1. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Chapter 34 Nutrition

2. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Physiology of Nutrition Digestion –Conversion of nutrients into physically absorbed state Absorption –Passage of end products of digestion through epithelial membranes in intestines to blood or lymph systems (continued)

3. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Physiology of Nutrition Metabolism –All chemical reactions and processes in every body cell as they relate to nutrient distribution Energy –Basal metabolic rate (BMR) Energy needed to maintain essential physiological functions (continued)

4. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Physiology of Nutrition Excretion –Digestive and metabolic waste products excreted through intestines and rectum –Other excretory organs: Kidneys Sweat glands Skin Lungs

5. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nutrients Water –60 to 70 percent of adult body weight –Acquired from diet –Body maintains balance Intake Output (continued)

6. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nutrients Vitamins –Organic compounds –Small quantities –Assist in normal metabolism –Cannot be manufactured in body Fat-soluble Water-soluble (continued)

7. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nutrients Minerals –Catalysts in biochemical reactions –Macrominerals Daily requirement: –100 milligram (mg) or greater (continued)

8. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nutrients Minerals –Microminerals Trace elements Daily requirement: –Less than 100 mg (continued)

9. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nutrients Carbohydrates –Organic compounds –Composed of carbon, hydrogen, and oxygen (continued)

10. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nutrients Carbohydrates –Classified according to number of saccharides (sugar units) Monosaccharides –Simple sugars Disaccharides –Double sugars (continued)

11. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nutrients Carbohydrates –Classified according to number of saccharides (sugar units) Polysaccharides –Complex sugars (continued)

12. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nutrients Proteins –Organic compounds –Contain carbon, hydrogen, oxygen, and nitrogen atoms –Amino acids End product of digestion –Nonessential –Essential (continued)

13. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nutrients Proteins –Positive nitrogen balance Nitrogen intake exceeds output –Negative nitrogen balance Nitrogen output exceeds intake (continued)

14. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nutrients Lipids –Fats –Insoluble in water (continued)

15. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nutrients Lipids –Fatty acids Basic structural unit –Saturated –Unsaturated –Monounsaturated –Polyunsaturated (continued)

16. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nutrients Lipids –Popular lipids: Triglycerides Phospholipids Cholesterol

17. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Promoting Proper Nutrition Dietary reference intakes and recommended daily allowances Food guide pyramid Societal concerns Weight management –Overweight –Underweight

18. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Factors Affecting Nutrition Age Lifestyle Ethnicity, culture, and religious practices (continued)

19. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Factors Affecting Nutrition Other factors: –Economics –Preferences –Gender

20. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nutrition and the Nursing Process Assessment –Nutritional history 24-hour recall Food-frequency questionnaire Food record Diet history (continued)

21. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nutrition and the Nursing Process Assessment –Physical examination Intake and output Anthropometric measurements –Skinfold measurement –Mid-upper-arm circumference –Abdominal girth measurement (continued)

22. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nutrition and the Nursing Process Assessment –Diagnostic and laboratory data Protein indices –Serum albumin –Prealbumin –Serum transferrin (continued)

23. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nutrition and the Nursing Process Assessment –Diagnostic and laboratory data Hemoglobin level Total lymphocyte count Nitrogen balance Urine creatinine excretion (continued)

24. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nutrition and the Nursing Process Diagnosis –Imbalanced nutrition: Less than body requirements –Imbalanced nutrition: More than body requirements –Risk for imbalanced nutrition: More than body requirements –Other nursing diagnoses (continued)

25. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nutrition and the Nursing Process Planning and outcome identification –NOC for nutrition: Nutritional status –Biochemical measures –Energy –Food and fluid intake –Nutritional intake –Collaboration (continued)

26. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nutrition and the Nursing Process Implementation –Monitoring weight and intake –Initiating diet therapy –Assisting with feeding –Providing nutrition support (continued)

27. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nutrition and the Nursing Process Implementation –Enteral tube feeding Feeding tubes Insertion of enteral feeding tubes Enteral formulas Administration of enteral feedings (continued)

28. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nutrition and the Nursing Process Implementation –Enteral tube feeding Safety considerations Potential complications Removal of nasogastric tube (continued)

29. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nutrition and the Nursing Process Implementation –Providing parenteral nutrition Components: –Carbohydrates –Amino acids –Lipids –Admixtures –Medications (continued)

30. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nutrition and the Nursing Process Implementation –Providing parenteral nutrition Refeeding syndrome (continued)

31. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nutrition and the Nursing Process Implementation –Administering medication through feeding tube –Employing complementary therapy (continued)

32. Copyright © 2011 Delmar, Cengage Learning. ALL RIGHTS RESERVED. Nutrition and the Nursing Process Evaluation –Ongoing –Assess achievement of goal and outcomes –Revise accordingly