Larson Nutrition student

Unit 8 Nutrition

Instructor: Christy Larson MSN, RN

Daily Dietary Intake Recommendations

Fruits: 2 cups
Vegetables: 2 ½ cups
Grains: 6 oz
Proteins: 5 ½ oz
Dairy: 3 cups

Nutrients Overview

Macronutrients

Milk
Carbohydrates- provide most body’s energy and fiber
Proteins- contribute to the growth, maintenance and body repair
Fats- provide energy and vitamins. main source of calories, absorb vitamins
Vitamins- necessary for metabolism
- Fat soluble- A D E
- water soluble- C B
Minerals- biochemical reactions in the body ( calcium, potassium, sodium, iron)
Water- critical for cell function and replaces fluids the body loses thru perspiration, respiration, elimination and other metabolic processes.

Vitamins and Minerals

Micronutrients

Water Soluble Vitamins
- Vitamin C
- B1 (Thiamin)
- B2 (Riboflavin)
- B3 (Niacin)
- B5 (Pantothenic Acid)
- B6 (Pyridoxine)
- B7 (Biotin)
- B9 (Folate)
- B12 (Cobalamin)
Fat Soluble Vitamins
- Vitamin A
- Vitamin D
- Vitamin E
- Vitamin K

Minerals

Major Minerals
- Calcium
- Chloride
- Magnesium
- Phosphorus
- Potassium
- Sodium
- Sulfur
Trace Minerals
- Chromium
- Copper
- Fluoride
- Iodine
- Manganese
- Molybdenum
- Selenium
- Zinc
Omega-3 Fatty Acid
- memory function

Importance of Water

Water: A vital nutrient essential for various body functions
- more than half your total body weight
- , water plays a crucial role in maintaining memory function and cognitive performance, as it aids in the transportation of nutrients to the brain and helps regulate temperature.
- Additionally, adequate hydration can improve mood and reduce feelings of fatigue, making it essential for overall well-being.
- weight management, lubricant

Nutritional Status Assessment

Body Mass Index (BMI) Calculation
- Example: A client who is 5 feet 4 inches (64 total inches) and weighs 170 lb
  1. BMI Calculation:
  - 170 lb/64 in = 2.6562
  - 2.6562/64 in = 0.0415
  - 703 × 0.0415 = 29.17 (BMI)

Additional Assessments for Nutritional Status

Physical Appearance
Laboratory Tests
Vital Signs
Weight and BMI
Elimination Patterns
Daily Intake History
Digestive Issues
Sedentary Activity Level
Medications

Therapeutic Diets Overview

NPO (Nothing by mouth)
Regular Diet: All foods as tolerated, no restrictions
Soft Diet: Soft foods that are easy to swallow
Pureed Diet: Foods that don’t require chewing; liquid consistency
Full Liquid Diet: Liquid at room temperature
Clear Liquid Diet: Only clear liquids permitted

Aspiration and Dysphagia

Causes of Dysphagia

Stroke
Acid reflux
Mouth sores
Dental issues
Improper enteral feeding

Complications of Dysphagia

Choking
Airway obstruction
Respiratory distress
Pneumonia
Possible death

Tube Feeding

Nasogastric Tube

Indications:
- Provides nutrition
- Administers medication
- Removes substances
- Decompression
Short-Term Use Method
Placement: Through the esophagus into the stomach
measure from tip of nose, to earlobe, then to the xiphoid process

Gastrostomy Tube

Purpose: Delivers nutrition directly into the stomach
Methods for Placement:
- PEG (Percutaneous Endoscopic Gastrostomy)
- Laparoscopic
- Open surgery
Long-Term Use functionality

Parenteral Nutrition

Administration: Given
- via (TPN) Central Line for long-term;
- via (PPN) Peripheral IV for short-term

Components of Parenteral Nutrition

Nutrients
- Vitamins
- Electrolytes
- Proteins
- Minerals
- Fats
- Carbohydrates

Study Guide: Nutrition and Caloric Intake in Nursing

Key Concepts:

