LA

NUR 221 Week 6 Notes

Nutrition Overview

  • Nursing responsibility to ensure patients receive adequate nutrition.

  • Importance of nutrients for bodily functions.

    • Macronutrients: Include fats, carbohydrates, proteins. Provide energy (calories).

    • Micronutrients: Vitamins and minerals essential for cellular functions.

  • Metabolism: Converts food into energy, can vary between individuals.

    • Importance of calculating and memorizing calories per gram:

      • Carbohydrates: 4 cal/g

      • Protein: 4 cal/g

      • Fat: 9 cal/g

Macronutrients

  • Carbohydrates: Primary energy source, important for muscle and organ function, particularly the brain.

    • Simple carbohydrates (sugars) prevalent in processed foods.

    • Complex carbohydrates provide longer-lasting energy.

  • Proteins: Critical for healing and body repair.

    • Comprise essential (must be ingested) and non-essential amino acids.

    • Proteins are classified as complete (all amino acids present) and incomplete.

  • Fats (Lipids): Serve as a backup energy source, insulation, and protection for organs.

    • Cholesterol concerns due to its role in coronary artery disease.

Micronutrients

  • Required in small amounts to regulate body functions.

  • Includes various vitamins and minerals beneficial for health.

    • Iron: Essential for patients with anemia.

    • Importance of hydration: Water makes up approximately 55% of body weight; vital for bodily functions and impacts recovery.

Nutritional Assessment and Monitoring

  • Importance of regular nutritional assessments upon patient admission.

  • Prealbumin vs. Albumin:

    • Prealbumin provides a more accurate snapshot of nutritional intake over the last few days.

    • Albumin reflects longer-term nutritional status and may be misleading if patient is in acute distress.

  • Body Mass Index (BMI) as an assessment tool for nutritional status.

    • Weight loss assessment guidelines:

      • 5% in 30 days or > 10% in 180 days indicates possible malnutrition.

Nursing Diagnoses Related to Nutrition

  • Key symptoms indicating nutritional deficiency or excess include:

    • Unintentional weight loss.

    • Risk for impaired skin integrity due to malnutrition.

    • Obesity assessments: Must identify underlying causes (overeating, lack of exercise, etc.).

    • Examples of Nursing Diagnoses: "Impaired skin integrity, risk for malnutrition..."

    • Importance of evaluating psychological, social, and economic factors impacting nutrition.

Nutrition Guidance for Patients

  • Understand dietary modifications based on patient needs:

    • Diabetic diet: Consistent carbohydrate intake.

    • Cardiac diet: Low cholesterol and saturated fats.

  • Importance of hydration should be emphasized.

  • Delegation of responsibilities: UAPs can assist with recording intake/output, while nurses should focus on analysis and patient education.

Interventions for Patients with Dietary Restrictions

  • Clear liquid diets vs. full liquid diets and subsequent advancement:

    • Clear liquids: Should include water, broth, clear juices.

    • Full liquids: May include cream soups, yogurt, shakes.

  • Nutritional referrals: Utilize dietitian/nutritionist resources for comprehensive patient dietary plans.

Wound Healing and Nutrition

  • Role of nutrition in wound healing, especially proteins for tissue repair.

  • Phases of wound healing: Inflammatory, Proliferative, and Maturation stages.

  • Common types of wounds:

    • Primary intention (closed edges)

    • Secondary intention (open, healing from inside out)

    • Tertiary intention (delayed closure)

Documenting and Assessing Wounds

  • Criteria for assessing wounds:

    • Wound depth: Superficial, Partial thickness, Full thickness.

    • Types of drainage: Serous (clear), Sanguineous (bloody), Serosanguineous (pink), Purulent (yellow/green).

  • Be careful with terminology when documenting to ensure accurate assessments.

  • Risk factors for pressure injuries focus on immobility, moisture, and nutritional deficits.

Patient Advocacy and Involvement

  • Nurses play a key role in advocating for patients regarding dietary needs and restrictions.

  • Importance of patient education about nutritional status and dietary needs to enhance recovery.