Presentation on theme: "Nutrition Developed by D. Ann Currie, R.N,M.S.N.."— Presentation transcript:
Nutrition Developed by D. Ann Currie, R.N,M.S.N.
Nutrition Proper nutrition is needed for maintaining health and preventing illness. It also helps with wound healing. A well balance diet helps in the care and treatment of many diseases and conditions. The nurse needs to understand how a diet can help the client to achieve a healthy lifestyle, and help in the healing process.
Recommended Dietary Allowances RDA- Amount of a nutrient need by a healthy individual. Requirements for nutrients may be increased during illness and other times such as periods of growth, pregnancy, and physical demands or stress.
Nutrients Nutrients are substances that are needed for: Cell growth, Cellular function, Enzyme activity, Carbohydrate/ fat/protein synthesis, Muscle contractions, Wound healing, Immune competence, and LIFE.
WATER H2O Water is not a nutrient but is needed for life. A human can only live 3-5 days without water, but days without food. Calories: 0
Water -Sources Tap water- Bottle water Fruits Vegetables Juices Some in meats, fish, gravies. IV fluids Tea,coffee and soda may have caffeine not good sources.
Water- Function in Body It is part of body fluids: Cellular fluids, blood, hormones, sweat, urine, tears, lymph. Lubricant. Adult body fluid volume: 60% Infant (newborn) body fluid volume: 77% Embryo: 90%
Water- Requirements Depends on: Age Activity Temperature-both internal and external. Losses
Water -Requirements Adult- 30ml/Kg/day Adult of 70Kg X 30 ml.= 2100 ml/day. Or 15 ml/lb/day. Adult weighing 150 lbs. X 15 ml.= 2250ml /day. 6-8 glasses of water to 8-10 glasses of water per day. Hot climates 2-3liters per day.
Medications/Supplements Tap water. Gatorade- Sport drinks. IV fluids Pedialyte Enteral feedings TPN
Water- Excess (Too much) Toxicity Fluid Volume Excess- FVE Edema Causes: Excess intake usually because of IV fluids. Renal failure Clinical manifestations: Weight gain. Hypertension-High B/P Edema- pitting vs Non-pitting Moist lung sounds ( crackles/ rales)
Nursing Interventions Monitor intake and output ( I&0) What goes IN:( I) Oral IV Fluids N/G Tubes. What goes OUT:( I) Emesis Urine Stool Drainage Bleeding
NSG. Interventions Diaper weight: 1 gram wt.=1 ml. This would go for dressings or pads too: A dressings weighing 10 grams=10 ml.of drainage or blood. Assess weight daily. Assess skin turgor. Listen to lung sounds. Check for edema. Provide fresh pitcher of water several times a day, for the client with no restrictions of fluid. Check the doctors order for IV rate. Monitor IV fluids carefully.
Calories- Requirements Adult calorie requirements are based are age, sex, activity level and need. Base adult calorie needs are: Calories per IBW ( Ideal body weight) Kg. (Kilograms) example: Adult who IBW is 58 Kg.: 58kgx 30 calories/Kg = 1740 calories/day. 58Kgx 35 calories/Kg=2030 calories/day. So the range would be calories per day.
Protein (Amino Acids) Calories: 4 calories per 1 gram
Protein-Food Sources Complete proteins come from animal sources: Diary Products- Cheese, Milk, Yogurt, Ice Cream. Meat. Fish. Poultry. Eggs.
Protein- Food Sources Incomplete proteins from plants sources: Beans Legumes Nuts Brown rice Whole grains and cereals. Soy products- Tofu
Protein- Food Sources Complementary Proteins: Beans and Rice. Whole grain macaroni and Cheese. Peanut butter and Whole grain bread.
Protein- Function in The Body Amino acids help to build and maintain all body tissues. Part of : Hormones. Blood. Antibodies. Albumin.
Protein- Function in the body Provides energy after carbohydrate and fat supplies are exhausted. Needed for growth and development of tissues. Wound healing.
Protein- Requirements Men: grams per day. Women: grams per day. Pregnant women: 60 grams per day. Increase requirements of protein are needed with illness and healing process % of total daily calories should be from protein.
Protein- Medication/Supplements Nutrition supplements: Ensure Protein shakes Whey products Protein bars. TPN (Total Parental Nutrition)-IV Central Line. (Place TPN on an infusion device.) Albumin. Enteral Feedings. –Feeding Tubes.
