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The processes involved in the ingestion, digestion, absorption, and use of foods and fluids by the body.
A substance that is ingested, digested, absorbed, and used by the body.
Fats, proteins, and carbohydrates give the body fuel for energy. The amount of energy provided by nutrients is measured in caloris. A calorie is the amount of energy produced when the body burns food:
- 1 gram of fat -- 9 calories
- 1 gram of protein -- 4 calories
- 1 gram of carbohydrate -- 4 calories
The Food Guide Pyramid promotes wise food choices. A low-fat diet the is the goal. More bread, cereal, rice, and pasta (level 1) and more vegetables and fruits (level 2) are eaten. Food from the milk, yougurt, and cheese gruop are eaten in moderate amounts. So are foods from the meat, poultry, fish, beans, eggs, and nut group. Fats, oils, and sweets (level 4) are used sparingly.
- Breads, cereals, rice, and pasta group. A person needs 6 to 11 servings a day. They provide protein,
carbohydratres, adn some vitamins and minerals.
- Vegetable group - A person needs 3 to 5 servings a day. Low in fat, vegetables provide fiber,
vitamins A and C, carbohydrates, and minerals.
- Milk, yogurt, and cheese group. A person needs 2 to 3 servings daily. This group is high in protein,
carbohydrates, fat, calcium, and riboflavin.
- Meat, poultry, fish, dry beans, eggs, and nuts group. A person needs 2 to 3 servings a day. This food
group is high in fat and protein. Fish and shellfish are low in fat. Chicken and turkey have less fat
than veal, beef, pork, and lamb. Veal has less fat than beef.
- Fats, oils, and sweets group. Fats, oils, and sweets (foods with added sugar) are high in fat with few
Involuntary muscle contractions move food down the esophagus into the stomach.
Changes with aging.
Salivary glands produe less saliva.
Secretion of digestive juices decreases.
Fewer calories are needed.
- Common Disorders
- - Diabetes, an endocrine disorder, affects nutrition. The body cannot produce or use insulin properly.
- -- Type 1 -- Occurs most often in children and young adults. The pancreas produces little or no insulin.
- onset is rapid.
- -- Type 2 -- Occurs in adults. Persons over 40 years of age are at risk. Obesity and hypertension are
- risk factors. The pancreas secretes insulin. However, the body cannot use it well. Onset is slow.
- -- Gestational diabetes - developa during pregnancy. (Gestaton comes from gestare. It means to
- bear.) It usually goes away after the baby is born
- - Hypoglycemia means low (hypo) sugar (glyc) in the blood (emia).
- - Hyperglycemia means high (hyper) sugar (glyc) in the blood (emia).
The most important nutrient. It is needed for tissue growth and repair.
Povide energy adn fiber for bowel elimination.
Provide energy. They help the body use certain vitamins.
They are needed for certain body functions.
Vitamins. The lack of a vitamin results in signs and symptoms of an illness. The body stores vitamins A, D, E, and K. Vitamin C and the B complex vitamins are not stored. They must be ingested daily.
They are needed for bone and tooth formaton, nerve and muscle function, fluid balance, and other body processes.
Appetite relates to the desire of food. However, loss of appetite (anorexia) can occur. Causes include illness, drugs, anxiety, pain, and depression.
Appetite usually decreases during illness adn recovery from injuries. However, nutritional needs are increased.
Special eating equipment and utensils. They allow the person to eat independently.
Doctors may order special diets for a nutritional deficiency or a disease.
The average amount of sodium in the daily diet is 3000 to 5000 mg. The body needs no more than 1500 to 2400 mg.
Sodium causes the body to retain water. If there is too much sodium, the body retains mre water. Tissues swell with water. There is excess fluid in the blood vessels. The heart has to work harder. The body retains less water. Less water in the tissues and blood vessels reduces the heart's workload. The doctor orders the amount of sodium restriction.
- Diabetes is chronic disease from a lack of insulin. Diabetes is usually treated with insulin or other drugs, diet, and exercise.
- Meal adn snack times are the same from day to day. The person eats at regular times to maintain a certain blood sugar level. The same amount of carbohydrates, protein, and fat are eaten at the same time each day.
