Nutrition

A client has unintentional weight gain or loss. What does this suggest?

A possible warning sign of an underlying health problem; the cause must be investigated.

Why is nutrition important for a client's recovery?

Food is the body's fuel and building material; a client who is not eating well heals slower, gets more infections, and feels worse overall.

What balance explains weight gain or weight loss?

The balance between calories eaten (intake) and energy burned (expenditure).

Which nutrition findings should the nurse recognize?

The signs (findings) that show whether a client's nutrition is good or poor.

In general, what is the PN's role compared with the RN's in nutrition care?

The PN gathers data and reports to the RN or provider, usually under RN supervision; the RN does the full assessment and the plan of care.

Scope of practice

The list of things a nurse (RN or PN) is legally allowed to do; PN scope also varies by state.

Calories eaten are greater than energy expended. What happens?

Extra energy is stored: weight gain.

Calories eaten are less than energy expended. What happens?

The body uses its stored energy: weight loss.

Calories eaten equal energy expended. What happens?

Weight stays the same.

Calorie

The energy stored in food; the body needs it for everything (walking, breathing, running).

Energy expenditure includes what activities?

Breathing, walking, healing, exercising (all the ways the body uses energy).

Digestion

The body breaking food down into simple substances that are either absorbed into the blood as nutrients or eliminated as waste.

Is digestion voluntary or involuntary?

Involuntary; it happens automatically.

Where does digestion begin?

In the mouth, where saliva begins breaking food down.

Peristalsis

Involuntary, wave-like muscle contractions that push food through the digestive tract.

List the organs food passes through, in order.

Mouth, esophagus, stomach, small intestine, large intestine, rectum, anus.

Memory trick for the food path (mouth to anus)

"My Elephant Swallowed Some Large Rocks Anyway": Mouth, Esophagus, Stomach, Small intestine, Large intestine, Rectum, Anus.

What is the function of the esophagus?

A hollow tube in the neck and chest that moves food from the mouth to the stomach.

What is the function of the stomach?

Holds food and digests it using acids and enzymes.

What are the two main functions of the liver?

Filters toxins from the blood and makes bile (which helps break down carbohydrates, proteins, and fats).

What does the gallbladder do?

Stores bile from the liver and releases it when needed.

Which organ makes insulin, and what does insulin do?

The pancreas;

insulin is a hormone that controls how the body uses sugar.

Where are MOST nutrients absorbed into the blood?

The small intestine.

What does the large intestine do?

Removes water and electrolytes from leftover food and turns the rest into feces; contains billions of helpful bacteria.

Rectum

The storage area for feces at the end of the large intestine.

Anus

The external opening where feces leave the body.

Which digestive organs are "helper" organs that food does NOT pass through?

The liver, gallbladder, and pancreas (they send in bile and enzymes).

Which organ makes bile?

The liver.

Which organ stores bile?

The gallbladder.

NCLEX: Which structure absorbs most nutrients: stomach, small intestine, or large intestine?

Small intestine.

NCLEX: Which structure absorbs water and electrolytes and forms stool?

Large intestine.

List the common digestive problems the nurse should assess for.

Diarrhea, constipation, nausea, vomiting, abdominal pain, gas, and bloating (signs the digestive system may not be working normally).

What three things does healthy eating involve?

A balanced diet every day, watching calories, and getting enough of each nutrient.

Which foods provide the best calories?

Fresh fruits and vegetables, legumes (beans/lentils), whole grains, and lean proteins.

Why should a healthy diet fit a client's tastes, lifestyle, and budget?

If it doesn't, the client won't stick with it.

List the 5 basics of a healthy diet.

Eat fruits and vegetables; choose whole grains; limit unhealthy fats; eat more low-fat proteins; reduce salt.

Eating habits are linked to which diseases?

Heart disease, type 2 diabetes, and 13 types of cancer.

USDA daily MyPlate amount for FRUIT (adult)

2 cups

USDA daily MyPlate amount for VEGETABLES (adult)

2 1/2 cups

USDA daily MyPlate amount for GRAINS (adult)

6 oz

USDA daily MyPlate amount for PROTEIN (adult)

5 1/2 oz

USDA daily MyPlate amount for DAIRY (adult)

3 cups

MyPlate

The USDA's picture of a plate divided into food groups; a simple visual reminder of what and how much to eat.

Why do whole grains, fruits, and vegetables help control weight?

They have bulk and fiber; fiber makes you feel full so you eat fewer calories.

What is a healthy rate of weight loss?

1 to 2 lb per week.

Weight loss requires which changes?

Diet changes, lifestyle changes, AND exercise.

How much body weight loss improves blood pressure, blood sugar, and cholesterol?

5% to 10% of body weight.

A client has unintentional weight loss. What should the nurse do?

Find the cause; the client could have an undiagnosed health problem.

What should healthy weight gain aim to increase?

Muscle or bone mass, using nutrient-rich foods instead of empty calories.

