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Nutrition Lecture Notes

Objectives of Nutrition

  • Well-Balanced Diet Effects:

    • Essential for maintaining health throughout life.
    • Impacts growth, development, disease prevention, and management.

  • Current Dietary Guidelines:

    • Recommended daily intakes of nutrients for various populations (based on age, gender, and health).
    • Encourages a balanced approach integrating different food groups.

  • Nutritional Assessment Methods:

    • Anthropometric: Measurements (height, weight, BMI).
    • Biochemical: Lab tests to assess nutrient levels (blood tests, glucose levels).
    • Clinical: Physical examination for signs of malnutrition or deficiency.
    • Dietary: 24-hour dietary recall or food frequency questionnaires to analyze eating patterns.

  • Enteral Feedings Management:

    • Using feeding tubes to provide nutrition directly to the stomach or small intestine.
    • Importance of monitoring for complications such as aspiration and tube displacement.

  • Parenteral Nutrition Complications:

    • Risks associated with IV feeding such as infection, blood clots, or metabolic imbalances.
    • Need for careful monitoring of electrolytes and fluid balance.

Nutritional Labeling Guide

  • Reading Labels:
    • Check serving sizes and calorie content to manage dietary intake.
    • Understand the % Daily Value (%DV):
    • High: Over 20% DV of a nutrient indicates a nutrient-rich food.
    • Low: 5% DV or lower is considered low.
  • Important Nutrients:
    • Limit saturated fat, added sugars, and sodium.
    • Get enough dietary fiber, and vitamins A, C, calcium, and iron.

Anatomy and Physiology of the Digestive System

  • Digestion Overview:
    • Involves mechanical and chemical processes to break down food.
  • Key Organs:
    • Mouth: Begins mechanical digestion.
    • Stomach: Secretes acid and enzymes for food breakdown.
    • Small Intestine: Major site for digestion and nutrient absorption.
    • Large Intestine: Reabsorbs water and forms waste.

Alternative Food Patterns

  • Vegetarian Diets:
    • Plant-based, emphasizing fruits, vegetables, grains, and legumes while excluding animal products.
  • Cultural Considerations:
    • Many diets influenced by religious and cultural practices affecting food choices.

Risk for Malnutrition Indicators

  • Clinical Signs:
    • Serum albumin < 3.5g/dl; nausea/vomiting lasting >3 days; >10% unplanned weight loss.
  • Nursing Diagnoses:
    • Includes risk for aspiration, impaired nutrition intake, and impaired self-feeding based on assessments.

Implementation Strategies for Nutrition

  • Health Promotion:
    • Education on dietary best practices, early identification of problems, and meal planning.
  • Interventions:
    • Support patient nutrition through meal planning and food safety practices.

Enteral Nutrition Methods

  • Types:
    • Nasogastric tube (NG), Orogastric tube (OG), Percutaneous Endoscopic Gastrostomy (PEG) for long-term feeding.
    • Need for monitoring tube placement and feeding intolerance.

Total Parenteral Nutrition (TPN) Considerations

  • Indications:
    • Used when oral or enteral feeding is inadequate or not possible.
  • Complications:
    • Risk of infection, glucose intolerance, and metabolic derangements, requiring close monitoring.

General Nursing Responsibilities

  • Feeding Tube Management:
    • CNA can assist with hygiene but not with feeding; caregivers must monitor for signs of aspiration.
  • Monitoring Parameters:
    • Assess lab values, feeding residuals, skin conditions, and patient's GI status for tolerance.