Transcript Basic Nursing: Foundations of Skills and Concepts Chapter 13

Basic Nursing: Foundations of
Skills & Concepts
Chapter 18
BASIC
NUTRITION
Nutrition
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All of the processes involved in
consuming and utilizing food for energy,
maintenance, and growth.
Physiology of Nutrition
Five processes are involved in the body’s
use of nutrients:
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Ingestion.
Digestion.
Absorption.
Metabolism.
Excretion.
Ingestion
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The taking of food into the digestive tract,
generally through the mouth.
Digestion
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The mechanical and chemical processes
that convert nutrients into a physically
absorbable state. Digestion includes:
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Mastication (chewing).
Deglutition (swallowing).
Peristalsis (coordinated, rhythmic, serial contractions
of the smooth muscles of the GI tract).
Absorption
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The process by which the end products of
digestion pass through the small and
large intestines into the blood or lymph
systems.
Metabolism
 The
body’s conversion of nutrients into
energy.
 Basal
metabolism is the amount of
energy needed to maintain essential
physiologic functions when a person is
at complete rest, both physically and
mentally.
Excretion
 The
process of eliminating or removing
waste products from the body.
The Six Essential Nutrients
Water
 Carbohydrates
 Fats
 Proteins
 Vitamins
 Minerals
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Water
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The Most Important Nutrient.
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Daily requirements: 1,000mL of water to
process 1,000kcal eaten.
Functions of Water
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Solvent (dissolves
substances to form
solutions).
Transporter (carries
nutrients, wastes, etc.
throughout the body).
Regulator of body
temperature.
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Lubricant (aids in
providing smooth
movement for joints).
Component of all cells.
Hydrolysis (breaks apart
substances, especially in
metabolism).
Classification & Sources
of Water
Liquids consumed (water, coffee, juice,
tea, milk, soft drinks).
 Foods consumed (especially fruits and
vegetables).
 Metabolism (produces water when
oxidization occurs).
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Water: Digestion, Absorption
and Storage
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Water is not digested. It is absorbed and
used by the body as we drink it. It cannot
be stored by the body. The body loses
water in four ways:
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Urine.
Feces.
Perspiration.
Respiration.
Water: Signs of Deficiency
Abnormal water losses include profuse
sweating, vomiting, diarrhea, hemorrhage,
wound drainage (burns), fever, and
edema.
 A deficiency of water is called
dehydration. Prolonged dehydration
results in death.
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Carbohydrates
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The chief source of energy for the body.
Made up of carbon, hydrogen, and
oxygen. They are the major source of
food for all people.
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Daily requirements: 50% to 60 of an
individual’s kcal intake per day.
Functions of Carbohydrates
Carbohydrates are...
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The primary source of energy for the body.
Spares proteins from being used for energy, thus
allowing them to perform their primary function of
building and repairing body tissues.
Needed to oxidize fats completely and for synthesis of
fatty acids and amino acids.
Carbohydrates: Classification
and Sources
Carbohydrates may be simple or
complex.
 Simple are single or double sugars.
 Complex are composed of many single
sugars joined together (starch, dietary
fiber, glycogen).
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Carbohydrates: Digestion,
Absorption and Storage
Digestion of cooked starches begins in
the mouth.
 Little digestion occurs in the stomach.
 Carbohydrate digestion completed in the
small intestine.
 Carbohydrates are used completely,
leaving no waste for the kidneys to
excrete.
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Carbohydrates: Signs of
Deficiency
Mild deficiency can result in weight loss
and fatigue.
 Serious deficiency can result in ketosis.
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Fats
The most concentrated source of energy
in the diet. An essential nutrient, but too
much can be a health hazard.
 Daily requirements: should not exceed
25% to 30% of an individual’s caloric
intake per day.
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Functions of Fats
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Provides concentrated source of energy.
Assists in absorption of fat-soluble vitamins.
Is a major component of cell membranes and myellin
sheaths.
Improves flavor of foods and delay’s stomach’s
emptying time.
Protects and hold organs in place.
Insulates body, thus assisting in temperature
maintenance.
Classification of Fats
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Triglycerides (true fats).
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Phospholipids (lipoids, composed of
glycerol, fatty acids, and phosphorus).
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Cholesterol.
Sources of Fats
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Animal (lard, butter, milk, cream, egg
yolks, and fat in meat, poultry, and fish).
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Plant (oils from corn, safflower, peanut,
palm, etc., as well as nuts and avocado).
Digestion, Absorption and
Storage of Fats
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No chemical breakdown of fats occurs in
the mouth and very little in the stomach.
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Digestion occurs in small intestine.
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Fats not immediately needed by the body
are stored as adipose tissue.
Fats: Signs of Deficiency and
Excess
Deficiency occurs when fats provide less
than 10% of daily kcal requirement.
 Gross deficiency may result in eczema,
retarded growth, and weight loss.
 Excess fat consumption can lead to
overweight and heart disease.
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Proteins
The only nutrient that can build, repair,
and maintain body tissues.
 Daily requirements: determined by size,
age, gender, and physical and emotional
conditions.
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 Daily
protein requirement for average
adults is 0.8g for each kilogram of
weight.
Functions of Proteins
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To provide amino acids necessary for synthesis of body
proteins, used to build, repair, and maintain body
tissues.
To assist in regulating fluid balance.
Used to build antibodies.
Plasma proteins help control water balance between the
circulatory system and surrounding tissues.
In event of insufficient stores of carbohydrates and fats,
protein can be converted into glucose and used for
energy.