Protein-Deficit ( not enough) The lack of enough protein intake can lead to: In children effects growth. Anemia. Increase infections. Delayed wound healing.
Nursing Interventions. Monitor Protein intake- Do hours dietary intake history. Monitor Lab tests: BUN- Low BUN can indicate low protein intake. Albumin- Low Albumin can also indicate low protein intake. Total Protein- Low Total Proteins can indicate low protein intake.
Carbohydrates Calories: Food-4 calories per 1 gram. IVs- 3.4 calories per 1 gram
Carbohydrates- Food Sources Refine sugars- White sugars, cane sugar, candy, etc. Fruits. Vegetables- Starchy vegetables. Beans. Nuts. Legumes. Whole grains. Rice. Oysters and clams. Some meats. Fiber is indigestible carbohydrates.
Carbohydrates-Function in the Body Carbohydrates are the main source of energy for the body. Maintains protein and fat balance.
Carbohydrates-Requirements Depends on: Size. Activity level. Age. Sex. If couch potato a person needs less. A client on bedrest needs less % of total calories should come from carbohydrates.
Carbohydrates- Requirements Carbohydrates should come from: 2-4 servings of fruits. 3-5 servings of vegetables servings of whole grains. Only a small amount from refined sugars.
Medications/ Supplements Dietary supplements- Ensure. IV Fluids- D5W TPN- Total Parental Nutrition. D5W- 5% Dextrose solution=5gramof glucose per 100ml. So a 1000ml bag of D5W = 50 grams of glucose. 50gramsx 3.4 calories/1 gram= 170 calories per bag.
Carbohydrate- Deficit A deficiency of carbohydrates in the diet can lead to: Weight loss. Hypoglycemia: Headache, confusion, tired, irritability, hungry, muscle wasting, ketoacidosis, and ketones in the urine.
Carbohydrate-Excess Too many carbohydrates in the diet can lead to: Weight gain. Hyperglycemia: Increase thirst, hungry, increase urination, dry skin, fruity breathe. Diabetes mellitus- increase blood sugar due to problem with insulin.
Carbohydrates Nursing Interventions Assess dietary intake of carbohydrates with a hours dietary history. Weight the client. IV- Check order for type of fluids. and Check rate. Place IV on infusion device. TPN- Total Parental Nutrition- Check order with two nurses. Check rate. Follow Protocol for TPN. Check blood sugars level as ordered. Place IV on infusion device. NPO- Nothing by mouth. Are calories coming from IVs or TPN?
Fats Calories: Food- 9 calories per 1 gram of fat. IV fluids- Intralipids: 10% solution=1.1calories per 1 ml. 20% solution= 2.2calories per 1 ml.
Fats- Function in the Body Fat makes up part of the cell membranes. The lining around nerves. Steroid Hormones- Estrogen and testosterone. If womens body fat decreases below 18% they will stop menstruation and have fertility problems. Fat for padding for warmth in cold climates. Secondary source for energy.
Fats- Requirements Less than 30% of total calories should come from fats. (US government). According to AHA &ADA: No more than 30 grams of fat per day. People with Gall Bladder problems should have less than 20 grams of fat per day. No one under 4 years of age should be placed on a low fat diet.
Fat-Deficit Lack of fat in the diet can lead to: Weight loss. Decrease in hormone production. In children- neurological problems. Labs- decrease in cholesterol levels.
Fats- Excess Too much fat in the diet can lead to: Increase weight. High cholesterol levels and high triglycerides levels. CAD- Heart Disease-MIs or CVA- Strokes.
Fats- Nursing Interventions Assess dietary intake of fats with a hour diet history. Monitor cholesterol levels- LDH &HDH, Total cholesterol level and triglyceride levels. Monitor IV fats- Check order, rate, site, and I&O. Place Iv of infusion device. Weigh client.
Vitamins Vitamins are organic compounds required by the body in small amounts for growth and normal metabolic processes. Vitamins- 13 Types: Water soluble-Vitamin C and B complex. Fat soluble-Vitamins A, D, E, and K.
Vitamin A Fat soluble vitamin. Retinol Required for normal vision, growth, bone development, skin, and mucous membranes. Repair tissue especially epithelial cells. Requirements-Men mcg. Women mcg. Pregnancy-up to 800mcg. Lactation mcg.