Dysphagia. In severe cases, food enters the airway. Aspiration is breathing fluid or an object into the lungs. The dysphagia diet involves changing food thickness to meet the person's needs.
If fluid intake exceeds fluid output, body tissues swell with water. This is called edema. Edema is common in people with heart and kidney diseases. Dehydration is a decrease in the amount of water in body tissues. Fluid output exceeds intake.
An adult needs 1500 ml of water daily to survive. About 2000 to 2500 ml of fluid per day is needed for normal fluid balance.
Signs and Symptoms of Dyshagia
- The person avoids foods that need chewing.
- Food spill out of the person's mouth while eating.
- Food comes up through the person's nose.
- There is excessive drooling of saliva.
- Aspiration Precautions
- - Position the person in Fowler's positjon or upright in a chair for meals and snacks.
- - Support the upper back, shoulders, and neck with a pillow.
- - Position the person in a chair or in semi-Fowler's position after each meal or snack. The person
- maintains this position for a least 1 hour after eating. Follow the care plan.
The person cannot eat or drink anything. NPO means nothing by mouth. NPO often is ordered before and after surgery, before some laboratory tests and diagnostic procedures, and to treat certain illnesses. The person is NPO 6 to 8 hours before surgery and before some laboratory tests and diagnostic procedures.
Before meals, the person needs to eliminate and have oral hygiene.
If food is not served withinn 15 minutes, recheck food temperature following center policy. If not at the right temperature, get other food. Some centers allow reheating in a microwave oven.
- Feeding the person
- Spoons are use to feed the person. The spoon should be only-third full.
- If strong enough, they can hold milk or juice glasses (never hot drinks).
- Always tell the person what is on the tray. When feeding a visually impaired person, describe what you are offering. For persons who feed themselves, describe foods and fluids adn their place on the tray. Use the numbers on a clock for the locatiion of foods.
- Sit so taht you face the person. Sitting is more relaxing. Standing communicates that you are in a hurry.
Enteral nutrition is giving nutriets through the gastrointestinal tract. Formula is given through a feeding tube. (Gavage is another term for tube feeding)
- - A nasogatric tube is inserted through the nose into the stomach.
- - A gastrostomy tube is inserted into the stomach. A surgically created opening (stomy) in teh stomach is
- - The doctor orders the type and amount of formula. Formula is given through a syringe, a feeding bag,
- or electronic feeding pump.
The breathing of fluid or an object into the lungs. It can cause pneumonia and death.
Aspiration. Aspiration is a major risk of enteral nutrition. The RN checks tube placement before a feeding. You are never responsible for checking feeding tube placement.
The backward flow of food from the stomach into the mouth.
- Reguritation. Aspiration also occurs from regurgitation. Delayed stomach emptying adn overfeeding are common causes. To prevent regurgitation:
- - Position the person in semi-Fowler's position. Follow the care plan.
- - This position may be required for 1 or 2 hours or at all times. Semi-Fowler's position allows formula to
- move through the gastrointestinal system and prevents aspiration.
- - Avoid the left side-lying position. This position prevents the stomach from emptying.
The person with a feeding tube is usually NPO. Dry mouth, dry, lips, and sore throat cause discomfort. The person needs frequent oral hygiene, lubricant for the lips, and mouth rinses. These are done every 2 hours while teh personn is awake. The nose and nostrils are cleaned every 4 to 8 hours.
Giving fluids through a needle or catherter inserted into a vein.
- Intravenous (IV) therapy. IV and IV infusion also refer to IV therapy. Doctors order IV therapy to:
- - Provide fluids
- - Replace minerals and vitamins
- - Provide sugar for energy
- - Give drugs and blood
- - Provide hyperalimentation - a solution highly concentrated with proteins, carbohydrates, vitamins,
- minerals, and sometimes fat.
- The doctor orders the amount of fluid to give (infuse) per hour and the amount of time to give it in.
- An alarm sounds if something is wrong. Tell the nurse at once if you hear an alarm. Never adjust any controls on IV pumps.
- You are never responsible for starting or maintaining IV therapy. Nor do you regulate the flow rate or change IV bags. You never give blood or IV drugs.
- Do not move the needle or catheter. Needle or catherter position must be maintained.
- Tell the nurse at once if bleeding occurs from the insertion site.