Ch. 39 Nutrition and Oral Hydration

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34 Terms

1
What role do nutrients play in the body?
  • Nutrients provide energy for cellular metabolism, tissue maintenance and repair,

  • Organ function, growth and development, and physical activity.

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2
Why is water considered a crucial nutrient?
  • Water is critical for all body fluid and cellular functions.

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3
What is the primary energy source for the body?
  • Carbohydrates provide most of the body’s energy.

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4
How many kcal does one gram of fat provide?
  • 1 gram of fat = 9 kcal.

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5
What are the fat-soluble vitamins?
  • A, D, E, and K.

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6
What age group has the highest energy requirements?
  • Newborns and infants.

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7

How much kcal/kg do infants need for the first 6 months?

  • 108 kcal/kg.

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8
<p>What are two characteristics of<strong><em> anorexia nervosa</em></strong>?</p>

What are two characteristics of anorexia nervosa?

  • Significantly low body weight and

  • Fear of being fat.

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9
<p>Describe <strong>bulimia nervosa.</strong></p>

Describe bulimia nervosa.

  • Binge eating followed by purging, such as vomiting or using diuretics.

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10
What is considered obese in terms of BMI?
  • BMI 30 or greater.

  • < 18.5 is considered underweight, while a

  • BMI 25 to 29.9 is classified as overweight.

  • Normal BMI is between 18.5 and 24.9.

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11
What factors can diminish appetite?
  • Illness, medications, pain, depression, and unpleasant environmental stimuli.

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12
What dietary change is important for older adults to prevent dehydration?
  • Increased fluid intake.

Rationale: Older adults have a decreased sense of thirst, which can lead to dehydration.

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13
What is nutrient density and why is it important for toddlers and preschoolers?
  • Nutrient density is more important than quantity for their growth and development.

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14
What should a nutritional assessment help identify?
  • Areas to modify in nutrient intake or caloric intake.

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15

Which type of diet should a client with dysphagia expect?

  • A pureed diet with thickened liquids.

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16
What are symptoms of poor nutrition?
  • Nausea, vomiting, diarrhea, change in weight, and weakness.

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17
What is the recommended action when caring for a client at high risk for aspiration?
  • Instruct the client to tuck their chin when swallowing.

  • Do NOT use a straw.

  • Give Pureed foods and thickened liquids to help prevent aspiration.

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18
What is the proper procedure for monitoring fluid intake and output?
  • Measure and calculate all fluid intake and output in mL.

  • Daily weights

  • Daily I&O

  • 1 kg = 1 L of fluid.

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19
What dietary considerations should be made for adolescents?
  • High protein, calcium, iron, and iodine needs due to high metabolic demands.

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20

Which of the following options are necessary for metabolism?

  • Proteins

  • Fats

  • Carbs

  • Vitamins

  • Vitamins: essential nutrients that aid in metabolic processes and overall health.

  • Fat-soluble vitamins are A, D, E, and K. The water-soluble vitamins include C and the B complex (eight vitamins). QEBP

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21
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22

Solid foods in infants can be introduced at which age?

  • Solid foods can be started at 6 months of age.

  • Single-grain cereals like rice or oatmeal.

  • Introduce one new food at a time and monitor for allergic reactions.

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23

Nutrient density vs quantity in toddlers (1 to 3 yrs) and pre-schoolers (3 to 6 yrs)?

  • Nutrient density is more important than quantity.

  • Calcium and phosphorus are important for bone health.

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24

Important nutritional aspects in School-age children (6 to 12 yrs) include:

  • They grow at a slower & steadier rate, w/ a gradual decline in energy requirements.

  • Tend to eat foods high in carbohydrates, fats, and salt.

  • Need supervision to consume adequate protein and vitamins C and A.

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25

Factors affecting nutrition in Adolescents (12- 20 yrs) include:

  • Body image and appearance, fast foods, peer pressure, and fad diets influence adolescents’ diets.

  • Metabolic demands are high and require more energy.

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26

Factors affecting nutrition in Older Adults (65+) include:

  • A slower metabolic rate requires fewer calories.