Vitamin A- Food Sources Liver-Beef, Meat, butter, Fortified Margarine, egg yolks, cheeses, Whole milk, kidneys and fish oil. Dark green vegetables-spinach, kale, turnip greens, asparagus, and broccoli. Bright orange vegetables and fruits- carrots, sweet potatoes, pumpkin, cantaloupes, apricots, and peaches.
Vitamin A-Medication and Supplements Isotretinon (Accutane)-Acne, skin problems. Increase Vitamin A- Skin healing, Macro degeneration, Reversing Vitamin A deficiency,and some forms of leukemia. Vitamin A supplements should not be taken in megadoses.
Vitamin A-Deficiency A lack of Vitamin A can lead to vision problems- Night blindness, xerophthalmia, corneal ulcerations and blindness. Skin lesions and infections. Respiratory tract infections. Urinary calculi.
Vitamin A- Excess Hypervitamintosis A: Clinical manifestations: Anorexia, vomiting, irritability, skin changes, yellow- orange color of skin, Pain in muscle, joints and bones, enlargement of spleen and liver, Increased intracranial pressure and other neurological signs, weakness, decreased B/P, low WBC count, weight loss and Teratogenic effect in the fetus.
Nursing Interventions Assess dietary intake of Vitamin A. Teach clients to never take excess amounts of Vitamin A especially in children and pregnant women. Monitor amount of Vitamin A in supplements. Observe for signs of toxicity.
Vitamin D Fat soluble vitamin. Ergocalciferol -obtained from food. Cholecalciferol -formed by exposure of skin to sunlight. Necessary for the absorption of calcium. Helps to maintain healthy bone and teeth. Requirements-Men and women 5-15 mg.
Vitamin D- Food Sources Milk and some milk fat products Irradiated foods Liver Egg yolks Salmon Tuna fish Sardines Certain cereals. Also Sunshine.
Vitamin D Medication and Supplements Vitamin D supplements- Calcitriol( Rocaltrol, calcijex). Cholecalciferol (Delta-D) Multivitamins. Clients should not take mega doses of Vitamin D.
Vitamin D- Deficiency Lack of Vitamin D can lead to changes in serum calcium levels, rickets in children and osteomalacia in adults.
Vitamin D - Excess Too much Vitamin D can lead to hypercalcemia, calcification of soft tissues, cessation of life, and teratogenic effects in the fetus.
Nursing Interventions Monitor dietary intake of Vitamin D. Teach client not to take excess Vitamin D. No mega doses.
Vitamin E Fat soluble vitamin. Tocopherol Antioxidant. Maintains integrity of muscles and nerves. Protect other nutrients-especially Vitamins A & C. Helps with the formation of RBCs. Prevents the destruction of certain fats including the lipid portions of cell membranes.
Vitamin E- Requirements Men and Women- 15mg. Lactation-19mg.
Vitamin E- medication and Supplements Tocopherol (Aquasol E, Vita-Plus) PO/IM units/day
Vitamin E- Deficiency Vitamin E deficiency is rare. In adults only seen in severe malabsorption disorders. In premature neonates may lead to hemolytic anemia.
Vitamin E- Excess High doses- nausea, vomiting, fatigue, headaches blurred vision, diarrhea, In preterm infants- excess Vitamin E can cause : respiratory distress, liver failure, thrombocytopenia, and ascites.
Nursing Interventions Assess dietary intake of Vitamin E. Check dose of supplements. Teach clients not to take mega doses of Vitamin E.
Vitamin K Fat soluble vitamin. Phytonadione. Essential for normal blood clotting. Activates precursor proteins found in the liver into clotting factors ll, Vll, lX, and X. Requirements- Men & Women-65-70mcg. 1mcg/Kg.
Vitamin K- Food Sources Green Leafy Vegetables- Spinach, kale, turnip greens, broccoli, and green tea. Liver Oatmeal Soy beans Moderate amount in coffee.
Vitamin K-Medication and Supplements Phytonadione (AquaMEPHYTON ) PO/IM/Subcutaneous 1mcg/Kg Use to Treat-Clients with clotting disorders, antidote for overdose of warfarin (coumadin), and prevent hemorrhagic disease in the newborn infant.
Vitamin K -Deficiency A deficit of Vitamin K can lead to: Abnormal bleeding( melena, hematemesis, hetaturia, epistaxis, petechiae, ecchymoses, hypovolemic shock)
Vitamin K- Excess Too much Vitamin K can lead to excessive clotting. Antidote for an overdose of Vitamin K is Heparin. Clients on warfarin (Coumadin) Should not take Vitamin K supplements or eat too much Vitamin K high foods.
