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DFS Approved Curriculum-Unit 61 Unit 6 Nutrition and Hydration Nurse Aide I Course.

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Presentation on theme: "DFS Approved Curriculum-Unit 61 Unit 6 Nutrition and Hydration Nurse Aide I Course."— Presentation transcript:

1 DFS Approved Curriculum-Unit 61 Unit 6 Nutrition and Hydration Nurse Aide I Course

2 DFS Approved Curriculum-Unit 62 Nutrition and Hydration Introduction This unit introduces the nurse aide to the basic principles of nutrition and emphasizes the functions of the major nutrients required for health.

3 DFS Approved Curriculum-Unit 63 Nutrition and Hydration Introduction (continued) This unit covers the Food Guide Pyramid, the use of therapeutic diets, adaptive devices, alternative methods of feeding, providing water and nourishments, the procedure for feeding a resident, and the effects of good nutrition and poor nutrition.

4 DFS Approved Curriculum-Unit 64 Nutrition and Hydration Introduction (continued) Knowledge of nutrition will enable the nurse aide to recognize the important relationship between food and good health.

5 DFS Approved Curriculum-Unit 65

6 6 6.0Identify the general principles of basic nutrition. 6.1Identify factors that influence dietary practices.

7 DFS Approved Curriculum-Unit 67 Good Nutrition Promotes physical and mental health Provides increased resistance to illness Produces added energy and vitality

8 DFS Approved Curriculum-Unit 68 Good Nutrition (continued) Aids in healing process Assists one to feel and sleep better

9 DFS Approved Curriculum-Unit 69 Functions of Food Provides energy Growth and repair of tissue Maintenance and regulation of body processes

10 DFS Approved Curriculum-Unit 610 Factors Influencing Dietary Practices Personal preference Appetite Finance Illness Culture

11 DFS Approved Curriculum-Unit 611 6.1.1Review cultural variations in diet.

12 DFS Approved Curriculum-Unit 612 Culture and Dietary Practices The diets of Chinese, Japanese, Koreans and people from Far East include rice and tea The diets of Spanish- speaking people include spicy dishes containing rice, beans and corn

13 DFS Approved Curriculum-Unit 613 Culture and Dietary Practices (continued) The Italian diet includes spaghetti, lasagna, and other pastas Scandinavians have a lot of fish in their diets

14 DFS Approved Curriculum-Unit 614 Culture and Dietary Practices (continued) Americans eat a lot of meat, fast foods, and processed foods Use of sauce and spices are culturally related

15 DFS Approved Curriculum-Unit 615 Culture and Food Preparation Frying Baking Smoking Roasting Fresh/raw

16 DFS Approved Curriculum-Unit 616 6.1.2List seven examples of foods avoided by some religious denominations.

17 DFS Approved Curriculum-Unit 617 Religion and Dietary Practices Days of fasting when all or certain foods are avoided. Christian Science - avoid coffee/tea and alcohol Roman Catholic - avoid food one hour before communion, observe special fast days

18 DFS Approved Curriculum-Unit 618 Religion and Dietary Practices (continued) Muslim/Moslem - avoid alcohol, pork products 7th Day Adventist - avoid coffee/tea, alcohol, pork and some meats, caffeine

19 DFS Approved Curriculum-Unit 619 Religion and Dietary Practices (continued) Baptists – some avoid coffee, tea and alcohol Greek Orthodox - fast days, but usually forgiven when ill

20 DFS Approved Curriculum-Unit 620 Religion and Dietary Practices (continued) Conservative Jewish faith –Prohibits shellfish, non- kosher meats such as pork –Requires special utensils for food preparation

21 DFS Approved Curriculum-Unit 621 Religion and Dietary Practices (continued) Conservative Jewish faith –Forbids cooking on Sabbath –Forbids eating of leavened bread during Passover

