Download Ch07 Summary

Ch07 Summary
The key concepts discussed in this chapter include dietary and nutritional guidelines
throughout the life cycle, signs and symptoms of poor nutritional status, and clinical
indicators of malnutrition (anthropometric measures and laboratory and diagnostic data).
The two most common dietary guidelines are the recommended dietary allowances
(RDA) and the USDA Food Guide. The RDA stipulates the recommended amounts of
nutrients that a healthy individual should consume. These guidelines vary depending on
an individual’s age, sex, and whether the person is pregnant or lactating.
The USDA Food Guide and the DASH Eating Plan recommend that healthy
individuals consume 7 to 8 servings/day from the bread, cereal, rice, and pasta group; 4 to
5 servings/day from the vegetable group; 4 to 5 servings/day from the fruit group; 2 to 3
servings/day from the milk/dairy group; and 4 to 5 servings/week from the meat and
beans group. Additionally, individuals should limit their consumption of fats, oils, and
sweets.
Nutritional requirements change throughout the lifespan. Infants experience rapid
growth and development during their first 12 months of life; thus their caloric and energy
requirements are high. The American Academy of Pediatrics recommends the use of
breast milk during this period of time. Iron-fortified cereals may be introduced when the
infant is 4 to 6 months old, fruits and vegetables may be added when the infant is 5 to 8
months old, and finger foods may be introduced at 9 to 10 months. While physical
growth may slow in toddlers, they continue to experience rapid development. Toddlers
should be fed small portions, usually 1 to 2 tablespoons per year of age, and foods that
they can feed themselves. Preschoolers enjoy small servings, food choice, and finger
foods. School-age children experience erratic growth and eating patterns. They should be
encouraged to consume a well-balanced diet and to limit highly sweetened snacks.
Adolescents undergo periods of rapid growth and change, and thus have fluctuating
nutritional needs. Because teens also develop an increased concern for body image, they
may be at risk for eating disorders such as anorexia nervosa or bulimia.
Caloric needs stabilize in young and middle-aged adults, whereas they decrease in
older adults. Adults may be at nutritional risk for developing diseases such as obesity,
osteoporosis, type 2 diabetes mellitus, and atherosclerosis. Caloric requirements will be
determined by one’s activity level.
Pregnant women are encouraged to consume an additional 300 calories per day
and to drink six to eight glasses of fluid per day. Lactating women are encouraged to
consume an additional 500 calories per day and 2 to 3 quarts of fluid daily. All women of
childbearing age are encouraged to consume 0.4 mg/day of folic acid because scientific
evidence suggests that folic acid supplementation may decrease the risk of neural tube
defects in infants.
Regardless of an individual’s age, a thorough nutritional assessment is essential.
The nurse will obtain a nutritional history, anthropometric measurements, and laboratory
and diagnostic data. The nurse will also assess for common signs of poor nutritional
status such as fatigue, weight changes, changes in appetite, weakness, dry skin, cracked
lips, swollen or bleeding gums, edema, and decreased muscle tone. The hematocrit,
hemoglobin, cholesterol, triglyceride, transferrin, iron, total lymphocyte count, albumin,
prealbumin, glucose, creatinine, and nitrogen values should be assessed, as abnormal
findings may indicate nutritional alterations. Diagnostic data such as radiographic studies
may also be obtained to identify nutritionally related diseases.
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