Betty Sawyer, M Ed RD LD Registered Clinical Dietitian Clinical Nutrition Betty Sawyer, M Ed RD LD Registered Clinical Dietitian

PURPOSE To increase knowledge about the importance of good nutrition and how it affects health and longevity. To understand how disease affects nutrition requirements. To recognize members of the healthcare team.

How do you become a registered dietitian? What do they do? Clincial Community Sports Food service Wellness Food science

Altered nutrition needs Wounds Impaired swallow Diabetes Underweight Heart Disease Obesity Renal dysfunction Liver dysfunction

Altered lab data Altered intake Altered height/weight Nutrition assessment Altered lab data Altered intake Altered height/weight

HYDRATION/DEHYDRATION SODIUM Na BLOOD UREA NITROGEN BUN CREATININE CR

HEPATIC FUNCION AST – aspartate aminotransferase LDH – lactate dehydrogenase ALT – glutamic pyruvic transaminase ALK PHOS-alkaline phosphotase BILIRUBIN – bili Ammonia – NH3

LIPIDS TRIGLYCERIDES CHOLESTEROL HIGH DENSITY LIPIDS HDL’S LOW DENSITY LIPIDS LDL’S

HYPERGLYCEMIA SERUM GLUCOSE BLOOD SUGAR HEMAGLOBIN A1C

RENAL FUNCTION BLOOD UREA NITROGEN CREATININE MICROALBUMINEMIA PHOSPHORUS POTASSIUM CGFR

INFECTION WHITE BLOOD COUNT WBC

ANEMIA HEMAGLOBIN HGB HEMATOCRIT HCT

NUTRITION RENAL FUNCTION LIVER FUNCTION PREALBUMIN/ALBUMIN TOTAL PROTEIN

CONGESTIVE HEART FAILURE B TYPE NATRIURETIC PROTEIN BNP

ELECTROLYTES POTASSIUM (K) PHOSPHORUS (PO4) MAGNESIUM (Mg) CALCIUM (Ca)

BOWEL FUNCTION CLOSTRIDIUM DIFFICILE TOXIN (C. DIFF+)

HEART MUSCLE TROPONINS

Enteral nutrition Parenteral nutrition Tube feedings IV nutrition

Wounds Adequate protein/calories Multivitamin Vit C – 500 mg daily Zinc – 50 mg daily (4-6 weeks)

Increased frequency Reduced carbohydrate Regular meals and times Diabetes Increased frequency Reduced carbohydrate Regular meals and times

Hospital Nutrition Serivces Nutrition evaluation Nutrition education Room service

Ideal body weight calculation Women: 5” 100# then 5# for every additional inch Men: 5’ – 106# then 6# for every additional inch

QUESTIONS?