  • Thirst sensations diminish, increasing the risk for dehydration.

  • Older adults need the same amount of most vitamins and minerals as younger adults.

  • Calcium is important for both men and women.

  • Many older adults require carbohydrates that provide fiber and bulk to enhance gastrointestinal function.

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27

A nurse in a senior center is counseling a group of older adults about their nutritional needs and considerations. Which of the following information should the nurse include?

  • Recommended intake of daily fiber decreases due to their lower caloric intake.

  • Older adults are more prone to dehydration than younger adults.

  • Many older adults need calcium and supplementation (to prevent bone demineralization).

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28

Fluid Intake and Output (I&O) measurements include:

  • Fluid intake includes ALL liquids (oral fluids, foods that liquefy at room temperature, IV fluids, IV flushes, IV medications, enteral feedings, fluid instillations, catheter irrigants, tube irrigants).

  • Fluid output includes all liquids (urine, blood, emesis, diarrhea, tube drainage, wound drainage, fistula drainage).

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29

Expected Findings of Poor Nutrition include:

  • Nausea, vomiting, diarrhea, and constipation

  • Flaccid muscles

  • Mental status changes

  • Loss of appetite

  • Change in bowel pattern

  • Spleen and liver enlargement

  • Dry, brittle hair and nails

  • Loss of subcutaneous fat

  • Dry, scaly skin

  • Inflammation and bleeding of gums

  • Poor dental health

  • Dry, dull eyes

  • Enlarged thyroid

  • Prominent protrusions in bony areas

  • Weakness and fatigue

  • Change in weight

  • Poor posture

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30

Nursing interventions for patients with dysphagia or at risk of aspiration include?

  • Position in high Fowler’s position or in a chair.

  • Support the upper back, neck, and head.

  • Have clients tuck their chins when swallowing to help propel food down the esophagus.

  • Avoid the use of a straw.

  • Observe for aspiration and pocketing of food in the cheeks or other areas of the mouth.

  • Observe for indications of dysphagia (coughing, choking, gagging, and drooling of food).

  • Keep clients in semi-Fowler’s position for at least 1 hr after meals.

  • Provide oral hygiene after meals and snacks.

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31

Types of therapeutic diets include:

  • NPO (nil per os): no food or fluid at all by mouth, not even ice chips, requiring a provider’s prescription before resuming oral intake

  • Clear liquid: liquids that leave little residue (clear fruit juices, gelatin, broth); can see through the glass/container.

  • Full liquid: clear liquids plus liquid dairy products and all juices. Some facilities include pureed vegetables in a full liquid diet.

  • Pureed: clear and full liquids plus pureed meats, fruits, and scrambled eggs

  • Mechanical soft: clear and full liquids plus diced or ground foods

  • Soft/low-residue: foods that are low in fiber and easy to digest (dairy products, eggs, ripe bananas)

  • High-fiber: whole grains, raw and dried fruits

  • Low sodium: no added salt, or 1 to 2 g sodium

  • Low cholesterol: no more than 300 mg/day of dietary cholesterol

  • Diabetic: balanced intake of protein, fats, and carbohydrates of about 1,800 calories

  • Dysphagia: pureed food and thickened liquids

  • Regular: no restrictions

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32

For patients with a orders to “restrict oral fluid intake,” what should the nurse do to maintain strict I&Os?

  • Remove water pitcher from bedside.

  • Inform dietary staff of the amount of fluid to serve with each meal tray.​​​​​​​

  • Inform staff of each shift of the amount of fluid clients may have in addition to what they receive with each meal tray.

  • Record all oral intake, and inform the family of the restriction.

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33

Examples of foods high in fiber (whole foods) include:

  • Cooked barley (barely & oats)

  • Pureed broccoli (broccoli and cabbage in coleslaw)

  • Lentil soup (lentils and black beans)

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34
<p>Examples of low-residue diets (low fiber) include:</p>

Examples of low-residue diets (low fiber) include:

  • Vanilla custards, yogurt

  • Dairy products

  • white rice, bananas, cooked carrots, eggs, and tender meats.

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