Nutrition By Dr. Ali Saleh 2/27/2014 1
Nutrition Functions of nutrients: Providing energy for body processes and movement. Providing structural material for body tissues. Regulating body processes. 2/27/2014 2
Essentials Nutrients Adequate well-balanced food intake include: Water Carbohydrate Protein Fat Vitamins Minerals. 2/27/2014 3
Healthy Body Weight Balance between the expenditure of energy and the intake of nutrients Ideal body weight (IBW) is the optimal weight recommended for optimal health Body mass index (BMI) is considered to be the more reliable indicator by health professionals BMI= Weight in kg/(height in meters)² 2/27/2014 4
Factors Influencing Nutrition Developmental considerations Gender Ethnicity and culture Beliefs about food Personal preferences Religious practices Lifestyle 2/27/2014 5
Factors Influencing Nutrition Economics Medications and therapy Health Alcohol consumption Advertising Psychologic factors 2/27/2014 6
Altered Nutrition Malnutrition: lack of necessary or appropriate food substances which include undernutrition or overnutrition. Overnutrition: caloric intake in excess of daily energy requirements, resulting in storage of energy in the form of adipose tissue. Overweight: BMI = 25-29.9 kg/m² Obese: BMI >30kg/m² 2/27/2014 7
Effects of Overnutrition More stress on body organs Predispose chronic health problems such as HF, MI, HTN, DM. Obesity may interfere with mobility or breathing and is called morbid obesity 2/27/2014 8
Altered Nutrition Undernutrition: insufficient nutrients to meet daily energy requirements due to inadequate food intake, improper digestion or absorption of food Causes of inadequate food intake: Inability to acquire and prepare food Lack of knowledge about essential nutrients Discomfort during or after food intake Dysphagia (inability to swallow), Anorexia (loss of appetite), Nausea and vomiting Causes of improper digestion or absorption of food Inadequate production of hormones or enzymes Medical conditions 2/27/2014 9
Undernutrition Undernutrition is associated with: Weight loss Generalized weakness Altered functional abilities Delayed wound healing Risk for infection Decreased immunocompetence Impaired pulmonary function Prolonged length of hospitalization 2/27/2014 10
Altered Nutrition Protein-calorie malnutrition (PCM) seen in starving children Depressed visceral proteins (albumin) Weight loss Muscle and fat wasting 2/27/2014 11
NANDA Nursing Diagnoses Imbalanced Nutrition: More Than Body Requirements Imbalanced Nutrition: Less Than Body Requirements Risk for Imbalanced Nutrition: More Than Body Requirements 2/27/2014 12
Nursing Interventions for Optimal Nutrition Assisting with special diets: Clear liquid diet Full liquid diet Soft diet Diet as tolerated Modification for disease. 2/27/2014 13
Nursing Interventions for Optimal Nutrition Stimulating patient s appetite Food that person likes Small amounts Avoid unpleasant or uncomfortable treatment immediately before or after meal Provide tidy, clean, pleasant presented environment. Provide oral hygiene before mealtime. Relieve illness symptoms such as pain Reduce psychologic stress such as lack of understanding, anticipation of operation, and fear 2/27/2014 14
Nursing Interventions for Optimal Nutrition Assisting the patient with meals - Blind patient - Offer hand washing, oral hygiene - Comfortable Position - Record and monitor eating pattern for amount, pain, fatigue etc 2/27/2014 15
Nursing Interventions for Optimal Nutrition Enteral Feeding Provided when the patient unable to ingest food or with impaired GI tract. Nasogastric tube Nasoenteric tube(nasointestinal) longer tube Gastrostomy and jejunostomy tubes Gastrostomy and jejunostomy are created for long term nutritional support, more than 6-8 weeks Using percutaneous endoscopic gastrostomy (PEG), percutaneous endoscopic jejunostomy (PEJ) Enteric feeding pumps 2/27/2014 16
Nursing Interventions for Optimal Nutrition Total Parenteral Nutrition (TPN) Hypertonic (highly concentrated) solutions of dextrose, water, fat, protein, electrolytes, vitamins, and trace elements Injected only into high flow central veins where diluted by patient s blood. 2/27/2014 17