22 DFS Approved Curriculum-Unit 622 Religion and Dietary Practices (continued) Conservative Jewish faith –Forbids serving milk and milk products with meat –Strict rules regarding sequence in which milk products and meat may be consumed

23 DFS Approved Curriculum-Unit 623 6.1.3Review the major classification of nutrients and their function in the body.

24 DFS Approved Curriculum-Unit 624 Nutrients Nutrients are essential Four classifications of nutrients 1.Fats - provide energy, help body use certain vitamins, conserve body heat and protect organs from injury 2.Proteins – build and repair tissue

25 DFS Approved Curriculum-Unit 625 Nutrients (continued) Four classifications of nutrients (continued) 3.Carbohydrates - provide energy and fiber that help in bowel elimination 4.Vitamins and minerals - ingested through food and are necessary for carrying out and maintaining specific body functions

26 DFS Approved Curriculum-Unit 626 Nutrients (continued) Fats, proteins and carbohydrates measured in calories

27 DFS Approved Curriculum-Unit 627 Nutrients (continued) Water - solvent for nutrients and metabolic waste products –Found in all body tissue –Essential for digestion of food –Makes up most of blood plasma –6 to 8 glasses necessary per day –Has no caloric value

28 DFS Approved Curriculum-Unit 628 6.1.4Describe six factors that influence caloric needs.

29 DFS Approved Curriculum-Unit 629 Factors That Influence Caloric Need Age Sex Size and activity level Climate State of health Amount of sleep obtained

30 DFS Approved Curriculum-Unit 630 6.1.5Cite nine age-related changes/factors that affect the residents nutritional status.

31 DFS Approved Curriculum-Unit 631 Age Related Changes/Factors Affecting Nutrition Need for fewer calories Vitamin and mineral requirements change Drugs that affect how nutrients are absorbed and used Teeth/dentures affect ability to chew food

32 DFS Approved Curriculum-Unit 632 Age Related Changes/Factors Affecting Nutrition (continued) Diminished sense of taste and smell Assistance required with eating Decreased saliva and gastric juices production Discomfort caused by constipation Decreased appetite and thirst

33 DFS Approved Curriculum-Unit 633 6.1.6Recognize the signs of good nutrition.

34 DFS Approved Curriculum-Unit 634 Signs Of Good Nutrition Healthy, shiny looking hair Clean skin and bright eyes A well-developed, healthy body An alert facial expression An even, pleasant disposition

35 DFS Approved Curriculum-Unit 635 Signs Of Good Nutrition (continued) Restful sleep patterns Healthy appetite Regular elimination habits Appropriate body weight

36 DFS Approved Curriculum-Unit 636 6.1.7Identify seven results of poor nutrition.

37 DFS Approved Curriculum-Unit 637 Results of Poor Nutrition Hair and eyes appear dull Irregular bowel habits Weight changes Osteoporosis and other diseases

38 DFS Approved Curriculum-Unit 638 Results of Poor Nutrition (continued) Lack of interest - mental slowdown Skin color and appearance poor

39 DFS Approved Curriculum-Unit 639 Results of Poor Nutrition (continued) Anemia leading to: –tired feeling –shortness of breath –increased pulse –problems with digestion –pale skin –poor sleep patterns –headaches

40 DFS Approved Curriculum-Unit 640

41 DFS Approved Curriculum-Unit 641 6.2Discuss the six basic food groups from the Food Guide Pyramid that contribute to balanced nutrition.

42 DFS Approved Curriculum-Unit 642 Dietary Guide For Americans Guidelines are the foundation of the Food Guide Pyramid and include nine key recommendations. Key recommendation #1: Consume nutrient-dense foods and beverages within calories needed for age, sex and activity level.

43 DFS Approved Curriculum-Unit 643 Dietary Guide For Americans Key recommendation #2: To maintain health body weight, balance calories consumed with calories expended. Key recommendation #3: Engage regularly in a variety of physical activities and reduce sedentary activities.

