N210 Week-7 Lecture Nutrition

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Leon
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309506
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N210 Week-7 Lecture Nutrition
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2015-10-12 13:55:16
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N210 Week Lecture Nutrition
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  1. 1. Discuss the relationship between health and nutrition
    • A. Nutrition
    • 1. Food people eat and how body uses it
    • B. Health
    • 1. Absence of disease
    • I. High-quality nutrition is essential to good health
  2. 2. Identify which food nutrients are essential to good health and well-being
    • A. Carbs
    • B. Proteins
    • E. Minerals
    • C. Fats
    • D. Vitamins
    • E. Minerals
    • F. Water
  3. 3. Discuss the function of nutrients in food
    • A. Provide energy
    • B. Build tissue
    • C. Regulate metabolic process
  4. 4. Define kilocalorie and calorie
    • A. Kilocalorie (kcal)
    • 1. Amount of heat necessary to raise 1 kg of water 1 Celsius
    • B. Calorie
    • 1. Amount of energy in food or the amount that’s expanded in physical actions
  5. 5. Identify risk factors for poor nutritional status
    • A. Oral feedings
    • B. Enteral feedings
    • C. Parenteral nutrition
    • 1. IV
    • 2. Peripheral vein access
    • I. Can’t tolerate food
    • 3. Central vein access
    • 4. Total Parenteral Nutrition (TPN) and Lipids
    • I. Damages the liver
  6. 6. Discuss the components of a nutritional assessment
  7. 7. Define the function of carbohydrates, proteins, and fats
    • A. Carbohydrate
    • 1. Basic fuel supply
    • I. Provide fuel
    • 2. Reserve fuel supply
    • I. Glycogen in liver is primarily reserved to maintain blood glucose levels and to ensure brain
    • Function
    • 3. Liver
    • I. Protect cells from depressed metabolic function
    • 4. Protein and fat
    • I. Protects protein for growth and maintain
    • II. Regulates ketones
    • 5. Heart
    • 6. CNS
    • I. Proper functions
    • B. Proteins
    • 1. Tissue building
    • I. Repair worn-out, wasted, or damaged tissue and build new tissue
    • II. Biochemical machinery that make cells work
    • 2. Energy
    • I. May furnish additional fuel to sustain heat and energy
    • 3. Water balance
    • I. Water is attracted to proteins
    • A. Help control water balance by exerting osmotic pressure
    • II. Maintains normal circulation of tissue fluids
    • 4. Metabolism
    • I. Aids metabolic functions through enzymes, transport agents, and hormones
    • II. Acts as vehicle in nutrients necessary to transport fats in water-soluble blood supply
    • III. Peptide hormones à metabolism of glucose
    • 5. Body defense
    • I. Build special WBC and antibodies
    • C. Fats
    • 1.Energy
    • I. Fat serves as a fuel for energy production
    • II. Excess caloric intake from macronutrient source à converted into stored fat
    • 2. Essential nutrients
    • I. Dietary triglycerides supply body w/ essential fatty acids
    • II. Adequate amount of essential fats acid in = body produces other fats and cholesterol
    • III. Aid in absorption of vitamins
    • 3. Flavor and satisfaction
    • I. Adds flavor to foods
    • II. Slower rate of digestion
    • 4. Fat substitutes
    • I. Improve flavor and physical texture
    • II. Help reduce total dietary fat intake
  8. 8. Identify food sources of carbohydrates, proteins, and fats
    • A. Carbohydrate
    • 1. Starch
    • I. Rice, corn, wheat, potatoes
    • 2. Sugar
    • B. Proteins
    • 1. Complete
    • I. All nine indispensable amino acids
    • II. Animal origin
    • A. Egg D. Meat
    • B. Milk E. Poultry
    • C. Cheese F. Fish
    • 2. Incomplete
    • I. Deficient in one or more indispensable
    • II. Plant origin
    • A. Grains C. Nuts
    • B. Legumes D. Seeds
    • C. Fats
    • 1. Animal fats
    • I. Saturated fats comes from animal sources
    • A. Meat fats
    • 1. Bacon, sausage
    • B. Dairy
