1. Nutrition in Health Care
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2. Effects of Illness on Nutrition Status
Relationship between nutrition & illness is complex
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3. Medical problems can alter nutrient needs & result in malnutrition
Reduction in food intake( nausea, depression, chemotherapy, and radiation )
Interference with digestion & absorption (vomiting, diarrhea, chemotherapy, radiation, and some mediations
Alteration of nutrient metabolism & excretion
Increase metabolic rate & energy needs ( fever- stress)
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4. Poor nutrition can affect: Course of disease
Body’s response to treatment
Poor nutrition can delay wound-healing, contribute to anemia, depress immune system, and increase susceptibility to infections.
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5. When malnutrition occurs as a result of hospitalization, it is called
Iatrogenic malnutrition
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6. so : the Purpose of Clinical Nutrition (Medical Nutrition Therapy)
is to achieve or maintain good nutritional status.
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7. What is Medical nutrition therapy?
Medical nutrition therapy (MNT) is a therapeutic approach to treating medical conditions and their associated symptoms via the use of a specifically tailored diet devised and monitored by a: certified clinical nutritionist [CCN], registered dietitian or Functional Doctor.

8. The diet is based upon the patient's medical and psychosocial history, physical examination, functional examination and dietary history.
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9. The role of MNT when administered by a dietitian is to reduce the risk of developing complications in pre-existing conditions such as diabetes as well as ameliorate the effects any existing conditions such as high cholesterol.
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10. Patient Care Team Physician Clinical Dietitian Nurse Pharmacist
Occupational Therapist
Social Worker
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11. Responsibility for Nutrition Care
Physician:
prescribes diet orders & other aspects of nutrition care
Clinical dietician
identify nutritional problems, suggest strategies, provide nutritional services.
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12. What happens during a visit to a clinical nutritionist?
First, the clinical nutritionist will ask you questions about your medical history, family history, and personal lifestyle. The medical history might include questions about your diet, digestion, history of weight loss or gain, sleep and exercise patterns, and relaxation habits..

13. Some clinical nutritionists will ask you to bring a 3 day food diary and list of any herbs, supplements, or medicines that you take regularly. Laboratory tests might be used to find out if you are low in any nutrients and to test your organ function. This way, a nutritionist will get a full picture of your nutritional lifestyle
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14. During the second part of the visit, the nutritionist will suggest ways that you can fill the gaps and reduce the nutritional "overloads" in your diet. For example, your nutritionist may suggest that you eat your meals at different times or cut down on the amount of carbohydrates that you eat. The nutritionist will also offer advice on specific nutritional supplements if necessary. The nutritionist will then schedule follow up visits to monitor your health.

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16. Dr.Lamiaa Ali
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17. Improving Client’s Food Intake
Loss of appetite is common among patients in hospitals or other medical care facilities
Result of medical condition, treatment, emotional distress
Can be affected by medications & other treatments that alter taste perceptions
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18. Improving the Client’s Nutrition
Make formal nutritional assessments on regular basis
All members of health care team should be alert to signs of malnutrition every day
Listen to client’s concerns about diets served
Watch reaction to food served
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19. these may indicate that :
1. The client may need information about nutritional needs
2. The client may need a supplement
3. The client may want other foods
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20. Clinical dietitian have central role in helping patients to eat
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21. Helping patients to eat
At hospital , motivate patient to eat.
Help patient select foods he likes & mark menus appropriately according to his health condition
Suggest foods that require little effort to eat
Check patient’s tray to confirm correct diet & food selections
Take a positive attitude toward hospital foods
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22. Feeding the Client
At home, family menu should serve as basis for client’s meal whenever possible.
Family meals are easily adapted for the client by:
omitting or adding certain foods or
varying the method of preparation.
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23. Mashed potatoes with butter Buttered peas Salad with French dressing
Suppose the client was to limit fat intake and the family menu was the following:
Fried hamburgers
Mashed potatoes with butter
Buttered peas
Salad with French dressing
Ice cream with fresh strawberries
Whole milk
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24. Serving the Meal
Make tray and food arrangement as attractive as possible with a colorful garnish which must fit into the client’s diet plan
Serve water and another beverage (unless it is prohibited by the physician)
Serve food at proper temperature
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25. Offer bedpan and hygiene care before and after meal
When the client is on complete bed rest, special preparations are required before the meal is served:
Ensure client is in comfortable position with tray and utensils placed conveniently
Offer bedpan and hygiene care before and after meal
Remove any unpleasant sights
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26. Give sufficient time to eat.
continue
Open containers and try to anticipate client’s needs (If the client needs help, the napkin should be opened and placed, the bread spread, the meat cut, and the straw offered
Give sufficient time to eat.
If the meal is interrupted, the tray should be reheated and served again as soon as the interruption has resolved.
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27. The kinds and amounts of food refused, the time, type of diet, and client’s appetite should be recorded on the client’s chart after each meal.
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28. Feeding the Client Who Requires Assistance
Encourage clients to feed themselves
However, offer help when needed
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29. If the client is unable to feed herself or himself the person doing the feeding:
Sit near side of bed
Small amounts of food should be placed toward back of mouth with slight pressure on tongue with spoon or fork
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30. If one-sided paralysis, food and drinking straw should be placed on non-paralyzed side of mouth
If client begins to choke, help sit up straight. Do not give food or water while the client is choking
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31. Feeding the Blind Client
Arrange food as if plate were face of clock
Use consistent pattern so client knows where each item will be each time
Client usually feels better when helping themselves.
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33. Feeding the physically impaired Client
Eating and drinking require a considerable number of individual coordinated motions.
Adaptive feeding equipment can help patients with feeding disabilities gain independence.
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34. • Provide plates with food guards to prevent spilling.
Provide utensils that have modified handles, or are smaller or larger as necessary.
• Encourage the use of hands for feeding if utensils are difficult to maneuver.
• Provide plates with food guards to prevent spilling.
• Supply clothing protection
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