Nutrition, Assisting with Meals

Transcription

1 Duty: Address Client s Nutritional Needs Task : C.01 Encourage healthy eating choices C.02 Monitor client s food/fluid intake and output C.03 Inspect expiration of client s food C.04 Assist client with food preparation C.05 Serve client s meals C.06 Assist client with feeding C.07 Monitor client during mealtime E.07 Record fluid and food intake/output Objectives: Describe the importance of good nutrition and list basic nutrients. Describe MyPlate guidelines. Identify nutritional problems of the elderly or ill.

2 Objectives (cont.) Identify ways to assist clients in maintaining fluid balance. Explain how to prepare a basic food plan. List food shopping guidelines. List guidelines for safe food preparation. Describe therapeutic diets and how to prepare them. List guidelines for safe food storage. Describe guidelines for assisting with eating. Demonstrate assisting a dependent client with feeding.

3 Good nutrition maintains health, strength and energy. Eating a variety of foods provides the nutrients needed to support body functioning, fight infections, and recover from illness or injury. Elderly people have the same nutritional needs as younger people. However, they usually need fewer calories because they are less active. They may also have reduced sense of taste and smell leading and a loss of appetite. Dentures and vision loss may reduce the pleasure of eating. Medications and medical conditions may interfere with the absorption of nutrients from foods.

4 Nutrition is the method the body uses food and fluids to repair, maintain and grow new cells. Nutrients are the mechanism for this process. Proteins, carbohydrates, fats, vitamins, minerals and water are nutrients. Protein Essential for tissue growth and repair Provides a supply of energy Proteins Include: seafood, poultry, meat, eggs, milk, cheese, nuts, dried beans or legumes, and soy

5 Carbohydrates Fats Nutrition, Assisting with Meals Provide fuel for energy Provide fiber Complex carbohydrates include bread, cereal, potatoes, rice, pasta, vegetables, and fruits Simple carbohydrates include sugars, sweets, syrups, and jellies Help the body store energy Protect the organs Fats include butter, margarine, salad dressings, oils, and animal fats in meat, dairy products, fowl, and fish Monounsaturated and polyunsaturated fats are healthier fats

6 Vitamins Nutrition, Assisting with Meals Vitamins are essential to body functions Fat-soluble vitamins are A, D, E, and K Water-soluble vitamins are B and C Minerals Fiber Water Minerals form and maintain body functions Assists the body in digestion and elimination Found in fresh fruits, vegetables and whole grains Helps carry nutrients to cells and helps the body eliminate wastes. Found in mild, juice, other fluids, and many foods.

7 The Dietary Guidelines for Americans describe a healthy diet as one that: Emphasizes fruits, vegetables, whole grains, and fatfree or low-fat milk and milk products; Includes lean meats, poultry, fish, beans, eggs, and nuts; and Is low in saturated fats, trans fats, cholesterol, salt (sodium), and added sugars MyPlate helps individuals use the Dietary Guidelines: Make smart choices from every food group. Find balance between food and physical activity. Get the most nutrition out of calories. Stay within daily calorie needs.

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9 Guidelines for preventing unintended weight loss: Report observations and warning signs. Assure food looks, tastes, and smells good. Encourage clients to eat. Learn about and honor clients food likes and dislikes. Offer many different kinds of foods and beverages. Allow enough time for clients to finish eating. Help clients who have trouble feeding themselves. Report difficulty chewing or swallowing, mouth pain or dentures that do not fit properly.

10 Water is essential for life. Water aids in digestion, absorption of food, elimination of wastes, and maintaining normal body temperature. We need 64 ounces per day. Fluid balance is important in order to maintain good health. It is important to monitor fluid intake and output in clients at risk for imbalance. Dehydration - a serious condition in which a person does not have enough fluid in the body. Fluid overload - a condition that occurs when the body is unable to handle the amount of fluid consumed. Edema -swelling caused by excess fluid in body tissues.

11 Symptoms of dehydration Sudden weight loss Dry mouth and skin Cracked lips Constipation Dark, strong-smelling urine Weak pulse and low blood pressure Confusion or fatigued Symptoms of fluid overload Weight gain Swelling/edema Decreased urine output Difficulty breathing

12 Guidelines for preventing dehydration: Encourage clients to drink every time you see them. Offer fresh water or other fluids often. Make sure a pitcher and cup are near enough and light enough for a client to lift. Offer assistance with drinking. Accurately record fluid intake and output if part of the care plan or if client is at risk of dehydration. Be especially attentive to dehydration during hot weather seasons. Report symptoms of dehydration to supervisor.

13 Guidelines for preventing fluid overload: Restrict fluid intake to amount on care plan. Support client if restriction is difficult for them. Offer ices chips. Provide good oral care, including lubrication for lips. Monitor sodium intake.

14 Measuring fluid intake and output My be ordered to assure in clients at risk of dehydration or fluid overload. Fluids are measured and recorded in cubic centimeters cc). One ounce equals 30 cc. Intake record all fluids taken by mouth and soft foods that turn to liquid at room temperature (e.g. ice cream, gelatin, custard). Also record intravenous fluids or tube feedings. Daily intake for an adult is normally 2,500 cc unless fluids are restricted to a lesser amount. Output includes urine, watery stool, blood loss, vomitus, wound drainage, and perspiration. Urine is the easiest and most common measurement of output. Fluid intake and output should be fairly equal.

