Transcript NUTRITIONx
nutrition 0 A basic component of health and is essential for normal growth and development, tissue maintenance and repair, cellular metabolism, and organ function. 0 The giving or taking of food is part of ceremonies, celebrations, religious events, mourning, and social events. Healthy people 2020 Increase proportion of adults who have a BMI 18.5-24.9 Reduce proportion of obese adults and children Decrease saturated fat intake in population >2yrs old Increase variety of fruits and veg in population >2 Reduce sodium intake Increase work-site nutrition education and weight management 0 Offer nutrition assessment at primary care sites 0 Increase schools that offer nutritious food and beverages outside of school meals 0 Increase food security to 94% of households 0 0 0 0 0 0 Nutritional balance 0 When energy requirements are met by kcal intake of food, weight does not change 0 BMR- energy needed to maintain life-sustaining activities at rest 0 Nutrient density 0 Proteins, carbohydrates, fats 0 Vitamins, minerals, water proteins 0 4 kcal/gram 0 Essential for synthesis of tissue in growth, maintenance, repair 0 Ingestion maintains nitrogen balance 0 positive nitrogen balance needed for growth, wound healing, maintaining lean muscle mass, pregnancy 0 Becomes energy source when insufficient carb intake 0 Excess intake is stored in muscle mass carbohydrates 0 Main source of fuel for brain, skeletal muscles during exercise, RBC and WBC production, cell function of the renal medulla 0 Mostly plant based (ex lactose) 0 Insolulble fiber , a polysaccharide, is not digestible 0 4Kcal/gram fats 0 9 kcal/g 0 Most calorie dense nutrient 0 Deficiency occurs when fat intake is below 10% of daily nutrition 0 Water is most essential nutrient. Balance occurs when intake from liquids and water-containing solids equals loss from elimination, perspiration, respiration 0 Vitamins essential to normal metabolism. Antioxidants include betacarotene and vits A,C, E 0 Minerals are inorganic elements, catalysts in biochemical reactions. Assist in acid/base balance. Selenium is a antioxidant Cultural Aspects of Food 25 year old man needs about 60 g protein a day 25 year old man needs about 90 mg Vit C a day 25 year old man needs about 4.7 grams Potassium a day 25 year old man should have 1.5-2.3 g sodium per day Assessing for signs of poor nutrition 0 Weight, BMI, muscle tone 0 Fatigue, dry skin, hair loss, pale conjunctiva 0 Apathy, confusion, cachetic 0 Obese 0 Constipation or diarrhea 0 Spongy or bleeding gums 0 Poorly healing wounds Poor nutrition may be secondary to 0 Swallow difficulties 0 Deficient knowledge 0 Oral trauma or tooth problems 0 Financial difficulties 0 Self care deficit 0 Increased nutritional need in illness, burns, pregnancy 0 Psychological condition 0 Social setting Special Diet Orders 0 0 0 0 0 0 0 0 0 0 Gluten free (for celiac disease) Low residue (for diverticulitis) Carb consistent (for DM) Low fat, low sodium (“heart healthy”) Bland, no caffeine (for peptic ulcers) Soft Mechanical altered Pureed Thickened liquids Fluid restrictions Enteral Nutrition 0 Provides nutrition into the GI tract 0 Used if pt unable to swallow or for some other reason unable to take PO, yet has functioning GI tract 0 Nasogastric, jejunal, or gastric 0 Verification by Xray before use 0 May give total (complete) or partial (single or elemental nutrient) nutrition 0 Formulas usually milk based Indications for Use 0 N-G pts with low risk of gastric reflux./Difficulty chewing or swallowing/ A. nervosa/ short term use 0 Gastric (PEG or Gtube) pts with oral or facial trauma/head or neck CA/esophageal adhesions/long term use 0 N-I pts with gastric ileus or reflux (keo or duo tube)/short term/delayed gastric emptying 0 J-tube pts without a stomach, with colitis or fistulas, decreased LOC/ lying flat Placement Check 0 Withdraw small amt GI aspirate, preferably before feedings 0 Check a drop on pH paper 0 pH 1-4 normal for stomach. pH 6 or greater in intestine 0 pH 6 or greater MAY MEAN lungs, intestine or stomach full of food. 0 Xray verification when in doubt 0 Surgically placed and fixed feeding tubes are considered to have “reliable” placement 0 Use good nursing judgment when in doubt Parenteral Nutrition 0 TPN or PPN 0 For pts with non-functioning GI tracts 0 Amino acids, dextrose, electrolytes, vitamins 0 lipids Parenteral Nutrition 0 TPN must use central line 0 Filter tubing 0 Extra nutrition for burns, sepsis, head injury or other states of high stress 0 GI nutrition is always preferred 0 Unused gut—bacteria travel into blood stream 0 Vit K synthesized by microflora in normal gut 0 Sudden discontinuation may cause hypoglycemia