Nursing Interventions Assess dietary intake of Vitamin K. Check Vitamin K doses. Teach client on warfarin (Coumadin) not to eat excessive amounts of food high in Vitamin K. Know the antidote for overdose of Vitamin K is Heparin.
Vitamin C Water soluble vitamin. Ascorbic acid. Essential for the formation of skin, ligaments, cartilage, bone, and teeth. Required for wound healing and tissue repair. Metabolism of Iron and Folic acid. RBC formation. Synthesis of fats and proteins Preservation of blood vessel integrity. Resistance to infection. Collagen formation
Vitamin C- Requirements Men and Women-65-90mg/day. Lactation mg./day
Vitamin C Medications and Supplements Ascorbic acid PO/IM/IV Vitamin deficiency mg/day Burns mg/day.
Vitamin C- Food Sources Citrus fruits-oranges, lemons, limes, grapefruits. Tomatoes Strawberries Cantaloupes Green peppers Chili peppers** Raw Potatoes
Vitamin C-Deficiency Mild deficiency: irritability, malaise, arthralagia, increased tendency to bleed. Severe deficiency: Scury: gingivitis, bleeding gums, Problems with skin, joints, and other areas. Poor wound healing Anemia Coma Death
Causes of Vitamin C Deficiency Diet devoid of Fruits and Vegetables. Excess alcohol (ETOH) intake Elderly with limited diets. Chronic illness. Constance Stress.
Vitamin C- Excess Dirrhea Renal calculi In African Americans-retention of iron stores-iron toxicity.
Nursing Interventions Assess dietary intake of Vitamin C. Check dose of vitamin supplements. Caution overdoses of Vitamin C with African-Americans. Suggest Multivitamins for clients with poor diets- such as college students.
Vitamin B-1 Water soluble vitamin Thiamine Essential for maintaining of circulatory, digestion and nervous systems. A coenzyme in carbohydrate metabolism. Essential for energy production. Requirements mg/day for adults. Pregnancy and lactation-1.4mg/day
Nursing Interventions Assess dietary intake of Vitamin B-1. Check IV dose. Infuse with IV pump.
Vitamin B-2 Water soluble vitamin. Riboflavin Essential for RBC and antibodies formation. A coenzyme in metabolism. Necessary for growth. Aids in building nerve structures. Helps cells to utilize oxygen.
Nursing Interventions Assess dietary intake of Vitamin B-2. Check dose on supplement.
Vitamin B-3 Water soluble vitamin. Niacin Essential for glycolysis, fat synthesis, and tissue respiration. A coenzyme in many metabolic processes. Aids in circulation, growth of body tissues. Requirements-Women-14mg/day,pregnancy- 18mg/day,lactation-17-20mg/day. Men-16mg/day.
Vitamin B-3- Medications and Supplements. Niacin (Nicotinic acid) Niacinamide (nicotinamide) PO Deficiency-PO mg/day Pellagra-PO-up to 500mg/day Hyperlipidemia- PO 2-6 grams /day- divided in 3 doses.
Vitamin B-3-Deficiency Pellagra: erythematous skin lesions, GI problems- stomatitis, glossitis, enteritis, and diarrhea. Nervous system problems- Headache, dizziness, insomnia, depression, and memory loss. Severe deficiency: delusions, hallucinations, impairment of peripheral motor and sensory nerves.
Nursing Interventions Assess dietary intake of Vitamin B-3. Monitor for toxicity with high doses.
Vitamin B-6 Water soluble vitamin Pyridoxine Essential for RNA and DNA synthesis. Critical for hemoglobin production. A coenzyme in metabolism of carbohydrate, protein, and fat formation. Helps to release glycogen from the liver and muscle tissue. Maintains antibody function. Balances nervous system function.
Vitamin-B-6-Requirements Women mg/day, pregnancy- 1.9mg/day, Lactation-2mg/day. Men mg/day
VitaminB-6-Food Sources Yeast, wheat germ, liver, glandular meats, whole grains and cereals, potatoes, legumes, and prunes..
Nursing Interventions Assess dietary intake of Vitamin B-6 Check dose on Vitamin B-6 supplements.
