official e2 nutrition

Therapeutic diet

A diet used as a medical treatment.

There are 2 types of liquid diets

Clear liquid diet and full liquid diet.

Clear Liquid Diet

Low calorie diet of liquids that leave little residue such as water, broth, ginger ale, and gelatin; often used before surgery or procedures.includes liquids you can see through.

Full liquid diet

More nutritionally complete than a clear liquid diet but still low in iron, zinc, and fiber; includes milk, pudding, creamy soups, ice cream, gelatin, and juices.

Soft diet

Generally low in fiber and similar to a regular diet but excludes strong spices.Includes full liquids and ground or diced foods for patients with chewing or swallowing difficulties.

Low residue diet

Similar to a soft diet but also restricts milk and milk products limiting whole grains, nuts, seeds, fruits, and vegetables to reduce fecal residue.

Soft and low residue diets are used for

GI tract conditions such as diverticulitis, inflammatory bowel disease, gastritis, esophageal varices, indigestion, and diarrhea.

High fiber diet

Used to treat constipation and diverticulosis fiber should be increased gradually to avoid excess gas and increase water intake

High kilocalorie and high protein diets are used for

Trauma, cancer, burns, fractures, and pressure ulcers.

High kilocalorie and high protein diets provide

Increased calories and protein in small volumes to maintain nutritional intake.

Underweight BMI

Less than 18.5.

Normal BMI

18.5 to 24.9.

Overweight BMI

25 to 29.9.

Obese BMI

30 or greater.

Body composition

Percentage of body fat compared with lean tissue.

BMR when muscle mass is lost

Decreases.

Basal Metabolic Rate (BMR)

Energy the body uses to maintain involuntary body functions.

Minimum healthy calorie intake

1200 kcal/day.

Anorexia nervosa

Eating disorder characterized by self starvation.

Common behaviors in anorexia nervosa

Starvation, compulsive exercise, and purging.

Bulimia nervosa

Binge eating followed by purging, fasting, excessive exercise, or diet pill use.

Clinical symptoms of bulimia

Teeth erosion, swollen parotid glands, calloused knuckles, broken blood vessels, stomach lacerations, and infections from vomiting.

Electrolyte imbalances can cause

Muscle weakness, cramps, dysrhythmias, cardiac complications, and sudden death.

Binge eating disorder

Compulsive eating with large amounts of food consumed in a short period.

Carbohydrate modified diets are most often used for

Diabetes mellitus.

Type 1 diabetes

Disease in which the body produces no insulin.

Type 2 diabetes

Metabolic disorder caused by inability to properly use or make enough insulin.

Diabetic patients should consume

Fiber containing foods and limit fat intake.

Type 1 diabetics should balance

Carbohydrate intake with insulin administration and exercise.

Goals of nutrition therapy for type 2 diabetes

Maintain healthy weight, cholesterol levels, and blood glucose levels.

Exchange list

Foods grouped by carbohydrate, protein, and fat content for meal planning.

Dumping syndrome

Rapid emptying of stomach contents into the small intestine.

Symptoms of dumping syndrome

Nausea, cramping, diarrhea, sweating, light

Diet therapy for dumping syndrome

Small frequent meals high in protein and fat but low in carbohydrates; avoid concentrated sweets and drink fluids between meals.

Lactose intolerance

Inability to digest lactose because of low lactase enzyme.

Low fat diet

Diet low in total fat, saturated fat, and trans fats.

Low fat diets help prevent and treat

Atherosclerosis, heart disease, and hyperlipidemia.

Saturated and trans fats should be replaced with

Unsaturated fats.

Fat controlled diet

Restricts fat intake to about 25 g/day depending on symptoms.

Fat controlled diet is used for

Diarrhea, steatorrhea, flatulence, hepatobiliary disease, pancreatic disease, and malabsorption syndromes.

Metabolic syndrome

Group of risk factors increasing risk for heart disease, stroke, and type 2 diabetes.

Risk factors for metabolic syndrome

Abdominal obesity, dyslipidemia, hypertension, and insulin resistance.

Goal of treatment for metabolic syndrome

Reduce risk of heart disease and diabetes.

