Chapter 27 Diet therapy and assisted feeding

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  1. Goals of diet therapy
    • treat and manage disease
    • prevent complications
    • restore health
  2. Which patients need feeding assistance
    • patients with paralysis of the arms
    • patients with visual impairment
    • patients with IVs
    • weak/impaired
    • confused
  3. Post op patient
    • NPO 6 - 8 hrs before operation
    • progress from clear to full liquid diet
    • clear liquids started when bowel sounds are heard
    • clear liquids have low residue and are easily digested
    • liquid diets decrease risk of abdominal pain, nausea and vomiting
    • may progress to soft diet before regular diet begins
  4. Obesity
    • 20 - 30% above ideal body weight
    • morbidly obese are 100 lb above ideal body weight
    • 62% of US is obese
  5. Pregnancy
    • Weight gain should be 2 - 4 lb during the first trimester
    • 1 lb/week during the second and third trimester
    • no caloric increase in the first trimester
    • increase of 300 calories/day in the 2nd and 3rd trimesters
  6. Substance abuse
    • may impair absorption of nutrients
    • alcoholics usually have thiamine deficiency
    • if liver function impaired; fats restricted
    • Treatment:
    • vitamin and mineral supplements
    • fluid and electrolyte supplements
    • high calorie, high carb diet
  7. Cardiovascular disease
    • Includes diseases of the blood vessels, hypertension, myocardial infarction, and congestive heart failure
    • Focused on reduction of fat and sodium intake to decrease atherosclerosis
  8. 3 types of cholesterol
    • High-density lipoprotein (HDL) : good cholesterol; cleanse vessels of fatty deposits
    • Low-density lipoprotein (LDL) : increases fatty deposits
    • Very-low-density lipoprotein (VDL) : carries triglycerides; triglycerides contribute to atherosclerosis and coronary artery disease
  9. Diabetes Mellitus
    • Disturbance of the metabolism of carbohydrates and the use of glucose by the body
    • Type 1: juvenile onset (pancreas stops secreting insulin)
    • Type 2: adult onset (cell membrane loses sensitivity to insulin)
    • Meals should contain 45% to 60% carbohydrates, 20% to 25% protein, and 20% to 25% fat
    • Diet therapy to control carbohydrate intake to maintain serum glucose at 75 to 115 mg/dL
    • Carbohydrates should be complex
  10. Risks associated with diabetes mellitus
    • Cardiovascular disease
    • Hypertension
    • Kidney disease
    • Blindness
    • Stroke
  11. HIV/AIDS
    • Associated with:
    • Severe diarrhea
    • Profound weight loss
    • Muscle wasting
    • Therapy includes:
    • Replacement of fluids and electrolytes
    • Weight gain
    • Replacement of lost muscle mass
    • Maintaining the immune system
  12. Nasogastric and Enteral Tubes
    • Usually a temporary measure to provide nutritional support
    • Check tube placement prior to feeding or administering medications
    • Irrigate to ensure it is patent (clear)
  13. Reasons for nasogastric and enteral tubes
    • dysphagia
    • IBS
    • decompress stomach before or after surgery (remove contents)
    • obtain gastric specimens
    • gastric feeding or lavage
    • administer medication
  14. Percutaneous Endoscopic Gastrostomy Tubes
    • Generally used when a patient requires long-term nutritional support
    • Tube placement should be checked every shift and before feeding or administering medication
    • Before feeding or administering medications, amount of residual fluid in the stomach should be assessed
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Chapter 27 Diet therapy and assisted feeding
2011-12-10 08:03:59
Funds Chapter 27

Funds chapter 27
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