VitaminB-9 Water soluble vitamin Folic acid-(Folate) Essential for normal metabolism of all body cells. Needed for the formation of RBCs. Needed for nervous system formation. Requirements-Women and Men- 400mcg/day. Pregnancy mcg/day
VitaminB-9-Food Sources Liver, kidney and lima beans, dark green leafy vegetables( spinach, broccoli, asparagus), orange juice, fortified grain products-cereals and breads.
VitaminB-9- Medication and Supplements Folic acid PO/IM/IV/subcutaneous Deficiency- up to 1mg/day, when blood tests normal then 400mcg/day
Vitamin B-9-Deficiency Megaloblastic anemia and other blood disorders-Folic anemia. Elevated blood levels of homocysterine. Poor growth in children. Glossitis GI tract disturbances. Decrease intake during pregnancy can cause neural tube defects.
Vitamin B-9-Excess Rare Nausea/vomiting Diarrhea Increase urination Increase Folic acid intake with Dilantin will cause decrease effectiveness of the medication.
Nursing Intervention Asses dietary intake of Folic acid/Vitamin B-9. All women of childbearing age should take supplements of folic acid when pregnant. And Make sure they take in enough Folic acid contenting foods.
Vitamin-B-12 Water soluble vitamin Cyanocobalamin Essential for normal metabolism of all body cells. For the formation of RBCs. Healthy nervous system Requirements-Women and Men mcg /day
Nursing Interventions Assess for dietary intake of Vitamin B-12. Check dose/route with supplements. Folic acid supplements will mask the signs of anemia in pernicious anemia.
Vitamin Supplements A normal healthy individual who eats a well balanced diet does not need to take vitamin supplements. Vitamin supplements are required: During periods of increased growth, pregnancy, lactation, debilitating illnesses, inadequate dietary intake, fad diets (crash diets), and malabsorption processes.
Minerals Macro minerals-Need more than 100mg/day intake-Sodium, Potassium, Magnesium, Chloride, Calcium, etc. Micro minerals-Needs less than 100 mg/day intake-Iron, Chromium, Copper, Zinc, Iodine, Selenium, Fluoride, Cobalt, etc.
Calcium Macro mineral Requirements-Adults mg/day. Pregnancy mg/day. Lactation-1300mg/day. Needed for proper function of all body cells and tissue. Essential for formation of bones and teeth. Maintains blood clotting mechanism. Regulates heart beat. Regulates nerve conduction and muscle contractions. Serum level mg.
Calcium-Food Sources Diary products-milk, cheese, yogurt. Fish with bones- Sardines, salmon. Nuts Beans- Soy Products-Tofu. Green Leafy Vegetables. Fortified orange juice, cereals and breads.
Calcium- Deficiency Hypocalcemia- Serum level under 9 mg. Tetany, Dysrrhythmias, Pathological fractures of bones, Risk of bleeding, Brittle nails, Insomnia, Periodontal disease, Osteomalcia, Osteoporsis
Nursing Interventions IV calcium-infusion pump. Place client on EKG monitor, and Follow hospital policy.
Iron Micro mineral Requirements-Men mg./day Women mg. /day Pregnancy mg./day. Needed for formation of RBCs. Food sources-Organ meats-Livers, Red meat, Tuna fish, Beans, Nuts, Shellfish, Dried fruits- raisins, Dark molasses, Whole grains, Egg yolks, Red wine
Iron-Deficiency Microcytic anemia. Iron deficiency anemia. Weakness, Fatigue. Dizziness Altered immune response-increase risk of infections.
Iron-Excess Hemochromocytosis Iron Toxicity.
Nursing Interventions PO- dont give with milk or diary products or antiacids -Decreases absorption. Liquid-give through a straw-will stain teeth. IM- give deep IM-Z-track. IV- Give with infusion pump slowly. Watch for allergic reactions.
Potassium Macro mineral Requirements-Adults-2 grams Serum levels mEq/L Necessary for transmission and conduction of nerve impulses and contraction of skeletal, cardiac, and smooth muscles. For enzyme action used to change carbohydrates to energy and amino acids to protein.
