1. Unit 6 Nutrition and Hydration
Nurse Aide I Course
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2. 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.
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3. 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.
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4. Nutrition and Hydration Introduction (continued)
Knowledge of nutrition will enable the nurse aide to recognize the important relationship between food and good health.
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5. DFS Approved Curriculum-Unit 6
Principles of
Nutrition
Principles of
Nutrition
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6. DFS Approved Curriculum-Unit 6
Objectives
6.0 Identify the general principles of basic nutrition.
6.1 Identify factors that influence dietary practices.
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7. DFS Approved Curriculum-Unit 6
Good Nutrition
Promotes physical and mental health
Provides increased resistance to illness
Produces added energy and vitality
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8. Good Nutrition (continued)
Aids in healing process
Assists one to feel and sleep better
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9. DFS Approved Curriculum-Unit 6
Functions of Food
Provides energy
Growth and repair of tissue
Maintenance and regulation of body processes
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10. Factors Influencing Dietary Practices
Personal preference
Appetite
Finance
Illness
Culture
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11. DFS Approved Curriculum-Unit 6
Objective
6.1.1 Review cultural variations in diet.
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12. 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
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13. Culture and Dietary Practices (continued)
The Italian diet includes spaghetti, lasagna, and other pastas
Scandinavians have a lot of fish in their diets
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14. Culture and Dietary Practices (continued)
Americans eat a lot of meat, fast foods, and processed foods
Use of sauce and spices are culturally related
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15. Culture and Food Preparation
Baking
Frying
Smoking
Roasting
Fresh/raw
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16. DFS Approved Curriculum-Unit 6
Objective
6.1.2 List seven examples of foods avoided by some religious denominations.
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17. 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
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18. Religion and Dietary Practices (continued)
Muslim/Moslem - avoid alcohol, pork products
7th Day Adventist - avoid coffee/tea, alcohol, pork and some meats, caffeine
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19. Religion and Dietary Practices (continued)
Baptists – some avoid coffee, tea and alcohol
Greek Orthodox - fast days, but usually “forgiven” when ill
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20. Religion and Dietary Practices (continued)
Conservative Jewish faith
Prohibits shellfish, non-kosher meats such as pork
Requires special utensils for food preparation
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21. Religion and Dietary Practices (continued)
Conservative Jewish faith
Forbids cooking on Sabbath
Forbids eating of leavened bread during Passover
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22. 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
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23. DFS Approved Curriculum-Unit 6
Objective
6.1.3 Review the major classification of nutrients and their function in the body.
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24. DFS Approved Curriculum-Unit 6
Nutrients
Nutrients are essential
Four classifications of nutrients
Fats - provide energy, help body use certain vitamins, conserve body heat and protect organs from injury
Proteins – build and repair tissue
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25. Nutrients (continued)
Four classifications of nutrients (continued)
Carbohydrates - provide energy and fiber that help in bowel elimination
Vitamins and minerals - ingested through food and are necessary for carrying out and maintaining specific body functions
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26. Nutrients (continued)
Fats, proteins and carbohydrates measured in calories
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27. 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
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28. DFS Approved Curriculum-Unit 6
Objective
6.1.4 Describe six factors that influence caloric needs.
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29. Factors That Influence Caloric Need
Age
Sex
Size and activity level
Climate
State of health
Amount of sleep obtained
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30. DFS Approved Curriculum-Unit 6
Objective
6.1.5 Cite nine age-related changes/factors that affect the resident’s nutritional status.
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31. 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
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32. 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
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33. DFS Approved Curriculum-Unit 6
Objective
6.1.6 Recognize the signs of good nutrition.
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34. 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
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35. Signs Of Good Nutrition (continued)
Restful sleep patterns
Healthy appetite
Regular elimination habits
Appropriate body weight
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36. DFS Approved Curriculum-Unit 6