How quickly should weight gain occur?

Slowly and steadily, to avoid complications.

Give reasons a client might want to gain weight.

They lost weight unintentionally, an illness caused weight loss, or they want more muscle.

NCLEX: Does unintentional weight GAIN need to be investigated?

Yes. Any unintentional weight change (gain or loss) needs investigation for an underlying health problem.

What three factors determine how much of a nutrient a person needs?

Age, sex (gender), and activity level.

Sedentary

Mostly sitting/inactive.

Why do active people need more calories?

They burn more energy.

Why do males generally need more calories than females?

They tend to have more muscle.

Big-picture pattern of calorie needs

Active > sedentary; males > females; needs drop with older age.

Daily calories: 2-year-old (male or female)

1,000 (sedentary and active)

Daily calories: 3-5 years old

Sedentary 1,200; active 1,400-1,600

Daily calories: 6-8 years, male

Sedentary 1,400; active 1,600-2,000

Daily calories: 6-8 years, female

Sedentary 1,200-1,400; active 1,400-1,800

Daily calories: 9-12 years, male

Sedentary 1,600-1,800; active 1,800-2,400

Daily calories: 9-12 years, female

Sedentary 1,400-1,600; active 1,600-2,200

Daily calories: 13-18 years, male

Sedentary 2,000-2,400; active 2,200-3,200

Daily calories: 13-18 years, female

Sedentary 1,600-1,800; active 2,000-2,400

Daily calories: 19-20 years, male

Sedentary listed as 1,600 in the book (likely a typo; USDA is about 2,600);

active 2,800-3,000

Daily calories: 19-20 years, female

Sedentary 2,000; active 2,200-2,400

Daily calories: 21-40 years, male

Sedentary 2,400; active 2,600-3,000

Daily calories: 21-40 years, female

Sedentary 1,800-2,000; active 2,000-2,400

Daily calories: 41-60 years, male

Sedentary 2,200; active 2,400-2,600

Daily calories: 41-60 years, female

Sedentary 1,600-1,800; active 1,800-2,200

Daily calories: 60+ years, male

Sedentary 2,000; active 2,200-2,600

Daily calories: 60+ years, female

Sedentary 1,600; active 1,800-2,000

Macronutrients

Protein, carbohydrates, and fat; needed in large amounts; provide energy and are the main building blocks of the diet.

Micronutrients

Vitamins and minerals; needed in small amounts; support growth, development, and body function.

Which nutrients are macronutrients: protein, carbohydrates, fat, vitamins, minerals?

Protein, carbohydrates, and fat.

What is the major building block of the body?

Protein.

What does protein provide, and what does the body use it for?

Amino acids, used to build, repair, and maintain tissues (like muscle).

How much protein does a person need per day?

About 2 to 6 1/2 oz per day, depending on activity, age, and sex (very active people need more).

Good sources of protein

• Beans,

• soy,

• nuts,

• meats,

• eggs,

• fish.

Protein supplements should do what?

Add to (supplement) a good diet, not replace it.

Why might a client receiving chemotherapy or radiation be given protein drinks?

They may be unable to get enough protein through food because of illness.

Which clients need adequate protein for healing?

Any client with a wound, surgery, or illness that breaks down tissue.

Endurance athletes (events over 1 hour, or in heat or high altitude) may need extra of what?

Fluids, electrolytes, and carbohydrates.

What is the body's primary fuel source?

Carbohydrates (turned into glucose for cells, organs, and tissues).

What percentage of daily calories should come from carbohydrates?

45% to 65%.

Natural sources of carbohydrates

Vegetables, fruits, milk, nuts, grains, legumes, seeds.

Which carbs are better: healthy carbs or foods with added sugars and refined grains (white flour)?

Healthy carbs.

Simple carbohydrates (sugars)

The simplest form of carbohydrate: fructose, sucrose, lactose.

Fructose

Fruit sugar.

Sucrose

Table sugar.

Lactose

Milk sugar.

Memory trick for sugar names

"-ose" = sugar. Fructose = fruit; lactose = lactation (milk); sucrose = sucker/table sugar.

Complex carbohydrates

Starch (vegetables, grains, beans) and fiber (fruits, vegetables, beans, whole grains); take longer to break down.

Glycemic index (GI)

How fast a carbohydrate-containing food raises blood sugar.

High glycemic index foods

Raise blood sugar quickly (spike then crash, sluggish); examples: potatoes, white bread, processed snack foods.

Low glycemic index foods

Raise blood sugar slowly with no spike (steady energy); examples: legumes, vegetables, fruits, whole grains.

What are the functions of fat?

Gives energy and helps the body absorb vitamins (especially A, D, E, K); plays a big role in cholesterol levels.

Which type of fat is the WORST and should be avoided?

Trans fat (partially hydrogenated oils).

Where is trans fat found?

Processed foods: crackers, pastries, cookies, pizza dough.