Caloric Intake and Energy Expenditure:
- Balance: The balance between caloric intake (food and drinks consumed) and energy expenditure (calories burned through activities and metabolism) determines whether a person gains, loses, or maintains weight.
- Weight Loss: Occurs when caloric expenditure exceeds intake.
- Weight Gain: Occurs when caloric intake exceeds expenditure.
Physiology of Digestion:
- Digestive Process: The breakdown of food into smaller components for absorption by the body (carbs, proteins, fats, vitamins, and minerals).
- Absorption: Nutrients are absorbed primarily in the small intestine, then distributed to cells for energy or stored for later use.
Healthy Eating Patterns:
- Balanced Diet: Includes a variety of foods in the right proportions, ensuring a sufficient intake of all essential nutrients (macronutrients and micronutrients).
- Food Groups: Focus on fruits, vegetables, whole grains, proteins, and dairy.
- Portion Control: Helps to maintain energy balance and avoid overeating.
Nutritional Value of Food:
- Macronutrients: Carbohydrates, proteins, and fats provide energy.
- Micronutrients: Vitamins and minerals play critical roles in metabolism, immune function, and bone health.
- Fiber: Essential for digestive health and maintaining healthy blood sugar levels.
Understanding Food Labels:
- Nutrition Facts: Important for assessing the caloric content, serving sizes, macronutrient distribution, and micronutrient content of packaged food.
- Ingredients List: Helps identify unhealthy additives, preservatives, or excessive sugar, sodium, or fats.
- Serving Size: Essential for managing caloric intake; the serving size influences the nutritional values listed.
Role of Nurses in Nutritional Intake:
- Identifying Nutritional Adequacy: Nurses must assess client diets to ensure they are getting enough nutrients (e.g., protein, vitamins, minerals) or identifying deficiencies.
- Nutritional Education: Nurses help educate clients about the importance of healthy eating and interpreting food labels for better food choices.
- Monitoring Progress: Tracking weight changes, laboratory values (like albumin levels), and the client's general health to adjust nutrition plans.
Promoting Adherence to Prescribed Diets:
- Avoiding Complications: Ensuring clients follow prescribed diets reduces risk of complications like aspiration, malnutrition, and obesity.
- Personalized Plans: Diets should be tailored to individual needs, such as for diabetes, hypertension, or malnourishment.
Assisting with Eating and Feeding:
- Support: Providing assistance with feeding when clients cannot feed themselves helps maintain caloric intake.
- Quality of Life: Encouraging social interactions during meals and creating a positive mealtime environment improves the overall well-being of clients.
- Adaptive Tools: Use of feeding aids for clients with limited mobility or dexterity issues.
Enteral and Parenteral Nutrition:
- Enteral Nutrition: Administering nutrition through feeding tubes (e.g., nasogastric or gastrostomy tube) when clients cannot eat orally but have a functional digestive system.
- Parenteral Nutrition: Administering nutrition intravenously for clients who cannot digest food through their gastrointestinal tract.
- Scope of Practice: Nurses are responsible for the administration and monitoring of enteral and parenteral nutrition within their scope of practice, ensuring clients get the necessary nutrients and supplements for recovery.

Tips for Nurses:

Regular Nutritional Assessments: Continuously monitor clients’ eating habits and weight to identify any nutritional issues early.
Educate Clients: Offer advice on making healthier food choices and understanding food labels to make informed decisions.
Promote Hydration: Encourage proper fluid intake, especially for clients with medical conditions that affect fluid balance.
Collaborate with Dietitians: Work together with dietitians to create personalized meal plans and monitor clients' progress.
Monitor for Complications: Be aware of signs of malnutrition, dehydration, and other complications that might arise from poor nutritional intake.

Review Questions:

What is the relationship between caloric intake and energy expenditure in weight management?
How can a nurse help a client understand the nutritional value of the foods they eat?
Describe the process and benefits of enteral and parenteral nutrition.
Why is it important to assist clients with eating and feeding, especially those with difficulty eating independently?
What are the key components of a balanced diet, and how can nurses promote adherence to a healthy eating pattern?

By focusing on these areas, nurses can play a vital role in improving clients' nutritional health, promoting recovery, and preventing further complications.

24-hour recall

Assessment tool used to help a client recall what they have eaten over the last 24 hours.

added sugars

Sugars added to food that aren't naturally occurring.

antioxidants

Substances, commonly found in plant-based foods, that protect the cells against free radicals.

anus

External opening of the rectum where feces is removed from the body.

aspiration

When solids or liquids enter the lungs during inhalation.

assistive devices

Equipment or tools that help a client perform daily tasks easier.

blood glucose

Provides energy to the cells in the body, primary sugar in the body that is made from foods eaten.

calorie density

The number of calories a food contains related to its volume or weight.

calories

The energy that is stored in food and used for processes of the body such as walking, breathing, and running.