44 DFS Approved Curriculum-Unit 644 Dietary Guide For Americans Key recommendation #4: Encourage the following: –Choose variety of fruits and vegetables daily. –Half of daily grains should come from whole grains. –Consume 3 cups fat-free or low fat milk or equivalent milk products daily.

45 DFS Approved Curriculum-Unit 645 Dietary Guide For Americans Key recommendation #5: Consume foods and beverages that are low in saturated fats, trans fats and cholesterol. Key recommendation #6: For carbohydrates: Choose fiber-rich foods, vegetables and grains often. Reduce intake of sugar- and starch-containing foods.

46 DFS Approved Curriculum-Unit 646 Dietary Guide For Americans Key recommendation #7: Consume less than a teaspoon of salt per day. Key recommendation #8: Consume alcoholic beverages in moderation if alcohol intake is permitted. Key recommendation #9: Prepare foods in a safe manner to avoid microbial foodborne illness.

47 DFS Approved Curriculum-Unit 647 Six Basic Food Groups From the Food Pyramid Guide GRAINSVegetables Fruits Milk Meat & Bean s

48 DFS Approved Curriculum-Unit 648 Food Pyramid Guide Grain Group (breads, cereal, rice, pasta) Provides –carbohydrates –minerals –fiber

49 DFS Approved Curriculum-Unit 649 Food Pyramid Guide Grain Group (breads, cereal, rice, pasta) (continued) 1 ounce equivalent is about 1 slice of bread, about 1 cup of breakfast cereal or ½ cup cooked rice, cereal or pasta.

50 DFS Approved Curriculum-Unit 650 Food Pyramid Guide Grain Group (breads, cereal, rice, pasta) (continued) Daily: –6 ounce equivalents for males over 60 –5 ounce equivalents for females over 60

51 DFS Approved Curriculum-Unit 651 Food Guide Pyramid Vegetable Group Provides: –vitamins –minerals –fiber (roughage) Easier to chew if cooked, chopped or diced

52 DFS Approved Curriculum-Unit 652 Food Guide Pyramid Vegetable Group (continued) Chose from all five vegetable subgroups: –dark green –orange –legumes –starchy –other vegetables

53 DFS Approved Curriculum-Unit 653 Food Guide Pyramid Vegetable Group (continued) Daily: –2½ cups for males over 60 –2 cups for females over 60

54 DFS Approved Curriculum-Unit 654 Food Pyramid Guide Fruit Group Provides –vitamins –minerals –fiber Chose fresh, frozen, canned or dried fruits

55 DFS Approved Curriculum-Unit 655 Food Pyramid Guide Fruit Group (continued) Daily: –2 cups daily for males over 60 –1½ cups daily for females over 60

56 DFS Approved Curriculum-Unit 656 Food Pyramid Guide Milk, Yogurt and Other Milk Products Provides –proteins –vitamins (A) –minerals (calcium) –carbohydrates –Fat Choose low-fat or fat-free milk and milk products

57 DFS Approved Curriculum-Unit 657 Food Pyramid Guide Milk, Yogurt, Cheese Group (continued) Daily: –3 cups for males over 60 –3 cups for females over 60

58 DFS Approved Curriculum-Unit 658 Food Pyramid Guide Meat, Poultry, Fish and Beans Group Provides –protein –fats –vitamins –Minerals –1 ounce of meat, poultry or fish is about ¼ cup cooked beans, 1 egg, 1 tablespoon of peanut butter or ½ ounce nuts or seeds

59 DFS Approved Curriculum-Unit 659 Food Pyramid Guide Meat, Poultry, Fish and Beans Group (continued) Daily: –5½ ounce equivalents daily for males over 60 –5 ounce equivalents daily for females over 60

60 DFS Approved Curriculum-Unit 660 Food Pyramid Guide Oil Group = fats that are liquid at room temperature Provides e ssential fatty acids High in calories Use sparingly Keep total fat intake between 20% to 35% of calories

61 DFS Approved Curriculum-Unit 661 Food Pyramid Guide Oil Group = fats that are liquid at room temperature Most fats consumed should be polyunsaturated and monounsaturated. Make most fat sources from fish, nuts and vegetable oils. Limit solid fats like butter, stick margarine, shortening and lard.

