Transcript Nursing Assistant

Nursing Assistant
Nutrition
Body’s need for food & fluids
Provide energy for daily living & bodily
functions
 Promote growth & repair of tissue
 Provide necessary substances for
regulation of bodily fluids
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Nutrition
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Science of foods & their relationship to
health
– Essential to good health
– Composed of sufficient nutrients to meet
the body’s requirements
Common Nutrients
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Carbohydrates
– Grains
– Pastas
– Breads
– Cereals
– Fruits
– Vegetables
Proteins
Eggs
 Milk
 Meat
 Fish
 Nuts
 Poultry
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Fats
Oils
 Cream
 Cheese
 Meat fats
 Butter
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Vitamins
Vegetables
 Fruits
 Milk
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Minerals
Eggs
 Dried fruit
 Potatoes
 Fish
 Milk
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Dietary fiber
Raw fruits
 Raw vegetables
 Whole grains
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Fluids
Water
 Juices
 Other beverages
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Food Pyramid
www.mypyramid.gov
 Serving sizes based on age, gender, &
activity level
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Vegan
Vegetarian AND no animal by products
 Check www.mypyramid.gov for specifics
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Special nutrient needs of elderly
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Age related changes
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Fewer calories needed, decreased activity
Digestive disturbances = add vitamins & minerals
Meds may interfere with digestion & nutrient use
Poor oral hygiene, ill-fitting dentures
Ability to taste decreased
Many common diseases interfere with eating & or
the ability to use nutrients
– Social isolation = interference with appetite
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Food allergies – know status & check for
additives (peanuts, shellfish, wheat)
Therapeutic diets
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Low sodium
 Diabetic
 Low fat
 Liquid
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Full liquid
Clear liquid
Thickened liquids
Nectar thick
Honey thick
Special consistency diets
Mechanical soft
 Pureed
 Soft
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Responsibilities of nursing
assistant
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Check that residents receive diets ordered,
check arm bands with tray
Report any diet related problems –
preferences, difficulties, N & V, anorexia
Assist drs & nurses to evaluate fluid balance,
accurate I & O
Calculate food intake according to facility, if
eats all, eats 100%
Offer alternate menu with refusal
If alternate refused, report to licensed nurse
Technique for feeding
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Provide comfortable & enjoyable atmosphere
– Sit at eye level
– Maintain a positive attitude when feeding
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Provide assistance if needed
 Serve residents in room if unable to join
others in dining area (best choice is dining
area)
 Alternate liquid & solid food
Steps
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Wash hands
Check diet card for name, diet order, special
instructions, & allergies
Make sure food matches info on card
Remove tray from food cart, see that all items
are there
Knock & pause before entering room
Introduce self
Check armband
Explain procedure
Steps cont.
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Lower side rail
Place tray on overbed table
If in dining room, remove food items & place
on table – remove tray
Place a towel or clothing protector
Remove plate cover
Seat yourself at eye level
Arrange food, butter bread, season food
Steps cont
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Describe or show food before giving it to
resident
Use adaptive devices as indicated
Use straws & thickeners as indicated
Offer small portions of solids ( no more than
½ spoonful)
Alternate solids & liquids
Ask what they would like
Put food on unaffected side of mouth
Monitor for pocketing & swallowing difficulties
Remove tray when resident is finished
Prevention of choking
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High risk residents
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CVA
Neurological disease
Trauma to head, neck, or throat
Dementia
Close supervision when eating
 Follow individual feeding plan
 Cut food into small pieces, offer in small
amounts, wait until each portion is chewed &
swallowed before more is given
Choking cont.
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Notify licensed nurse if dysphagia
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Long time before swallowing
Swallows several times with each bite
Frequent throat clearing
Difficulty handling foods/fluids in mouth
Wet gurgling voice
Pocketing food
Unintentional weight loss
Feeling by resident that food is sticking
Choking cont
Proceed at resident’s pace – don’t rush
 Portion should be chewed & swallowed
before more is given
 Sit down while feeding helpless resident
 Use adaptive equipment as indicated
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Recognition of signs of choking
Universal sign
 Inability to speak, cough, breathe
 Cyanosis
 Loss of consciousness
 HEIMLICH MANEUVER
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DIETARY MODIFICATIONS
Affiliated with religions and/or cultures
 Ask if there are any preferences
 Ask family of residents who cannot
communicate
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Alternate ways to offer nutrition
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Tube feedings
– Ordered by doctor when resident unable to eat
– Started by a licensed nurse
– Your responsibility
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Monitor for tubing kinking or pressure
Monitor level of feeding
KEEP HOB AT 20 – 30 DEGREES AT ALL TIMES
DO NOT LOWER HOB EVEN WHEN REPOSITIONING
Never turn off pump – notify nurse of alarm
Notify nurse if signs of aspiration
Intravenous infusion
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Ordered by physician
 Started by licensed nurse
 Your responsibility
– Monitor IV for kinks, twisting, pressure, or
obstruction
– Report
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Alarms
C/o pain or burning at site
Swelling or redness at site
Fever
SOB
Bleeding of fluid leakage at IV site
Disconnected IV tubing
Empty IV container