Protein intake during healing

Increased.

Protein intake should be reduced in

Disorders of protein metabolism or excretion.

Conditions requiring protein restriction

Chronic renal failure and cirrhosis.

Complete proteins are found in

Eggs, meat, poultry, fish, and milk products.

Incomplete proteins are found in

Plant products such as beans and whole grains.

Sodium restricted diets are used for

Hypertension and heart failure.

Sodium restriction may also be needed for

Edema, myocardial infarction, cirrhosis, and chronic renal failure.

Sodium restricted diets may allow

About 2000 mg/day to as little as 500 mg/day.

Increased potassium intake may help with

Blood pressure control.

Potassium during renal failure

Retained in the body.

Potassium may need to be restricted to

2000 mg/day in renal disease.

Excess potassium can lead to

Dysrhythmias and sudden cardiac arrest.

Adults usually need

2 to 3 liters of water daily.

Fluid restriction in renal disease

About 500 to 750 mL/day.

Fluid restrictions are also common in

Congestive heart failure, myocardial infarction, hepatic coma, and ascites.

Increased fluid intake is used to treat

Renal calculi and urinary tract infections.

Fluid needs increase during

Diarrhea, vomiting, and malabsorption.

Tube feeding

Administration of liquefied nutrition through a tube into the stomach or intestines.

Enteral nutrition

Delivery of nutrients into the GI tract.

Tube feedings are used when

All or part of the GI tract is functioning.

Tube feedings may be given through

NG tube, nasojejunal tube, nasoduodenal tube, or feeding ostomy.

Nasojejunal or nasoduodenal tubes are used when

Gastric residuals are high or regurgitation occurs to reduce aspiration risk.

Feeding ostomies

Used for long

Continuous tube feedings are administered through

A continuous drip pump over 16–24 hours.

Intermittent feedings are given over

20–30 minutes, 4–6 times daily.

Distention, diarrhea, and nausea may indicate

Formula rate, volume, or strength is too high.

Most dependable way to verify NG tube placement

Radiologic confirmation (x

Parenteral nutrition

Intravenous nutrition through peripheral or central veins.

Peripheral parenteral nutrition (PPN)

Parenteral nutrition through peripheral veins.

TPN and PPN formulas contain

Glucose, amino acids, vitamins, minerals, electrolytes, and sometimes fats.

Parenteral nutrition is indicated for

Nonfunctioning GI tract, short term therapy, or patients needing nutritional supplementation.

Total parenteral nutrition (TPN)

Hypertonic solution administered through a central vein.

First choice for IV nutrition

PPN if appropriate.

TPN is indicated for

Patients needing highly concentrated formulas.

Normal gastric pH

0–4.

Normal lung pH

Greater than 5.

Normal intestinal pH

Greater than 7.

Gastric residual greater than 150 mL indicates

Delayed gastric emptying.

Fecal impaction

Hard stool mass stuck in the rectum.

Constipation

Hard, slow stools difficult to eliminate, often due to low fiber.

Most common eating disorders

Anorexia nervosa, bulimia nervosa, and binge eating disorder.

Symptoms of hypoglycemia

Confusion, shakiness, diaphoresis, fatigue, headache, palpitations, and poor coordination.

Symptoms of hyperglycemia

Polyuria, fruity breath, and headaches.

Long acting insulin examples

Lantus and Levemir.

Long acting insulin onset

2–4 hours.

Long acting insulin peak

No peak.

Long acting insulin duration

Up to 24 hours.

Best time to administer long acting insulin

Evening or bedtime at the same time daily.

Nursing interventions to prevent dumping syndrome

Sit upright after meals, avoid late meals, and eat small frequent meals.

Creatinine measures

Kidney function.

Common causes of cirrhosis

Alcohol abuse and excess fat.

Low protein diets are used for

Kidney failure.

High sodium foods

Canned foods, frozen foods, chips, crackers, seafood, and processed foods.

Swollen hands and feet

Peripheral edema.

Pulmonary edema is commonly caused by

Left sided heart failure.

Treatment commonly prescribed for edema

Diuretics such as Lasix.

Position for enteral feedings

Head of bed elevated 30–45 degrees.