Nursing Management: Nutritional Problems Chapter 40 Overview Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

2 Nutritional Problems Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

3 Normal Nutrition Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Fig In the MyPyramid, each food group is characterized by varying widths, representative of the proportion of each group that should be eaten. The person climbing the stairs on the side of the pyramid indicates the need to include daily physical activity in a healthy lifestyle.

4 Normal Nutrition Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Table Good Sources of Protein.

5 Normal Nutrition Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Table Major Minerals and Trace Elements.

6 Special Diets Vegetarian Diet Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

7 Culturally Competent Care: Nutrition Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

8 Malnutrition Types of Malnutrition  Protein-calorie malnutrition  Marasmus and kwashiorkor Etiology of Malnutrition  Socioeconomic factors  Physical illnesses  Incomplete diets  Food-drug interactions Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

9 Malnutrition Pathophysiology: Starvation Process Clinical Manifestations Diagnostic Studies  History and physical examination  Laboratory studies  Anthropometric measurements Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

10 Nursing Management: Malnutrition Nursing Assessment Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

11 Nursing Management: Malnutrition Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Fig Patient with malnutrition.

12 Nursing Management: Malnutrition Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Table Desirable Body Weight Based on Hamwi Formula (Rule of Thumb).

13 Nursing Management: Malnutrition Nursing Diagnoses Planning Nursing Implementation  Health promotion  Acute intervention  Ambulatory and home care Evaluation Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

14 Gerontologic Considerations: Malnutrition Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

15 Types of Specialized Nutrition Support Oral Feeding Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

16 Types of Specialized Nutrition Support Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Fig Nutrition support algorithm.

17 Types of Specialized Nutrition Support Enteral Nutrition Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

18 Types of Specialized Nutrition Support Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Fig Common enteral feeding tube placement locations.

19 Types of Specialized Nutrition Support Enteral Nutrition, continued  Nasogastric and nasointestinal tubes  Gastrostomy and jejunostomy Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

20 Types of Specialized Nutrition Support Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Fig Placement of a gastrostomy tube.

21 Types of Specialized Nutrition Support Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Fig Percutaneous endoscopic gastrostomy. A, Gastrostomy tube placement via percutaneous endoscopy. Using endoscopy, a gastrostomy tube is inserted through the esophagus into the stomach and then pulled through a stab wound made in the abdominal wall. B, A retention disk and bumper secure the tube.

22 Types of Specialized Nutrition Support Enteral Nutrition, continued  Procedures for tube feedings  Complications related to tubes and feedings Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

23 Gerontologic Considerations: Enteral Nutrition Parenteral Nutrition Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

24 Gerontologic Considerations: Enteral Nutrition Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc. Table Common Indications for Parenteral Nutrition.

25 Gerontologic Considerations: Enteral Nutrition Parenteral Nutrition, continued  Composition Calories Protein Electrolytes Trace elements Vitamins Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

26 Gerontologic Considerations: Enteral Nutrition Parenteral Nutrition, continued  Methods of administration Central PN Peripheral PN Comparison of central and peripheral PN  Administration of solution Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

27 Nursing Management: Parenteral Nutrition Home Nutrition Support Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.

28 Eating Disorders Anorexia Nervosa Bulimia Nervosa Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.