Potassium- Excess Hyperkalemia- Serum levels above 5.0 mEq/L EKG changes, skeletal muscle weakness, bradycardia, cardiac arrest, oliguria, intestinal colic, diarrhea. Causes: Severe burns, crushing injuries, Addisons disease, renal failure, acidosis, Excessive intake usually from IV administration or oral supplements. Not from foods
Potassium- Nursing Interventions Monitor potassium levels (K) IV- monitor rate, place on IV infusion pump. Check kidney function. Med/Surg. Units no faster than 10 mEg/hr. For K runs-Place client on EKG monitor PO- give with least ½ cup of water or juice Drug interactions-diuretics (Lasix ) Decrease K levels and K sparing diuretics will Increase K levels.
Sodium Macro mineral Requirements-Adults- 500mg-4000mg- 2-4 grams Serum levels of sodium mEq/L. Necessary for normal nerve conduction and muscle contraction. Principal cation in extra cellular fluids. Essential for acid-base balance. Food sources- table salt, process foods ( such as can foods), soy sauce, seafood, cured meats, and even sodas.
Sodium- Deficiency Hyponatremia- Serum level under 136 mEq/L Decreased cerebral function Weakness Nausea/ vomiting Decreased B/P Causes: Sodium deficit, GI losses, diuretics, burns, water intoxication.
Sodium- Excess Hypernatremia-Serum levels above 145 mEq/L Edema, weight gain, increased B/P, fluid volume overload, thirst. Causes: Too much sodium intake, renal failure, cirrhosis, steroid therapy, aldosterone excess.
Sodium-Nursing Interventions Monitor sodium levels. Maintain I&O. Weight daily. IV fluid- Monitor rate and place IV on infusion pump. Listen to lung sounds.
Chromium Micro mineral Requirements- Adults mg/day. Necessary for carbohydrate (glucose) metabolism. Potentiates insulin. Helpful in controlling (noninsulin dependent diabetes) Type II diabetes. Food sources- Brewers yeast, oysters, liver, potatoes, seafood, whole grains, cheeses. poultry, bran, and lean meat.
Chromium-Cont. Deficiency- Impaired glucose tolerance( hyperglycemia, glycosuria), impaired growth and reproduction and decreased life span. Excess- not established.
Copper Micro mineral Requirement-Adult mg/day. Cofactor for hemoglobin synthesis. Needed for collagen formation. Food sources- oysters, shellfish, liver, nuts, cereals, poultry, dried fruits, and chocolate***. Prolonged copper deficiency may lead to anemia which is not corrected by taking just iron. Also neutropenia, leukopenia, osteoporosis, depigmentation of skin. Menkes disease. Excess- Wilsons disease.
Zinc Micro mineral Requirements- Adult-Men mg/day, Women mg/day, pregnancy- 15 mg/day. Food sources- meat, liver, eggs, seafood, wheat germ. A component of many enzymes that are essential for normal metabolism Necessary for normal cell growth. Synthesis of RNA and DNA Maintains health skin and mucous membranes, and aids in wound healing. Maintains growth of sexual organs. Needed for proper protein structures.
Chloride Macro mineral Requirements-Adult mEq/day- 750mg/day. Serum levels mEq/L Major anion of body fluids Part of gastric acid secretion Helps to maintain osmotic pressure and electrolyte, acid-base balance. Food sources-Table salt and foods containing NaCl
Chloride-Cont. Chloride deficiency- Hypochloridemia- serum levels under 90 mEq/L- Dehydration, Low B/P, low shallow respirations, paresthesias of face and extremities, muscle spasms and tetany. Chloride excess- Hyperchloridemia- Serum level above 110 mEq/L-increased rate and depth of respirations, lethargy, stupor, disorientation and coma.
Phosphorus Macro mineral Requirements-Adults-700mg. Forms bone matrix. Part of ATP and nucleic acids.
Iodine Micro mineral Requirements-Adults-150mcg/day Component of thyroid hormones Food sources- sea salt, and seafood. Iodine deficiency-Thyroid gland enlargement, goiter, possible hypothyroidism Iodine excess- Iodism with coryza, edema, conjunctivitis, stomatits, and vomiting.
OTHER NUTRIENTS Nutrients not discussed in this presentation check the text and web.
Vegetarians Pure vegetarian- Only eat food from plant sources; Vegetables, fruits, grains, legumes, and nuts. May need Vitamin B12 supplements. Lacto vegetarian- Eats vegetarian diet and milk and milk products-cheeses, yogurt, etc. Lacto ova vegetarian- eats vegetarian diet plus eggs and milk products.
REMEMBER: NUTRITION IS AN IMPORTANT PART OF HEALTH AND LIFE