    • 1. Cream, ice cream, butter, cheese
    • C. Egg yolk
    • 1. Contains increase amounts of cholesterol
    • 2. Plant fats
    • I. Supply mostly monounsaturated and polysaturated
    • II. Includes essential fatty acids
    • III. Unsaturated fats
    • A. Monosaturated
    • 1. Olive oil
    • 2. Peanut
    • 3. Avocado
    • B. Polysaturated
    • 1. Vegetable oil
    • 2. Fish fat
  9. 9. Describe the principle functions of vitamins
    • A. Component of coenzyme
    • B. Antioxidant
    • C. Hormone that affect gene expression
    • D. Components of cell membranes
    • E. Components of light-sensitive rhodopsin molecule in eyes
    • F. Interact w/ enzymes + DNA replication
    • G. Antibacterial effects
  10. 10. Discuss differences of fat and water soluble vitamins
    • A. Fat-Soluble Vitamins
    • 1. Intestinal cells absorb fat-soluble vitamins with fat as a micelle and then incorporate all fat-soluble
    • nutrients into chylomicrons
    • 2. Absorption of fat-soluble vitamins is enhanced by dietary fat
    • B. Water-Soluble Vitamins
    • 1. Intestinal cells easily absorb water-soluble vitamins
    • 2. Transport of these vitamins do not require the assistance of carrier proteins
    • 3. Only B12 (cobalamin) and B6 (pyridoxine) are stored in the body
    • 4. Body relies on frequent intake of foods that are rich in water-soluble vitamins
  11. 11. Discuss function of minerals in the body’s metabolic processes
  12. 12. Explain the purpose of tools that plan or evaluate a diet for adequacy (1207?)
  13. 13. Develop nursing diagnoses that correct identify nutritional problems that may be treated by independent nursing interventions (1218)
    • A. Imbalanced nutrition: Less than body requirements r/t NPO, inadequate tube feeding, prolonged use of a
    • clear liquid diet, numerous food intolerance or allergies, excessive dieting, anorexia, chewing or swallowing difficulties, N/V, chronic diarrhea, malabsorption, psychological eating disorders, alcoholism, metabolic and endocrine disorders, inappropriate use of supplements
    • B. Imbalanced nutrition: More than body requirements r/t overeating, inactivity, metabolic and endocrine
    • disorders, inappropriate use of supplements
    • C. Risk for Imbalanced Nutrition: More than body requirements r/t inappropriate eating, closely spaced
    • pregnancies, metabolic and endocrine disorders, inappropriate use of supplements
  14. 14. Describe nursing interventions to help patients achieve their nutritional goals
  15. 15. Plan, implement, and evaluate nursing care r/t select nursing diagnoses that involve nutritional problems
  16. 16. Identify nursing interventions to safely deliver enteral nutrition (1230)
    • A. Check tube placement before administering any fluids, meds, or feeding
    • 1. XRAY
    • 2. pH testing
    • 3. Aspirate characterisitcs
    • 4. External length marking
    • 5. Carbon dioxide monitoring
    • B. Check gastric residual
    • 1. Check q4-6h during continuous feeding
    • 2. High gastric residual volumes (200-250 mL or greater) can be associated with high risk for aspiration
    • and aspiration related PNA
    • C. Assess ABD for abnormalities
    • 1. Assess for bowel sounds at least once per shift to check for peristalsis
    • 2. Delaying enteral feedings based on hypoactive bowel sounds may place pt. at risk for malnutrition
    • 3. Gastric distention, ABD girth, N/V, bloating, or pain are indicators of how pt. is tolerating feeding
    • D. Place patient at least 30 degrees during feeding for 1 hour afterward to prevent reflux and aspiration
    • E. Prevent contamination by maintaining integrity of feeding and using proper techniques
    • F. Administer oral hygiene q2-4h
    • 1. Prevent drying of tissues and to relieve thirst
    • G. Keep nares clean, especially around the tube, where secretions tend to accumulate
    • H. Encourage patient to verbalize concerns about tube feeding and presence of tube
    • I. Ensure tube is secured to prevent tension and tugging on the tube

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