62 DFS Approved Curriculum-Unit 662

63 DFS Approved Curriculum-Unit 663 6.3Define a therapeutic diet and recognize the need for alterations in a regular diet. 6.3.1List five purposes of a therapeutic diet.

64 DFS Approved Curriculum-Unit 664 Purposes of Therapeutic Diets Add or eliminate calories to cause a change in body weight Assist with digestion of food by taking foods out of diet that irritate digestive system Restrict salt intake to prevent or decrease edema

65 DFS Approved Curriculum-Unit 665 Purposes of Therapeutic Diets (continued) Help body organs to maintain and/or regain normal function Treat metabolic disorders by regulating amount of food

66 DFS Approved Curriculum-Unit 666 6.3.2Discuss the types of therapeutic diets that the physician might order for a resident.

67 DFS Approved Curriculum-Unit 667 Types of Therapeutic Diets Clear liquid Full liquid Bland Low residue Controlled carbohydrate (Diabetic) Low fat/low cholesterol

68 DFS Approved Curriculum-Unit 668 Types of Therapeutic Diets (continued) High fiber Low calorie High calorie Sodium restricted High protein Mechanical soft, chopped, pureed

69 DFS Approved Curriculum-Unit 669 Types of Therapeutic Diets (continued) Residents may have difficulty accepting special diets.

70 DFS Approved Curriculum-Unit 670

71 DFS Approved Curriculum-Unit 671 6.4Recognize adaptive devices used to assist residents with eating.

72 DFS Approved Curriculum-Unit 672 Adaptive Devices Food Guards Divided Plates Built-up handled utensils Easy grip mugs/glasses Residents have to be taught how to use these devices.

73 DFS Approved Curriculum-Unit 673

74 DFS Approved Curriculum-Unit 674 6.5Discuss alternate methods of feeding.

75 DFS Approved Curriculum-Unit 675 Parenteral Fluids (Intravenous Infusion) Fluids administered through vein. Little nutritional value Responsibility of licensed nurse

76 DFS Approved Curriculum-Unit 676 Parenteral Fluids (Intravenous Infusion) (continued) Observations to report –Near-empty bottle/bag –Change in drip rate –Pain at needle site, and/or redness and/or swelling, if observable –Loose, non-intact, or damp dressing

77 DFS Approved Curriculum-Unit 677 Enteral Feeding Residents unable to take nutrients by mouth Depressed Comatose Swallowing problem (stroke, Alzheimers or other medical conditions) Disorders of digestive tract

78 DFS Approved Curriculum-Unit 678 Enteral Feeding (continued) Liquid formula administered through tube by licensed nurse/NAII Nose to stomach - nasogastric tube Directly into stomach - gastrostomy tube

79 DFS Approved Curriculum-Unit 679 Nurse Aide Responsibilities in Alternative Nutrition Ensure that there is no tension or pulling on tube Keep residents nose clean and free of mucus Check that tube is securely taped to nose Perform frequent oral care with nasogastric tube

80 DFS Approved Curriculum-Unit 680 Nurse Aide Responsibilities in Alternative Nutrition (continued) Fasten tube with pin to shoulder area of clothing to prevent straining or tension on tube Report non-intact dressing around tube site

81 DFS Approved Curriculum-Unit 681 Nurse Aide Responsibilities in Alternative Nutrition (continued) Report any signs or symptoms related to aspiration or GI problems Mitts may be ordered to prevent resident from dislodging tube

82 DFS Approved Curriculum-Unit 682

83 DFS Approved Curriculum-Unit 683 6.6Identify the responsibilities of the nurse aide in preparing residents for meals. 6.6.1Serve prepared food as instructed.

