Competency 7 — Nutrition & Oral Hydration

What are the six classes of nutrients?

Carbohydrates, proteins, lipids, vitamins, minerals, and water.

What is the body's primary fuel source?

Carbohydrates.

What percentage of daily calories should come from carbohydrates?

45%-65% of total daily calories.

What is the main function of protein?

Growth, tissue repair, healing, and body maintenance.

What are good sources of protein?

Beans, soy, nuts, meat, eggs, and fish.

What are the main functions of lipids (fats)?

Provide energy, help absorb vitamins, and support cell structures.

Which fats should be limited or avoided?

Saturated fats should be limited; trans fats should be avoided.

What are examples of healthier fats?

Monounsaturated fats from avocados, nuts, olives, and their oils.

What are vitamins?

Micronutrients that support body functions, health, and disease prevention.

Which vitamins are water-soluble?

Vitamin C and the B-complex vitamins.

Which vitamins are fat-soluble?

Vitamins A, D, E, and K.

Where are fat-soluble vitamins stored?

In the liver and fatty tissues.

What are minerals?

Nutrients that support functions such as hydration, metabolism, bones, and nerves.

What is the main role of iron?

Transports oxygen through hemoglobin in red blood cells.

What is the main role of calcium?

Supports bones, teeth, muscles, nerves, and blood clotting.

What is the main role of zinc?

Supports growth, immune function, and wound healing.

Why is water an essential nutrient?

It hydrates, removes waste, regulates temperature, and supports body systems.

What are the three macronutrients?

Carbohydrates, proteins, and fats.

What are the two main micronutrient groups?

Vitamins and minerals.

What is energy balance?

Matching calorie intake with the body's energy expenditure.

What is dietary intake?

The foods and beverages a person consumes.

What happens with positive energy balance?

Calories consumed exceed calories burned, promoting weight gain.

What happens with negative energy balance?

Calories burned exceed calories consumed, promoting weight loss.

What factors determine nutrient and calorie needs?

Age, sex, activity level, health status, and individual needs.

What factors can influence dietary patterns?

Age, health, income, housing, culture, beliefs, support, and food access.

Why should nurses consider culture when planning nutrition?

Culture and beliefs can influence foods a client chooses or avoids.

What is BMI used to assess?

Weight in relation to height and whether weight falls in a standard category.

What is the adult BMI formula using pounds and inches?

Weight (lb) ÷ height (in)² × 703.

What BMI is considered underweight?

Less than 18.5.

What BMI is considered normal or healthy?

18.5-24.9.

What BMI is considered overweight?

25-29.9.

What BMI is considered obese?

30 or greater.

What is one limitation of BMI?

It may misrepresent body fat, especially in muscular or very lean clients.

What is a 24-hour dietary recall?

A record of foods, amounts, and portions consumed during the previous 24 hours.

What findings can suggest inadequate nutrition?

Low weight, muscle loss, weakness, fatigue, dry skin, brittle hair, or frequent infections.

What does NPO mean?

Nothing by mouth—no food or fluids until the diet is advanced.

Why might a client be NPO before surgery?

To reduce aspiration risk while under sedation or anesthesia.

What is dysphagia?

Difficulty or inability to swallow safely.

What is aspiration?

Food, liquid, or other material accidentally entering the airway/lungs.

What should the nurse do if manifestations of aspiration occur?

Place the client NPO and notify the provider immediately.

What position helps prevent aspiration during oral meals?

Sit the client upright at about 90°.

Why are thickened liquids prescribed for dysphagia?

They move more slowly and can decrease aspiration risk.

What are the three examples of thickened-liquid consistencies?

Nectar-like, honey-like, and pudding-like.

What is a regular diet?

Healthy foods from all food groups without major restrictions.

What is a soft diet?

Soft, easy-to-digest, low-fiber foods that are easier to swallow.

Who may need a pureed diet?

Clients with difficulty chewing or swallowing or clients recovering from oral surgery.

What is a pureed diet?

Soft, smooth foods that require little or no chewing.

What is a full liquid diet?

Liquids and foods that become liquid at room temperature.

What are examples of foods allowed on a full liquid diet?

Milkshakes, pudding, strained soup, ice cream, juice, and gelatin.

What is a clear liquid diet?

Clear, easily digested liquids that leave little intestinal residue.

What are examples of clear liquids?

Water, broth, gelatin, tea, pulp-free juice, and sports drinks.

Why should a clear-liquid diet usually be short-term?

It provides limited calories and nutrients.

What should be avoided on a clear-liquid diet before colon procedures?

Red-colored liquids or gelatin because they can resemble blood.

What does a cardiac or heart-healthy diet emphasize?

Fruits, vegetables, whole grains, lean protein, and reduced sodium and unhealthy fats.

What does a renal diet commonly restrict?

Sodium, potassium, phosphorus, and sometimes protein or fluids.

Why may potassium be restricted in clients with kidney disease?

High potassium can cause dangerous cardiac dysrhythmias.

What is enteral nutrition?

Nutrition delivered through the GI tract, commonly through a feeding tube.

When is enteral nutrition appropriate?

When oral intake is inadequate but the GI tract can still be used.

Which is preferred when the GI tract is functioning: enteral or parenteral nutrition?

Enteral nutrition.

What are common enteral feeding routes?

NG, gastrostomy/PEG, jejunostomy, and other intestinal feeding tubes.

What is an NG tube?

A tube inserted through the nose and esophagus into the stomach.

Is an NG tube generally used for short-term or long-term nutritional support?

Short-term.

How is initial NG-tube placement verified before use?

By x-ray.

What is a PEG tube?

A gastrostomy tube placed endoscopically through the abdomen into the stomach.

When is a PEG tube useful?

When longer-term gastric nutrition is needed and oral intake is inadequate.

What position should a client be in during tube feeding?

Keep the head of the bed elevated 30°-45°.

What findings suggest tube-feeding intolerance?

Gastric distention, abdominal discomfort, nausea, vomiting, diarrhea, or reflux.

What is gastric residual?

Stomach contents withdrawn through a feeding tube to assess feeding tolerance.

What should the nurse do if feeding intolerance occurs?

Assess the client, measure gastric residual as indicated, and follow facility policy.

What findings can indicate tube-feeding aspiration?

Coughing, choking, gagging, throat clearing, or vomiting.

What should the nurse do if tube-feeding aspiration is suspected?

Stop the feeding and immediately notify the provider.

What is parenteral nutrition?

IV nutrition used when adequate nutrition cannot be absorbed or tolerated by the GI tract.

What nutrients can parenteral nutrition provide?

Protein, fats, carbohydrates, vitamins, minerals, and electrolytes.

What does TPN stand for?

Total parenteral nutrition.

What does TPN provide?

The client's total daily nutritional requirements intravenously.

What is the difference between TPN and PPN?

TPN provides total nutritional requirements; PPN provides only part of the client's nutritional requirements.

What important complication should be monitored for with TPN?

Blood glucose abnormalities, especially hyperglycemia.

What should nurses monitor when assessing nutritional status?

Weight, appetite, food/fluid intake, laboratory results, skin and hair, oral health, and GI symptoms.

What nursing diagnoses can be related to nutritional needs?

Imbalanced Nutrition: Less Than Body Requirements; Imbalanced Nutrition: More Than Body Requirements; Risk for Deficient Fluid Volume; Risk for Impaired Swallowing; and Risk for Impaired Skin Integrity.

How do nutritional needs generally change in older adults?

Older adults generally need fewer calories but continued adequate protein, calcium, and vitamin D to support muscle and bone health.