HOSA - Medical Nutrition Therapy (Clients with Special Needs)

what happens during physical stress

Body signals endocrine system, activates self protective hypermetabolic (higher than normal metabolism) response; increases energy output

why does body need sufficient nutrients, fluids and calories asap after trauma

replace losses, build and repair tissue and return body to homeostasis

presurgery nutritional care

extra protein, carbs, vits and minerals

protein for

wound healing and tissue building

carbs for

energy after surgery

b vits for

increased metabolism

vit a and c and zinc for

wound healing

vit d for

calcium absorption

vit k for

proper blood clotting

iron for

blood building

calcium and phosphorus for

bones

other minerals for

maintenance of acid, fluid and electrolyte balance

diet after midnight the night before surgery

npo (nothing by mouth)

why is food withheld before surgery

so stomach has no food that can be regurgitated and inhaled into lungs during surgery

post surgery nutritional care

first 24 hrs, intravenous only; from clear liquid diet to regular diet; food 1-4 days after surgery

adult estimated calorie requirement

35-45 calories/kg

max calories form intravenous solutions

400-500

peristalsis evidence

bowel sounds

dumping syndrome

nausea and diarrhea caused by food moving too quickly from stomach to small intestine; follows gastric surgery

diet to prevent dumping syndrome

restrict carbs because they leave stomach faster, limit fluids, dont overload stomach

enteral nutrition

feeding by tube directly into the clients digestive tract

tube feeding

feeding by tube directly into the stomach or intestine or via a vein

usually tube feeding for less than 6 weeks is administered through

nasogastric tube; tube leading from nose to stomach for tube feeding

tube feeding for more than 6 weeks

requires an opening (ostomy)

gastrostomy

opening in stomach

jejunostomy

opening in intestine

polymeric formulas

commercially prepared formulas for tube feedings that contain intact proteins, carbs and fats; REQUIRE DIGESTION

elemental or hydrolyzed formulas

contain products of digestion of proteins, carbs and fats; FOR CLIENTS W LIMITED ABILITY TO DIGEST OR ABSORB NUTRIENTS

modular formulas

customized; supplements to other formulas

intermittent tube feeding

tf at night; food at day

bolus tube feeding

parental nutrition

giving nutrients through veins if gi tract isnt working; tpn = total parental nutrition; dextrose amino acid fat solution; catheter is inserted into vein

phlebitis

inflammation of the vein

thrombosis

blockage; blood clot

sepsis

infection of the blood; caused by infection at the site of the catheter

burn client diet

fluid and electrolytes immediately; need way more energy (high protein high cal), liquid to solid

client w infection

More protein, minerals, calories, vits, fluids

Thrush

caused by high doses of antibiotics; year infection of mucous membranes lining the mouth and tongue

Opportunistic infections

Only affect people with unhealthy immune systems

HIV

Weakens immune system

Aids

Incurable; fatal

HIV nutrition problems

PEM and decreased appetite