main source of energy

composed of carbon, hydrogen, and oxygen

minimum carbs needed per day

130 grams

proteins

amino acids- simplest form

necessary for nitrogen balance and transportation of nutrients

lipids

calorie dense

triglycerides, phospholipids, and sterols

glycemic index

the ability to raise the blood sugar level

protein

buildin block of the body

promotes growth, healling, and overall body maintainence

RDA rec for proetin

0.8g/kg

carbohydrates

nutrients that fuel the body, including the central nervous system and the brain, while helping protect against disease. they make up to 45-65% of total daily calories and are the body's primary fuel source

diff types of carbs classified how?

according to the number of saccharide units making up their structure

mono

simple carbs

glucose, fructose, and galactose

di

simple carbs

sucrose, lactose, and maltose

poly

complex carbs

starch, fiber, and glycogen

fiber categorized as what?

carb

recommeneded fiber for females?

25 grams per day

recommended fiber for males

38 grams per day

lipids

a diet high in fats is associated with CVD, HTN, and DM2

triglycerides

saturated/solid at room temp

unsaturated- olives, avocado

essentail- omega3 omega6 fatty acids

phospholipis

important to cell membrane structure, as well as the transport of fat soluble substances across the cell membrane

sterols

cholesterol- found in animal, and are not essential nutrients bc the liver is able to produce enough to meet needs

water

most basic nutrient

all cell function depends on a fluid environment

vitamins

essential for metabolism

water soluble or fat soluble

minerals

metabolic exchange

microminerals; trace elements

water makes up what?

more than half of the body weight and is needed for every system in the body

how much water should be lost/ intake?

1000mL lost daily

500mL urine daily

intake 1500mL daily= 50oz

vitamins

micronutrients that promote health and ward off disease while supporting functions of the body

water soluble vitamins

C and B

fat soluble vitamins

A D E K

minerals do what

support functions of the body including hydration, metabolism regulation, as well as strong teeth and bones

digestion

systemic process that includes the breakdown and absorption of nutrients

absorption

occurs as componenets of nutrients pass through the digestive system into the bloodstream and lymphatic system

metabolism

is the sum of all chemical processes that occur on a cellular level to maintain homeostasis

elimination

chyme is moved through peristalsis and is changed into feces

Digestion starts where

in the mouth and ends in the large intestine

absorption primary spot

intestines

metabolism at what level

cellular

catabolism

breaking down of substances with the resultant release of energy

anabolism

the use of energy to build or repair substances

elimination through what

feces out

factors influencing nutrition

religious and cultural practices

financial issues

appetite

negative experiences

environmental factors

developmental needs

disease and illness

medications

age

religious and cultural practices

: guide food preparation and choices

financial issues

prevent some pt from buying foods that are high in protein, vits, and mins

appetite

decreases with illness, meds, pain, depression, and unpleasant environments

negative experiences

with certain foods or familiarity with foods clients like help determine preferences.

environmental factors

: sed lifestyles, work schedules, and widespread access to less healthy foods=obesity

developmental needs/age

a baby is different than a toddler....affects nutritional requirements

disease and illness

: can affect the functional ability to prepare and eat food

medications

: can alter tastes and interfere with the absorption of certain nutrients

alternative food patterns

- vegetarian diet

- ovolactovegetarian

- lactovegetarians

- vegan

vegetarian diet

predominantly plant foods

ovolactovegetarian

avoids meat, fish, and poultry, but eats eggs and milk

lactovegetarian

drinks milk but avoids eggs

vegan

consumes only plant foods

assessment

Screening a patient is a quick method of identifying malnutrition or risk of malnutrition using sample tools:

Height

Weight

Weight change

Primary diagnosis

Comorbidities

Screening tools

always ask if their weight loss/gain was intentional

anthropometry

measurement system of the size and makeup of the body

- height and weight are most commonly used

body mass index

measures weight corrected for height and serves as an alternative to traditional height-weight relationships

underweight BMI

<18.5

normal weight BMI

18.5-24.9

overweight BMI

25-29.9

obese BMI

>30

morbidly obese BMI

>40

laboratory and biochemical tests

albumin

transferrin

prealbumin

nitrogen balance

albumin

looks at the last 20-22 days

transferrin

protein that transports iron in the blood, and its levels help assess a persons iron status and overall nutritional health

where is transferrin made?

in the liver, so low levels may indicate malnutrition or liver disease

prealbumin

looks at the last 2-4 days

nitrogen balance

refers to the relationship between protein breakdown/catabolism and protein synthesis/anabolism

dietary history focuses on what

patient's intake of foods and liquids and includes information about their preferences, allergies, and other relevant areas such as their ability to obtain food.

health history assess what

Health status; age; cultural background; religious food patterns; socioeconomic status; personal food preferences; psychological factors; use of alcohol or illegal drugs; use of vitamin, mineral, or herbal supplements; prescription or over-the-counter (OTC) meds (meds affect metabolism of nutrients), and general nutrition knowledge.

Can the read Food labels?

what is the most important part of nutritional assessment?

physical examination

nutrition can affect all systems

physical signs of nutritional status

dysphagia

difficulty swallowing

warning signs of dysphagia

cough 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, pocketing of food, regurgitating food

implementation and health promotion

Education

Early identification of potential or actual problems

Meal planning

Weight loss plans

Food safety

acute care risk factors

•Tests/procedures-NPO

•Frequent interruptions

•Poor appetite/anorexia

•Too fatigued/uncomfortable

•Decreased immune function

advancing diets

gradual progression of dietary intake or therapeutic diet to manage illness

promote appetite

clean, odor free, right temp of food

assist with oral feedings

check gag reflex

dysphagia may need what?

speech pathologist

regular diet

consists of healthy foods coming from all of the food groups

soft diet

contains foods that are soft and easy to digest as well as swallow

pureed diet

consists of foods that do not need to be chewed

full liquid diet

diet that only contains fluids, foods that are fluids at room temp

clear liquid diet

only contains clear liquids such as broth, gelatin, and water

enteral tube feeding

provides nutrients into the GI tract

physiological, safe, and economical nutritional support

enteral feeding a person can do what?

can digest but not ingest

•Nasogastric, jejunal, or gastric tubes

•Surgical or endoscopic placement

•Nasointestinal

•Gastrostomy

•Jejunostomy

•PEG (percutaneous endoscopic gastrostomy)

•PEJ (percutaneous endoscopic jejunostomy)

•Risk of aspiration

•Infection

Complications