Mosby items and derived items © 2005 by Mosby, Inc. Chapter 43 Nutrition

Mosby items and derived items © 2005 by Mosby, Inc. Elements of Energy and Nutrition Basal metabolic rate (BMR) Resting energy expenditure (REE) Nutrient density Nutrients: carbohydrates, proteins, fats, water, vitamins, minerals

Mosby items and derived items © 2005 by Mosby, Inc. Carbohydrates Produce 4 kcal/g Main source of energy Saccharides: simple and complex carbohydrates, fiber

Mosby items and derived items © 2005 by Mosby, Inc. Proteins Produce 4 kcal/g Essential for growth, maintenance, and repair of body tissue Amino acids: essential and nonessential Complete and complementary proteins Nitrogen balance

Mosby items and derived items © 2005 by Mosby, Inc. Fats (Lipids) Produce 9 kcal/g Triglycerides and fatty acids Saturated or unsaturated: monounsaturated or polyunsaturated fatty acids Essential or nonessential fatty acids

Mosby items and derived items © 2005 by Mosby, Inc. Water Comprises 60% to 70% of body weight Cell function depends on a fluid environment

Mosby items and derived items © 2005 by Mosby, Inc. Vitamins Essential to normal metabolism Fat-soluble: A, D, E, K Water-soluble: C and B complex

Mosby items and derived items © 2005 by Mosby, Inc. Minerals Inorganic elements essential as catalysts in biochemical reactions Macrominerals Microminerals or trace elements

Mosby items and derived items © 2005 by Mosby, Inc. Digestive System Anatomy and physiology –Digestion –Absorption –Metabolism and storage of nutrients –Elimination

Mosby items and derived items © 2005 by Mosby, Inc. Dietary Guidelines Dietary referenced intakes (DRIs) Food guidelines: food guide pyramid Daily values Healthy People 2010

Mosby items and derived items © 2005 by Mosby, Inc. Nutritional Needs throughout Growth and Development Infants through school-age –Breast-feeding –Formulas –Solid foods –Food habits Adolescents –Eating disorders –Activities

Mosby items and derived items © 2005 by Mosby, Inc. Nutritional Needs throughout Growth and Development (cont'd) Young and middle adults –Pregnancy –Lactation Older adults

Mosby items and derived items © 2005 by Mosby, Inc. Alternative Food Patterns Cultural and religious practices Vegetarian diets

Mosby items and derived items © 2005 by Mosby, Inc. Assessment: Diet History Dietary intake and pattern Symptoms Allergies Taste Chewing and swallowing Appetite Elimination Medications

Mosby items and derived items © 2005 by Mosby, Inc. Assessment Anthropometry Body mass index (BMI) Ideal body weight (IBW) Laboratory tests Clinical observations Client expectations

Mosby items and derived items © 2005 by Mosby, Inc. Nursing Diagnoses Risk for aspiration Constipation Diarrhea Imbalanced nutrition: less than/more than body requirements Feeding self-care deficit

Mosby items and derived items © 2005 by Mosby, Inc. Planning Goals and outcomes –Client’s daily nutritional intake meets the minimum DRIs –Client loses ½ pound per week Setting priorities Continuity of care

Mosby items and derived items © 2005 by Mosby, Inc. Implementation: Health Promotion Client education Meal planning Food storage and preparation safety

Mosby items and derived items © 2005 by Mosby, Inc. Implementation: Acute Care Advancing diets Promoting appetite Assisting clients with feeding Enteral feeding Parenteral nutrition

Mosby items and derived items © 2005 by Mosby, Inc. Enteral Feeding Nasogastric, jejunal, gastric tubes Insertion and verification of placement Types and preparation of formulas Complications

Mosby items and derived items © 2005 by Mosby, Inc. Parenteral Nutrition Initiation and management of insertion site Types of solutions Rate of infusion Prevention of complications

Mosby items and derived items © 2005 by Mosby, Inc. Implementation: Restorative Care Medical nutrition therapy for specific illnesses, conditions, or injuries –GI diseases –Diabetes –Cardiovascular diseases –Cancer –HIV

Mosby items and derived items © 2005 by Mosby, Inc. Evaluation Client care Client expectations