Nutrition I
Carbs:
Major source of?
Total cal daily and how much daily?
Mainly found in?
Sources?
Stored forms?
When to limit?
Major source of energy
50-60% of total daily calories
Found mainly in fruits and plants and have fiber
SOURCES - bread, pasta, potatoes, rice, dried beans and fruit
Stored forms - glycogen: muscle and liver (released from liver as needed)
Polycystic ovarian disease, celiac disease, diabetes mellitus
Fats:
Total daily calories?
Needed for?
Sources?
20-30% of total daily calories
Needed for energy and lipoproteins
Sources - fatty meats, ice cream, cream, butter nad butter products such as cakes, pies, cookies
Anthropometric measurements
Skinfold (tricep flat fold) - most common
Mid-arm circumference
Mid-arm muscle circumference
Waist circumference
Waist to Hip Ratio (WHR)
What to do about malnutrition
Assess food likes and dislikes
Provide high calorie diet (milkshakes, puddings, supplements)
Provide social interaction and pleasant environment
If unable to eat, may need Feeding Tube or TPN
Without me your wounds will not heal, your growth will be stunted, have hypogonadism, anemia and an impaired immune system. Who am I?
Simple Sugars
Fruits and processed plants
Provide quick energy
Break down quick - gone in two hours
Saturated fats and unsaturated fats
Saturated fats - trans fatty acids (bad fats that come from animal sources and increase bad cholesterol), blood cholesterol (made in liver)
Unsaturated fats - monounsaturated and polyunsaturated (good fats that come from vegetable oils)
Protein malnutrition
Kwashiorkor
- edema
- decreased wound healing
- Increased infections
- Albumin <2.8
- Skin breakdown/pluckable hair
Nursing Interventions for nutrition
Let client feed self as much as possible
Provide set up assist (open, cut)
Follow feed if necessary
If blind use clock method
Provide fluids
Toxicity of me will give you Wilson's Disease. I can accumulate in your brain, liver, kidney and cornea. I am found in all body tissue, needed for energy and aid in forming Hgb. Who am I?
Copper
Starch
Vegetables and grains
Break down slower than simple sugars
Energy requirements (BMR) functions and factors
BMR functions - breathing, digesting food, blood flow, muscle tone, body temp
Factors - physical activity, type of food and frequency of eating, health conditions
Malnutrition due to Protein and Calories
Marasmus
- Weight loss (severe fat and muscle loss; thin, weak, listless)
Hints for losing weight
Decrease weight 1-2 lbs/week
Keep foods in the kitchen, only eat there
Don't eat while doing other activites
Drink 8oz water before eating
Use small plates, smaller portions
Eat slowly, chew thoroughly
Put down utensils between each bite
Don't taste food while cooking
Don't shop while hungry
Don't keep snacks in house
Weigh weekly, not daily
Don't skip meals
Do a hobby instead of eating
Decrease liquid calories
Without me you will develop scurvy, anemia, death and kidney stones. I aid in forming collagen, decrease the impact of stress, am an antioxidant and protein metabolism. Who am I?
Vitamin C
Sources - Citrus fruits, cantaloupe, strawberries, broccoli, brussel sprouts, chicken liver and kidney, potato
Scurvy - red, sore mouth, bleeding gums, muscle weakness, rough brown dry skin, difficulty with wound healing, fractures loose teeth
Fiber:
Sources?
Retains?
Increases/Decreases?
What happens without water?
Delays? Lowers?
Nursing Actions?
Good for?
Sources - Cereal (esp. Bran), whole wheat, raw fruit and vegetables
Retains water so it liquifies stool
Increases the rate that food moves through the colon (diarrhea)/Decreases constipation
Without water can cause bowel obstruction
Delays absorption of glucose. Lowers cholestrol
Nursing Actions - add fiber gradually, drink plenty water
Good for - lowering BS, preventing colon cancer and controls weight
Causes of malnutrition
Anorexia, bulemia
Decreased mobility (difficult to make food)
Chronic alcoholism (doesn't eat, drinks constantly)
Unable to eat - cancer of mouth, throat, stomach, bowel, stomatitis, endentulous (no teeth)
Extreme needs for nutrients - burns, trauma
Isolation - elderly may not eat if living alone
Dementia - forget to eat
S&S Malnutrition
Fatigue
Frequent illness
Dry, flaky, scaly, pale skin
Lack of subcutaneous tissue
Petechiae or bruises
Pale ridges, spoon shaped nails
Dry, dull, sparse, loss of color hair
Pale or red conjunctive
Swollen, red cracked lips, gums and tounge
Common allergies among children
Allergies in adults
S&S of allergic reaction
Allergies in children - Peanuts (likely to go into adulthood), Milk, Soy products, Egg
Adults - nuts and fish
S&S - rash, itching, hives, tingling sensation in the mouth, vomiting, cramping, diarrhea, eye irritation and redness
S&S of Anaphylaxis (severe reaction) - swelling of tongue and throat, difficulty breathing, decreased BP, LOC, death TREATMENT - epinephrine
I am found in most food, esp. meat, and milk products. I look like red kool-aid in a vial and will give you sock and glove syndrome without me? Who am I?
Vitamin B12 - cyancobalamine
Deficiency - caused by lack of intrinsic factor in gastric contents, so can't absorb B12, causes anemia due to can't absorb iron, neuro problems and pernicious anemia (macrocidic anemia)
Treatments - monthly IM injections
Protein:
Daily calories?
Sources?
Breakdown and provides?
Needed for?
10-20% of daily calories
Sources: milk, meats, legumes (nuts)
Breakdown slow and provide energy for hours
Needed for skin, hair and nails, fluid balance (protein pulls H2O), tissue repair, enzymes for digestion/absorption, antibodies, RBC/WBC, lipids with proteins (lipoproteins)
Assessment of malnutrition
BMI <19
Low Hgb - possible anemia
High Hgb - possible dehydration
NL Hgb = 12-14 women/ 14-16 men
3xHgb = Hct
Cholesterol <160 can mean malnutrition
Albumin <3.5
Assisting with Eating/Feeding
Position (sitting up or HOB up)
Oral hygiene, wash hands
Maintain dignity (no bibs, use napkin)
Unhurried and chat with
Free of odors, treatments and equipment
Give small bites, slowly and allow to chew and swallow
I am needed for thyroid hormone to form T3 and T4. Without, I can develop goiters and Myxedema. What am I?
Iodine
Sources - iodized salt and seafood
Essential for normal function of the thyroid gland which determines rate of metabolism
Toxicity of me will give you hemochromatosis (liver, spleen and heart damage). Absorption of me is decreased with tea & coffee and stomach acidity is effected. Who am I?
Iron
Deficiency - fatigue, weakness, short of breath, irritability, pale skin, spoon shaped fingers