Objective
6.1.7 Identify seven results of poor nutrition.
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37. Results of Poor Nutrition
Hair and eyes appear dull
Irregular bowel habits
Weight changes
Osteoporosis and other diseases
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38. Results of Poor Nutrition (continued)
Lack of interest - mental slowdown
Skin color and appearance poor
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39. Results of Poor Nutrition (continued)
Anemia leading to:
tired feeling
shortness of breath
increased pulse
problems with digestion
pale skin
poor sleep patterns
headaches
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40. DFS Approved Curriculum-Unit 6
Principles of
Nutrition
Six Basic Food Groups
And The
Food Guide Pyramid
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41. DFS Approved Curriculum-Unit 6
Objective
6.2 Discuss the six basic food groups from the Food Guide Pyramid that contribute to balanced nutrition.
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42. 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.
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43. 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.
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44. 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.
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45. 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. 
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46. 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.
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47. Six Basic Food Groups From the Food Pyramid Guide
GRAINS
Vegetables
Fruits
Milk
Meat
&
Beans
OILS
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48. Food Pyramid Guide Grain Group (breads, cereal, rice, pasta)
Provides
carbohydrates
minerals
fiber
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49. DFS Approved Curriculum-Unit 6
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.
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50. DFS Approved Curriculum-Unit 6
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 
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51. Food Guide Pyramid Vegetable Group
Provides:
vitamins
minerals
fiber (roughage)
Easier to chew if cooked, chopped or diced
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52. Food Guide Pyramid Vegetable Group (continued)
Chose from all five vegetable subgroups:
dark green
orange
legumes
starchy
other vegetables
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53. Food Guide Pyramid Vegetable Group (continued)
Daily:
2½ cups for males over 60
2 cups for females over 60 
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54. Food Pyramid Guide Fruit Group
Provides
vitamins
minerals
fiber
Chose fresh, frozen, canned or dried fruits
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55. Food Pyramid Guide Fruit Group (continued)
Daily:
2 cups daily for males over 60
1½ cups daily for females over 60
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56. 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
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57. Food Pyramid Guide Milk, Yogurt, Cheese Group (continued)
Daily: 
3 cups for males over 60
3 cups for females over 60 
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58. 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
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59. 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
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60. DFS Approved Curriculum-Unit 6
Food Pyramid Guide Oil Group = fats that are liquid at room temperature
Provides essential fatty acids
High in calories
Use sparingly
Keep total fat intake between 20% to 35% of calories
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61. DFS Approved Curriculum-Unit 6
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.
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62. DFS Approved Curriculum-Unit 6
Principles of
Nutrition
Therapeutic
Diet
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63. DFS Approved Curriculum-Unit 6
Objectives
6.3 Define a therapeutic diet and recognize the need for alterations in a regular diet.
6.3.1 List five purposes of a therapeutic diet.
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64. 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
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65. Purposes of Therapeutic Diets (continued)
Help body organs to maintain and/or regain normal function
Treat metabolic disorders by regulating amount of food
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66. DFS Approved Curriculum-Unit 6
Objective
6.3.2 Discuss the types of therapeutic diets that the physician might order for a resident.
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67. Types of Therapeutic Diets
Clear liquid
Full liquid
Bland
Low residue
Controlled carbohydrate (Diabetic)
Low fat/low cholesterol
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68. Types of Therapeutic Diets (continued)
High fiber
Low calorie
High calorie
Sodium restricted
High protein
Mechanical soft, chopped, pureed
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69. Types of Therapeutic Diets (continued)
Residents may have difficulty accepting special diets.
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70. DFS Approved Curriculum-Unit 6
Principles of
Nutrition
Adaptive
Devices
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71. DFS Approved Curriculum-Unit 6
Objective
6.4 Recognize adaptive devices used to assist residents with eating.
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Adaptive Devices
Food Guards
Divided Plates
Built-up handled utensils
Easy grip mugs/glasses
Residents have to be taught how to use these devices.
