Nursing: Fluid and Electrolytes Nutrition

macronutrients

supply energy and build tissue such as carbs, fats, proteins

micronutrients

regulate body processes such as vitamins, minerals, and water

energy

measured as kilocalories (cal.)

1cal/kg/hr

basal metabolic rate (BMR) equation

basal metabolic rate (BMR)

increased with growth, fever, infection, stress

basal metabolism

amount required to maintain cell/tissue function, fluctuates for many reasons such as pregnancy and sickness (it goes up when your sick)

sleep, aging, fasting

what decreases basal metabolism

1-2%

what signifies significant weight loss in 1 week

5%

what signifies significant weight loss in 1 month

7.5%

what signifies significant weight loss in 3 months

10%

what signifies significant weight loss in 6 months

carbohydrates

are converted to glucose, primary source of energy, primarily from plant sources except for lactose

from GI tract through portal vein to liver

how are carbohydrates converted to glucose

protein

building blocks of body tissue in maintenance, growth, and repair; 10-20% of daily caloric needs; physiologically and financially expensive

albumin

the main protein in plasma, binds water, cations, fatty acids, hormones, bilirubin and drugs

main function of albumin

to regulate colloidal osmotic pressure of blood (regulates blood pressure)

signs or manifestations of low albumin

liver disease, burns, malnutrition, often presents with edema and third spacing

nutritional status

improving albumin levels often coincide with overall improvement

fats/lipids

most calorie-dense nutrient, insoluble in water/blood. 95% are triglycerides, should be 20-35% of total calories

hydrogen

saturation of fat is base on the amount of what

saturated fats

animal fats (butter, cheese, lard, etc), solid at room temp, raise cholesterol

unsaturated fats

vegetable fats, oil, nuts, avocado, and fish, liquid at room temp, lowers cholesterol

trans fats/hydrogenated liquid fat

raises serum cholesterol, man made

cholesterol

only in animal products, essential nutrient, coats brain/nerve cells for protection

vitamins

organic compounds needed in small amounts, fresh foods have higher amounts, essential nutrients

vitamins

does not provide energy, but are necessary for metabolism of carbs, proteins, and fats

water soluble vitamins

absorbed directly through the intestinal wall and are not stored, C and B complex

vitamin B

kick starts your metabolism, gives you energy have to help it to make red blood cells, found in dark leafy vegetables

vitamin C

found in oranges, fruits, potatoes, red and green chili peppers, guava, herbs and dark leafy vegetables

fat soluble vitamins

(A, D, E, K) absorbed with fat into lymphatic circulation, excess stored in liver/adipose tissue, are received from dietary intake except for D

vitamin K

blood clotting, given to babies (they are not born with this), found in bananas, dark green leafy vegetables, scallions, herbs

vitamin E

skin, hair, and nails burn patients, heart patients (heart disease), age related eye damage, cancer; found in green leafy vegetables and nuts especially sunflower seeds

vitamin D

absorbs calcium, helps with bone development, and alleviates inflammation, control of cell growth; found in the sun, fortified milk, mushrooms, fortified cereals. oysters and fish

vitamin A

vision and skin, have to have it for a good immune system, carrots, red and orange vegetables, liver, green leafy vegetables, sweet potatoes

macrominerals

Calcium, Phosphorus, Sulfur, Sodium, Chloride, Potassium, Magnesium

minerals

inorganic elements found in all body fluids; provide structure and regulate body processes

>100mg/day

macromineral need

micromineral need

microminerals

Iron, Zinc, Manganese, Chromium, Copper, Selenium, Fluoride, Iodine, trace elements: arsenic, boron, nickel, silicon, etc.

foods with low sodium

whole wheat bread, white bread, whole milk, chicken (light meat), plain baked potato, fresh vegetables EXCEPT for tomatos

foods high in sodium

table salt, soy sauce, cured pork, most cheeses, cottage cheese, processed meat

foods with high K+

raw codfish, pink salmon, tuna fish, banana, cantaloupe, raisins, avocado, tomatoes, salt substitue

foods low in K+

raw unskinned apple, cooked oatmeal, corn flakes, egg, american cheese, white bread, asparagus, cucumber, corn, lettuce, and onions

foods high in Ca++

low fat yogurt, Tums EX, skim milk, rhubarb, tofu

foods low in Ca++

raw broccoli, carrots, green beans, cottage cheese, spinach

foods high in phosphorus

white, canned, tunafish, beef liver, fresh pork, low fat yogurt, whole milk, skim milk

food low in phosphorus

eggs, raisins, white bread

green leafy vegetables, nuts, legumes, seafood, whole grains, oranges, cocoa, and chocolate

sources of magnesium in the diet

foods high in magnesium

raw spinach, avocado, almonds, sunflower and pumpkin seeds, MAALOX (antacid)

foods low in magnesium

cottage cheese, juices, oranges, tomato soup

dietary factors concerning alcoholics

nutrient deficiency (esp. vitamin B), impaired storage, increased catabolism and excretion

decreased drug absorption with milk

adverse effects of trtracyclines, cipro concerning food

green leafy vegetables

what should not be eaten with coumadin and vitamin K antagonist

clear liquid diet

made up of liquids clear at room/body temperature, maintain vital body fluids, salts, and minerals but is not adequate in calories and nutrients, often only transitional

full liquid diet

consists of both clear and opaque liquid foods with a smooth consistency, transitional, includes high calorie/protein supplements if full liquid for >3 days

pureed

foods of a smooth, soft "mashed potato" consistency that requires no chewing, usually blenderized

soft diet

transition from liquids to a regular diet,eases chewing/swallowing difficulties from dental surgery, weakness, chemo; high fiber, gas forming, fried, greasy foods may be restricted to ease digestion

mechanical soft

household tools and machines are used to make foods easier to swallow and chew; does not restrict fat, fiber, spices or seasonings; appropriate for recovering head/neck/oral surgery, or dysphagia; not as "blenderized" as pureed

enteral nutrition/feedings

reduced risk of sepsis, maintains intestinal function; continuous vs. intermittent; water is not received unless specifically given

aspiration

irritation of bronchial mucosa; decreased bronchial blood supply; pneumonia; ARDS (adult respiratory distress syndrome and worse than pneumonia); possible death.

parenteral nutrition

promotes tissue, wound, and bowel healing and is a highly concentrated/hypertonic solution

TPN

total parenteral nutrition, NOT peripheral line but central, for long term

PPN

peripheral paretneral nutrition, NOT central line but peripheral, for short term