Classification & Sources of
Proteins
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Complete proteins contain all 9 essential
amino acids. (All animal fats, except for
gelatin, are complete. Only plant fat that is
complete is soybeans).
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Incomplete proteins have one or more
essential amino acids missing (plant
proteins).
Digestion, Absorption and
Storage of Protein
Digestion begins in the stomach.
 Most digestion takes place in the small
intestine.
 Amino acids not used to build proteins are
converted to glucose, glycogen, or fat and
are stored.
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Signs of Deficiency and Excess
of Protein
Muscle wasting.
 Edema (swelling).
 Lethargy and depression.
 Excess can result in heart disease, colon
cancer, osteoporosis.
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Vitamins
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Essential organic compounds that
regulate body processes and are required
for metabolism of fats, proteins, and
carbohydrates.
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Needed in very small amounts.
Foundations of Vitamins
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Unique to each individual vitamin.
Classification and Sources of
Vitamins
Grouped according to solubility (fatsoluble or water-soluble).
 Sources are foods and vitamin
supplements.
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Digestion, Absorption and
Storage of Vitamins
Do not require digestion.
 Fat-soluble vitamins absorbed into
lymphatic system; water-soluble vitamins
absorbed into circulatory system.
 Excess fat-soluble vitamins stored in the
liver and adipose tissue.
 Excess water-soluble vitamins are
excreted through urine.
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Signs of Deficiency and Excess
of Vitamins
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Vitamin deficiencies commonly afflict
alcoholics, the poor, incapacitated elders,
clients with serious disease that affect
appetite, mentally retarded persons, and
neglected children.
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Vitamins consumed in excess can be
toxic.
Minerals
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Inorganic compounds that help regulate
Body processes and/or serve as structural
components of the body.
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Daily requirements: Amounts greater than
100 mg/day. Trace minerals less than 100
mg/day.
Functions of Minerals
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Unique to each individual mineral.
Classification & Sources of
Minerals
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Classified as major minerals or trace
minerals.
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Found in water and in natural foods, as
well as supplemental minerals.
Digestion, Absorption & Storage
of Minerals
Influenced by Three Factors:
 Type of food (minerals from animal foods
more readily absorbed than those from
plant foods).
 Need of body (a deficiency will result in
more absorption).
 Health of absorbing tissue.
Signs of Deficiency and Excess
of Minerals
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Too much mineral intake can be toxic.
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Excessive amounts of minerals can result
in hair loss and changes in the blood,
muscles, bones, hormones, blood
vessels, and nearly all tissues.
Four Food Groups (Historical)
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For many years, a plan to help people
construct a well-balanced diet, with food
choices from milk, meat, fruit/vegetable,
and bread/cereal groups.
Food Guide Pyramid
Fats, oils & sweets
Use sparingly
Milk, Yogurt & Cheese
Meat, poultry, fish, dry beans, eggs & nuts
2-3 servings
Vegetables & Fruits
(2-5 servings)
Bread, cereal, rice & pasta
(6-11 servings)
Dietary Guidelines for
Americans
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Eat a variety of foods.
Maintain healthy weight.
Choose a diet low in fat, saturated fat, and cholesterol.
Choose a diet with plenty of vegetables, fruits, and grain
products.
Use sugars, salts, and sodium only in moderation.
Drink alcoholic beverages only in moderation.
Factors Influencing Nutrition
Culture.
 Religion.
 Socioeconomics.
 Fads.
 Superstitions.
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Nutritional Needs During the
Life Cycle
Affected by:
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Nutritional status
Height and weight
Meal and snack pattern
Adequacy of intake based on food guide pyramid
Food allergies
Physical activity
Cultural, ethnic, and family influences
Use of vitamin/mineral supplements
Nutritional Diseases
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Primary Nutritional Disease: occurs when
nutrition is cause of the disease (scurvy,
rickets, beri-beri, anemia).
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Secondary Nutritional Disease:
complication of another disease or
condition.
Weight Management
Maintaining weight at a desired level can be
very difficult for some people.
 Overweight: 11% to 19% above desired
weight. Obesity is 20% or more.
 Underweight: 10% to 15% below desired
weight.
Safety of Food
Depends upon:
 Proper Storage.
 Proper Sanitation.
 Proper Cooking.
Food Allergies
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Occurs when the immune system reacts
to a food substance, usually a protein.
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When such a reaction occurs, antibodies
form and cause allergic symptoms.
The Nursing Process:
Assessment
Two types of data:
 Subjective.
 Objective.
Subjective Data
24-Hour Recall.
 Food-Frequency Questionnaire.
 Food Record.
 Diet History.
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Objective Data
Body Mass Index.
 Skinfold Measurement.
 Other Measurements (e.g. AbdominalGirth, Mid-Upper-Arm).
 Laboratory Tests.
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Diet Therapy
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The treatment of a disease or disorder
with a special diet. Dietary prescriptions
include:
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Nothing by Mouth.
Standard Diets (general, or regular; soft; clear-liquid;
full-liquid; edentulous; pureed).
Special Diets (low-residue, high-fiber, liberal bland,
fat-controlled, sodium-restricted).
Assistance with Meals
Preparing the client.
 Preparing the environment.
 Serving the tray.
 Assisting with eating.
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Nutritional Support
Two delivery Routes for adults:
Enteral nutrition: The ingestion of food
orally and the delivery of nutrients through
a GI tube.
 Parental nutrition: Nutrients bypassing the
GI system and entering the blood directly.
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