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73. DFS Approved Curriculum-Unit 6
Principles of
Nutrition
Alternative
Nutrition
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74. DFS Approved Curriculum-Unit 6
Objective
6.5 Discuss alternate methods of feeding.
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75. Parenteral Fluids (Intravenous Infusion)
Fluids administered through vein. Little nutritional value
Responsibility of licensed nurse
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76. 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
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77. DFS Approved Curriculum-Unit 6
Enteral Feeding
Residents unable to take nutrients by mouth
Depressed
Comatose
Swallowing problem (stroke, Alzheimer’s or other medical conditions)
Disorders of digestive tract
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78. Enteral Feeding (continued)
Liquid formula administered through tube by licensed nurse/NAII
Nose to stomach - nasogastric tube
Directly into stomach - gastrostomy tube
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79. Nurse Aide Responsibilities in Alternative Nutrition
Ensure that there is no tension or pulling on tube
Keep resident’s nose clean and free of mucus
Check that tube is securely taped to nose
Perform frequent oral care with nasogastric tube
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80. 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
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81. 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
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82. DFS Approved Curriculum-Unit 6
Principles of
Nutrition
Preparing Residents
For Meals
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83. DFS Approved Curriculum-Unit 6
Objectives
6.6 Identify the responsibilities of the nurse aide in preparing residents for meals.
6.6.1 Serve prepared food as instructed.
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84. 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
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85. 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
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86. 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
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87. 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
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88. Preparing Residents for Meals (continued)
Assist resident as needed with:
cutting meat
pouring liquids
buttering bread
opening containers
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89. Preparing Residents for Meals (continued)
Blind residents made aware of food placement according to face of clock
Stroke residents approached from non-effected side
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90. 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
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91. 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
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92. 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
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93. DFS Approved Curriculum-Unit 6
Principles of
Nutrition
Demonstration
and
Return
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94. DFS Approved Curriculum-Unit 6
Objective
6.7 Demonstrate the procedure for assisting with dining/feeding resident who cannot feed self.
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95. DFS Approved Curriculum-Unit 6
Principles of
Nutrition
Supplementary
Nourishments
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96. DFS Approved Curriculum-Unit 6
Objective
6.8 Discuss the various types of supplementary nourishments.
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97. DFS Approved Curriculum-Unit 6
Types of Nourishments
Milk
Juice
Gelatin
Custard, ice cream, sherbet
Crackers
Nutritional supplementation products (e.g., Ensure, etc.)
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98. Supplementary Nourishments
Usually served:
Midmorning
Mid-afternoon
Bedtime
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99. Supplementary Nourishments (continued)
Ordered by physician
Serve as directed by supervisor
Provide necessary eating utensils, straw and/or napkin
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100. DFS Approved Curriculum-Unit 6
Principles of
Nutrition
Demonstration
and
Return
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101. DFS Approved Curriculum-Unit 6
Objective
6.10 Demonstrate the procedure for serving supplementary nourishments.
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102. DFS Approved Curriculum-Unit 6
Principles of
Nutrition
Providing Fresh
Drinking Water
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103. DFS Approved Curriculum-Unit 6
Objective
6.11 Identify the special fluid orders that the physician could write.
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104. Providing Fresh Drinking Water
Fresh water should be provided periodically throughout day
Encourage to drink 6-8 glasses daily if appropriate
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105. Providing Fresh Drinking Water (continued)
Note residents who have special fluid orders
N.P.O.
Fluid restrictions:
Schedule 24-hour intake
Remind resident
RESTRICTED
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106. 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
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107. DFS Approved Curriculum-Unit 6
Principles of
Nutrition
Demonstration
and
Return
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108. DFS Approved Curriculum-Unit 6
Objective
6.11 Demonstrate the procedure for providing fresh drinking water.
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109. DFS Approved Curriculum-Unit 6
Principles of
Nutrition
THE
END
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