15 It is important to understand different types of diets in order to plan, shop for, and prepare meals. Bland diet used for clients with stomach and intestinal disorders. Food is unseasoned and easily digested. Avoid spices, whole grain, caffeine, raw fruits and vegetables. Mechanical soft diet used for clients who are having trouble chewing or swallowing. Regular food can be used, but must be softened, blended or pureed. Liquid diet for clients who are nauseated or having flulike symptoms. Two types: clear liquids such as water, clear soda, apple juice, Jell-o, broth.; full liquid such as milk, ice cream, yogurt, creamed soups.

16 Low sodium diet for clients who have blood pressure or heart problems. Do not add salt to cooking or at the table. Avoid foods such as ham, canned vegetables, bacon, lunchmeat, hot doges, most cheeses, tomato sauce/soup, salty snacks. Low fat diet may be ordered for clients with gall bladder, liver, or heart disease. Avoid fatty foods like sausage, butter, cheeses, fried food, whole milk, cream pies, cakes, donuts, ice cream, red meat. Low cholesterol diet used for clients with heart disease or history of stroke. Avoid foods high in saturated fat and cholesterol like eggs, red meat, fried foods, full fat dairy products. Diabetic diet based on calorie count and balanced protein carbohydrates, and fat. Avoid sugar foods and alcohol.

17 When creating a weekly meal plan and food shopping for the client, check the care plan for food allergies, dietary restrictions and special diet orders. Also consider : Food preferences Normal eating habits Cultural preferences Number of persons at meals Client s budget Nutritional value Food client already has on hand

18 Guidelines for grocery shopping: Read the unit price tags. Buy fruits and vegetables that are in season. Read food labels for nutritional values, especially if client is on a restricted diet. Shop from a list. Buy cheaper brands if approved by client. Use coupons if available. Avoid ready-made foods unless client needs these to microwave for ease and convenience.. Check expiration dates on food.

19 Guidelines for safe food preparation: Food-borne illnesses can be deadly for clients with weakened immune systems. Elderly clients are at higher risk for such illnesses. Wash hands frequently. Keep countertops and surfaces clean/disinfected. Handle raw meat, poultry, and fish carefully. Change dishcloths, sponges, and towels often. Thaw frozen foods in the refrigerator. Wash fruits and vegetables thoroughly. Cook meats, poultry, and fish thoroughly. Do not use cracked eggs or serve raw eggs.

20 Guidelines for safe food preparation (cont.): Do not taste and stir with the same utensil. Do not use expired foods. Use a sharp knife and clean cutting board. Keep equipment clean to prevent infection. Wash each piece of equipment in warm soapy water and rinse thoroughly..

21 Guidelines for safe food storage: Do not buy more food than can be safely stored. Refrigerate meat and dairy products immediately. Use small containers that seal tightly. Store canned good in a coo, dry place. Be aware of expiration dates. When in doubt, throw it out. Refrigerator should be kept clean and defrosted and the temperature at Freezer should be kept clean and defrosted and temperature at 0. Rotate grocery items so the oldest products are used first. Do not refreeze foods that have been thawed.

22 Some elderly who are on tight budgets do not throw away old foods. Be a role model for safe food storage with your clients.

23 Guidelines for serving a meal: Serve the meal in a relaxed and attractive way. Assist client with washing hands before and after meal. Serve appropriate portions. Assure food is at correct temperature. Serve the meal in the room the client desires. This may be in the living room on a TV tray. If your schedule permits, sit with the client or encourage family members to do so. Assist client with cutting meat or opening containers if needed. Observe amount of food and fluid the client consumes Observe for any problems with chewing or swallowing (dysphagia).

24 Guidelines for assisting with eating: Mealtime is a social time, which has a positive effect on eating. Client may be embarrassed when being fed. Encourage clients to do whatever they can for themselves. Do not treat the client like a child. Sit at client s eye level. Check the food temperature. Cut food as needed. Identify foods and fluids as needed. Call pureed foods by correct name.

25 Guidelines for assisting with eating: Allow client to make food choices. Do not mix foods unless asked. Do not rush the meal. Be social and friendly. Give the client your full attention while he or she is eating. Alternate offering food and drink.

26 Demonstrable Skill Feeding a Dependent Client (no I & O) 1. Identifies that hands should be washed and explains procedure to the client. 2. Positions the client in an upright position, at least 45 degrees. 3. Washes client's hands before feeding or gives client wash cloth and towel to wash her/his own hands and dries client's hands before feeding or assists client to dry hands. 4. Discards soiled linen in appropriate container. 5. Protects clothing from soiling by using napkin, clothing protector or towel. a. Actor responds in the affirmative when asked if they prefer a clothing protector. 6. Candidate positioned at eye level facing the client while feeding client and describes the foods being offered to the client. 7. Encourages as much independence as possible and offers each fluid frequently.

27 Demonstrable Skill Feeding a Dependent Client (cont.) 8. Offers small amounts of food at a reasonable rate and allows client time to chew and swallow a. Makes sure client's mouth is empty before offering the next bite or sip. 9. Wipes client's hands and face during meal at least one time and leaves client clean. 10. Leaves client in a position of comfort and talks with the client throughout the meal 11. Identifies that hands should be washed.