84 DFS Approved Curriculum-Unit 684 Preparing Residents for Meals Meals enjoyable, social experience Provide pleasant environment –Clean area –Odor-free area –Adequate lighting Flowers/decorations and music add interest to dining area

85 DFS Approved Curriculum-Unit 685 Preparing Residents for Meals (continued) All residents clean and dressed for meals Hair combed Oral care provided Encourage to use bathroom or urinal/bedpan Cleanse and dry incontinent residents

86 DFS Approved Curriculum-Unit 686 Preparing Residents for Meals (continued) Face and hands washed Provide for comfort –Raise head of bed –Position in chair –Transport to dining area Provide clothing protector if appropriate

87 DFS Approved Curriculum-Unit 687 Preparing Residents for Meals (continued) Check to be certain resident receives right tray and has correct diet Food should be attractively served and placed within reach Check tray to see that everything needed is there

88 DFS Approved Curriculum-Unit 688 Preparing Residents for Meals (continued) Assist resident as needed with: –cutting meat –pouring liquids –buttering bread –opening containers

89 DFS Approved Curriculum-Unit 689 Preparing Residents for Meals (continued) Blind residents made aware of food placement according to face of clock Stroke residents approached from non- effected side

90 DFS Approved Curriculum-Unit 690 Preparing Residents for Meals (continued) Residents should be encouraged to do as much as possible for themselves Provide time for resident to complete meal Display pleasant, patient attitude

91 DFS Approved Curriculum-Unit 691 Preparing Residents for Meals (continued) Remove tray when meal finished Report unconsumed food to supervisor Record fluid intake if ordered Assist to position of comfort

92 DFS Approved Curriculum-Unit 692 Preparing Residents for Meals (continued) Call signal and supplies positioned within reach Area should be left clean and tidy Hands washed before and after care of each resident

93 DFS Approved Curriculum-Unit 693

94 DFS Approved Curriculum-Unit 694 6.7Demonstrate the procedure for assisting with dining/feeding resident who cannot feed self.

95 DFS Approved Curriculum-Unit 695

96 DFS Approved Curriculum-Unit 696 6.8Discuss the various types of supplementary nourishments.

97 DFS Approved Curriculum-Unit 697 Types of Nourishments Milk Juice Gelatin Custard, ice cream, sherbet Crackers Nutritional supplementation products (e.g., Ensure, etc.)

98 DFS Approved Curriculum-Unit 698 Supplementary Nourishments Usually served: –Midmorning –Mid-afternoon –Bedtime

99 DFS Approved Curriculum-Unit 699 Supplementary Nourishments (continued) Ordered by physician Serve as directed by supervisor Provide necessary eating utensils, straw and/or napkin

100 DFS Approved Curriculum-Unit 6100

101 DFS Approved Curriculum-Unit 6101 6.10Demonstrate the procedure for serving supplementary nourishments.

102 DFS Approved Curriculum-Unit 6102

103 DFS Approved Curriculum-Unit 6103 6.11Identify the special fluid orders that the physician could write.

104 DFS Approved Curriculum-Unit 6104 Providing Fresh Drinking Water Fresh water should be provided periodically throughout day Encourage to drink 6-8 glasses daily if appropriate

105 DFS Approved Curriculum-Unit 6105 Providing Fresh Drinking Water (continued) Note residents who have special fluid orders –N.P.O. –Fluid restrictions: Schedule 24-hour intake Remind resident

106 DFS Approved Curriculum-Unit 6106 Providing Fresh Drinking Water (continued) Note residents who have special fluid orders –Force fluids Offer fluids in small quantities Offer fluids (resident preference) without being asked Remind resident of importance of fluids in bodily functions –No ice

107 DFS Approved Curriculum-Unit 6107

108 DFS Approved Curriculum-Unit 6108 6.11Demonstrate the procedure for providing fresh drinking water.

109 DFS Approved Curriculum-Unit 6109


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