1. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 19 Basic Nutrition

2. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins How Our Bodies Use Food All living things eat Nutrients

3. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Nutrition Nutrition is the process of taking in food and using it The process of nutrition involves –Ingestion –Digestion –Absorption –Metabolism Metabolism provides energy measured in units called kilocalories, more commonly known as calories

4. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Nutrients Food taken into our bodies is broken down into essential elements called nutrients Nutrients provide us with energy Nutrients help our bodies function properly

5. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Types of Nutrients Nutrients that supply energy: –Carbohydrates –Proteins –Fat Nutrients that regulate body processes: –Vitamins –Minerals –Water

6. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Balanced Diet A diet that provides the body with a balanced amount of the essential nutrients Tools to help in achieving a balanced diet: –Canada’s Food Guide –Food labels

7. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Canada’s Food Guide Obesity (extreme overweight) is increasing every year Significant increase in health problems Canada’s Food Guide –Emphasizes the importance of getting enough physical activity and eating a healthy, balanced diet

8. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins A healthy diet as one that –Emphasizes fruits, vegetables, whole grains, and fatfree or low-fat milk products –Includes lean meats, poultry, fish, beans, eggs, and nuts –Is low in saturated fats, trans fats, cholesterol, salt (sodium), and added sugars Canada’s Food Guide (cont.)

9. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Food Labels Second tool available to help you plan a balanced diet Education Include information about the food’s nutritional value, approximate serving size, and any related health claims

10. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Factors That Affect Food Choices and Eating Habits Some want a hot, hearty breakfast to start the day Some people like a light meal at lunchtime while others eat their main meal at mid-day Individual choices

11. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Factors that affect food choices: –Religion –Culture and geography –Finances –Kitchen skills –Individual taste –Appetite Factors Affecting Food Choices

12. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Respecting the Individual The nurse should complete a dietary assessment to find out as much as possible about the patient or resident’s eating habits and likes and dislikes Respecting the individual’s preferences is important when it comes to food

13. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Types of Special Diets Types of diets: –Regular “house” diet –Clear liquid diet –Full liquid diet –Soft diet –Diabetic diet (consistent-carbohydrate diabetes meal plan) –Sodium-restricted diet –Low-cholesterol diet Nutritional supplements are used to supply extra calories or protein in addition to a special diet

14. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins i-Clicker Question Tell whether the following statement is true or false. One tool for eating a healthy balanced diet is Canada’s Pyramid Guide. a.True b.False

15. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer b. False Rationale: Canada’s Food Guide emphasizes the importance of getting enough physical activity and eating a healthy, balanced diet and is a tool for eating a healthy, balanced diet

16. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Mealtime Mealtime for people in a health care setting can be difficult for many reasons: –The person may miss family members or familiar foods –Food choices may be limited or the food may not be prepared the way the person likes it –Meals are usually served at specific times, not just when the person feels like eating –Mealtime can be lonely, especially if the person must stay in his or her room to eat

17. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Mealtime (cont.) Mealtime for people in a health care setting can be difficult for many reasons: (cont.) –Physical problems (such as pain or nausea) and emotional problems (such as anxiety) can affect a person’s appetite –The person may be embarrassed if he or she needs help to eat –Long-term care facilities have policies that relate to the resident’s dining experience

18. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Importance of Mealtime Measures for setting a relaxed overall atmosphere and stimulating the appetite: –Provide companionship –Provide assistance as needed –Present food to stimulate the appetite –Offer small portions of favourite foods –Ensure that the patient or resident has a clean, fresh mouth

19. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Importance of Mealtime (cont.) Measures for setting a relaxed overall atmosphere and stimulating the appetite: (cont.) –Ensure that the patient or resident is in a comfortable position –Provide aids if used by the person –Provide pleasant conversation

20. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Preparing for Mealtime Personal support workers must –Allow time to prepare and complete early-morning or afternoon care –Assist with toileting –Assist with basic hygiene –Assist the person to the dining room –Position the person for eating –Provide a pleasant environment

21. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Assisting With Meals A clock face is used to reference the location of food on the tray for people with poor eyesight

22. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Feeding Dependent Patients and Residents Involve the person in the process as much as possible Sit down and talk to the person Use a spoon, not a fork, and fill it only about one third full Give the person time to chew and swallow each bite; never rush the person Offer liquids frequently between bites

23. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Measuring and Recording Food Intake Methods –Record the portion of the total meal that was consumed Inform the nurse if a patient or a resident eats less than 70% of his or her meal –Record the percentage of each food eaten

24. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Intravenous (IV) therapy Alternate Methods

25. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Enteral nutrition: –A nasogastric tube –A nasointestinal tube –A gastrostomy tube –A jejunostomy tube –A percutaneous endoscopic gastrostomy (PEG) tube Alternate Methods

26. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Total parenteral nutrition (TPN, hyperalimentation) Alternate Methods

27. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Fluid Balance When the amount of fluid taken into the body equals the amount of fluid that leaves the body, a state of fluid balance exists Fluid balance is important for health

28. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Dehydration Dehydration occurs when there is too little fluid in the body Causes include –Diarrhea –Vomiting –Hemorrhage –Severe burns –Excessive sweating –Not drinking enough fluids

29. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Edema Edema occurs when there is too much fluid in the body Causes include –Kidney disease –Heart disease

30. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Offering Fluids Encourage fluid intake unless otherwise ordered –People are more likely to drink fluids that taste good and are served at the proper temperature –Keep a water pitcher filled with ice water –Offer fluids frequently to people who are bed bound, confused, or taking pain medications A person who is not allowed to have any fluids at all is said to be on NPO status –No water, no ice, no food, no candy, no gum

31. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Measuring and Recording Intake and Output Use an intake and output (I&O) flow sheet to record the respective amounts of fluid 30 mL (30 cc) = 1 ounce Calculate intake by estimating or measuring leftover fluids with a graduate and subtracting that number from the amounts of fluids that were on the tray to begin with

32. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins i-Clicker Question You are caring for a resident who is considered legally blind. How would you reference the position of food on the resident’s plate? a.Use the reference of right/left and up/down b.Use the reference of a circle c.Use the reference of a triangle d.Use the reference of a clock face

33. Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins Answer d. Use the reference of a clock face Rationale: A clock face is used to reference the location of food on the tray for people with poor eyesight