1. Mosby items and derived items © 2005 by Mosby, Inc. Chapter 43 Nutrition

2. Mosby items and derived items © 2005 by Mosby, Inc. Elements of Energy and Nutrition Basal metabolic rate (BMR) Resting energy expenditure (REE) Nutrient density Nutrients: carbohydrates, proteins, fats, water, vitamins, minerals

3. Mosby items and derived items © 2005 by Mosby, Inc. Carbohydrates Produce 4 kcal/g Main source of energy Saccharides: simple and complex carbohydrates, fiber

4. Mosby items and derived items © 2005 by Mosby, Inc. Proteins Produce 4 kcal/g Essential for growth, maintenance, and repair of body tissue Amino acids: essential and nonessential Complete and complementary proteins Nitrogen balance

5. Mosby items and derived items © 2005 by Mosby, Inc. Fats (Lipids) Produce 9 kcal/g Triglycerides and fatty acids Saturated or unsaturated: monounsaturated or polyunsaturated fatty acids Essential or nonessential fatty acids

6. Mosby items and derived items © 2005 by Mosby, Inc. Water Comprises 60% to 70% of body weight Cell function depends on a fluid environment

7. Mosby items and derived items © 2005 by Mosby, Inc. Vitamins Essential to normal metabolism Fat-soluble: A, D, E, K Water-soluble: C and B complex

8. Mosby items and derived items © 2005 by Mosby, Inc. Minerals Inorganic elements essential as catalysts in biochemical reactions Macrominerals Microminerals or trace elements

9. Mosby items and derived items © 2005 by Mosby, Inc. Digestive System Anatomy and physiology –Digestion –Absorption –Metabolism and storage of nutrients –Elimination

10. Mosby items and derived items © 2005 by Mosby, Inc. Dietary Guidelines Dietary referenced intakes (DRIs) Food guidelines: food guide pyramid Daily values Healthy People 2010

11. Mosby items and derived items © 2005 by Mosby, Inc. Nutritional Needs throughout Growth and Development Infants through school-age –Breast-feeding –Formulas –Solid foods –Food habits Adolescents –Eating disorders –Activities

12. Mosby items and derived items © 2005 by Mosby, Inc. Nutritional Needs throughout Growth and Development (cont'd) Young and middle adults –Pregnancy –Lactation Older adults

13. Mosby items and derived items © 2005 by Mosby, Inc. Alternative Food Patterns Cultural and religious practices Vegetarian diets

14. Mosby items and derived items © 2005 by Mosby, Inc. Assessment: Diet History Dietary intake and pattern Symptoms Allergies Taste Chewing and swallowing Appetite Elimination Medications

15. Mosby items and derived items © 2005 by Mosby, Inc. Assessment Anthropometry Body mass index (BMI) Ideal body weight (IBW) Laboratory tests Clinical observations Client expectations

16. Mosby items and derived items © 2005 by Mosby, Inc. Nursing Diagnoses Risk for aspiration Constipation Diarrhea Imbalanced nutrition: less than/more than body requirements Feeding self-care deficit

17. Mosby items and derived items © 2005 by Mosby, Inc. Planning Goals and outcomes –Client’s daily nutritional intake meets the minimum DRIs –Client loses ½ pound per week Setting priorities Continuity of care

18. Mosby items and derived items © 2005 by Mosby, Inc. Implementation: Health Promotion Client education Meal planning Food storage and preparation safety

19. Mosby items and derived items © 2005 by Mosby, Inc. Implementation: Acute Care Advancing diets Promoting appetite Assisting clients with feeding Enteral feeding Parenteral nutrition

20. Mosby items and derived items © 2005 by Mosby, Inc. Enteral Feeding Nasogastric, jejunal, gastric tubes Insertion and verification of placement Types and preparation of formulas Complications

21. Mosby items and derived items © 2005 by Mosby, Inc. Parenteral Nutrition Initiation and management of insertion site Types of solutions Rate of infusion Prevention of complications

22. Mosby items and derived items © 2005 by Mosby, Inc. Implementation: Restorative Care Medical nutrition therapy for specific illnesses, conditions, or injuries –GI diseases –Diabetes –Cardiovascular diseases –Cancer –HIV

23. Mosby items and derived items © 2005 by Mosby, Inc. Evaluation Client care Client expectations