carbohydrates

Macronutrient that provides the body's cells, organs, and tissues with the energy they need to function.

clear liquid diet

Diet consisting of only liquids that are clear and offers little daily calories and nutrients.

digestion

When the body breaks down food into simple substances that can be used as nutrients or excreted as waste

dysphagia

Difficulty swallowing.

enteral nutrition

Nutritional intake through the GI tract, including the mouth or a GI tube.

esophagus

Organ responsible for moving food from the mouth to the stomach

fasting blood glucose

Blood sugar level taken after a person has not eaten or drank anything for a least 8 hours.

fat-soluble vitamins

Vitamins that do not dissolve in water but instead are dissolved in fats.

fats

Essential nutrient that help the body absorb vitamins while providing energy.

food frequency questionnaire

Tool used to determine a client's typical food consumption based on a list of foods.

full liquid diet

Diet of liquids, foods that are considered liquids, and foods that turn into liquids at room temperature.

gallbladder

Stores bile and then releases it when the body needs it.

gastrostomy tube (G-tube)

Delivers nutrition to a client via a tube in the stomach.

glycemic index

A carbohydrate-containing food's ability to increase the body's blood glucose level.

heart-healthy diet

Promotes cardiovascular health through controlling portion, eating a varied diet, and watching sodium intake.

hypoglycemia

A blood glucose level below the expected reference range.

laparoscopic technique

Procedure where small incisions are made on the abdomen and a tiny telescope is used to place a g-tube.

large intestine

Removes electrolytes and water from food while turning it into waste.

liver

Removes toxins from the blood and produces bile, which breaks down carbohydrates, proteins, and fats

macronutrients

Building blocks of a diet, which include carbohydrates, fat, and protein.

micronutrients

Vitamins and minerals which are consumed in small amounts and required for optimal growth, development, and body function.

minerals

Noncarbon, inorganic nutrients that promote health and support optimal functioning of the body.

nasogastric (NG) tube

Thin plastic tube placed via the nostril, down the esophagus and into the stomach.

nasojejunal (NJ) tube

Thin, soft tube placed in a nostril with the tip located in the jejunum.

net carbs

The amount of carbs counted toward consumption after taking away the amount of fiber and sugar alcohols in a food.

NPO

Abbreviation meaning nothing by mouth.

omega-3 fatty acids

Found in a number of foods, mainly fish. Fish oil supplements are the most common nonvitamin/nonmineral natural product taken by adults and children.

open surgery technique

Technique used to place a G-tube when laparoscopic is not an option; open surgery allowing the surgeon to complete other procedures if indicated.

overt aspiration

Aspiration causing symptoms such as coughing or trouble breathing.

pancreas

Aides in the metabolism of sugar by producing insulin.

parenteral nutrition

Nutritional intake through the veins, given when a client's GI system does not function.

partial parenteral nutrition

Supplies a client with part of their nutritional requirements allowing for supplemental oral intake.

percent daily value (%DV)

The percentage of the recommended daily value for each individual nutrient in a single serving of food.

peristalsis

Involuntary muscle contractions that occur throughout the digestive system that move food along the pathway to be digested.

protein

Building blocks of the body that provide amino acids that the body needs to build and repair muscle

pureed diet

Diet of foods that do not require chewing.

rectum

Storage area for feces at the end of the large intestine.

regular diet

A healthy, varied diet with foods from all food groups.

renal diet

Diet for individuals with kidney disease that limits intake of sodium, potassium, and phosphorus.

serving size

The number of servings in a package of food.

silent aspiration

Aspiration with no obvious symptoms.

small intestine

Where food is broken down and the majority of the nutrients are absorbed

soft diet

Diet containing foods that are soft, easy to digest, low in fiber, and easy to swallow without difficulty.

stomach

Organ that holds food and uses acids and enzymes to digest food.

thickened liquids

Liquids that are thickened using powder or gel to help prevent aspiration for those with dysphagia.

total parenteral nutrition

Intravenous liquid nutrition that makes up all of a client's nutritional intake.

total sugars

Sugars that occur naturally in foods.

trace minerals

Needed in small amounts to help with different body functions.

vitamins

Carbon-based organic micronutrients that promote health and support optimal functioning of the body.

warfarin

Medicine that thins the blood to prevent blood clots.

water

An essential nutrient that makes up more than half of the body weight and is required by systems in the body to function properly.

water-soluble vitamins

Vitamins that are carried to the tissues of the body but are not stored in the body