* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download Nutrition Concept.Final
Stunted growth wikipedia , lookup
Vegetarianism wikipedia , lookup
Calorie restriction wikipedia , lookup
Overeaters Anonymous wikipedia , lookup
Epidemiology of metabolic syndrome wikipedia , lookup
Food studies wikipedia , lookup
Plant nutrition wikipedia , lookup
Low-carbohydrate diet wikipedia , lookup
Dietary fiber wikipedia , lookup
Abdominal obesity wikipedia , lookup
Obesity and the environment wikipedia , lookup
Saturated fat and cardiovascular disease wikipedia , lookup
Gastric bypass surgery wikipedia , lookup
Malnutrition wikipedia , lookup
Diet-induced obesity model wikipedia , lookup
Malnutrition in South Africa wikipedia , lookup
Food choice wikipedia , lookup
Academy of Nutrition and Dietetics wikipedia , lookup
MusclePharm wikipedia , lookup
Childhood obesity in Australia wikipedia , lookup
NUTRITION Heather Rawls RN MS Goals for This Concept Presentation 1. Define and describe the concept. 2. Notice risk factors that place individuals at risk for nutrition problems. 3. Recognize when an individual is experiencing inadequate nutrition. 4. Provide appropriate nursing and collaborative interventions to optimize nutrition. Define and Describe the Concept of nutrition Definition Nutrition is the science of optimal cellular metabolism and its impact on health and disease Nutrition- the process by which the body ingests, absorbs, transports uses and eliminates nutrients and foods . Key Terms Discuss the meaning of the following terms: – Macronutrients – Micronutrients – Kilocalorie – Malnutrition – Hypoalbuminemia How do the terms relate to the concept of nutrition? Scope and Categories of Nutrition Problems • Excessive or Insufficient quantity of • Macronutrients • Micronutrients Health status and nutrition are integral to one another—that is, poor nutritional status negatively impacts health, and poor health status can negatively impact nutritional status. • Insufficient quantity of • Macronutrients • Micronutrients • Sufficient quantity of • Macronutrients • Micronutrients CONCEPT ----------NUTRITION Cognition Thermoregulation Attributes Adequate Intake for: Development-Energy- GrowthTissue Repair Ideal Ht-Wt-BMI—(MAC) (MAMM) Muscle Tone-Strength-Agility-Reflex Response Cognitive & Mood Response. Albumin WNL Hemoglobin & Hematocrit WNL Electrolytes WNL Nursing Care Patient Education Metabolis m Interrelated Concepts Clotting Fluid and Electrolytes Diversity-(Lifestyle-Culture) Human Development Antecedents Normal Alimentary Tract and Associated Organs Adequate Ingestion of Nutrients and Water Normal Temperature Normal ph Medical Conditions Nutrition The process by which the body ingests, absorbs, transports uses and eliminates nutrients and foods (NC) Consequences (Outcomes) Negative Malnutrition Insufficient/Excess Intake Failure to thrive--Obesity Malnutrition Physiological-Psychological- Dysfunction Ingestion- Digestion-Absorption-Metabolism Risk factors Physiological & Psychological Development Medications Age-Gender-Genetics Sub Concepts Ethnicity Socioeconomics Knowledge Lifestyle Behaviors Diets Growth & Tissue Repair Positive Homeostasis/Adequate Nutrition Hydration Nutrients Food Allergies Physiological and Psychological Wellness Engage in Physical Activity Altered Hydration Status Low energy-Fatigue Depression-Isolation Growth/ Developmental Delay Decreased Bone Density Delayed-Inadequate Healing Illness-Muscle wasting-Death Components of Concept Analysis Diagram Attributes -- Characteristics Adequate intake Ideal height, weight, BMI Presence of adequate muscle tone, strength, agility Appropriate cognition and mood response Albumin, Electrolytes and Hbg, Hct, within defined limits Antecedents – What comes before Normal alimentary track and associated organs Adequate intake of nutrients and water Normal temperature Normal pH Components of Concept Analysis Diagram Continued Interrelated Concepts Sub-Concepts Thermoregulation Age, Gender, Genetics Metabolism Risk factors Cognition Clotting Fluid and Electrolytes Immunity Lifestyle and Culture Developmental Ethnicity, Socioeconomics Lifestyle behaviors Medications Medical conditions Food allergies Physiological/Psychologica l development Consequences Positive Consequences Negative Consequences Homeostasis, adequate Malnutrition – obesity nutrition and hydration Physiological/Psychologica l wellness Growth and tissue repair Ability to engage in physical activity Malnutrition – failure to thrive Low energy, fatigue Depression Growth and development delay Decreased bone density Delayed or inadequate healing Illness, muscle wasting, death Review of Anatomy and Physiology Protein Our overall physical health and well-being depend on our eating enough essential amino acids for body protein synthesis. Proteins are organic compounds formed by the linking of many smaller molecules of amino acids, amino acids contain nitrogen, which distinguish protein from other nutrients. Functions Growth and maintenance needed to make the proteins required to support muscle, tissue, bone formation, and the cells themselves Creation of communicators and catalysts vital substances produced by our bodies are formed of protein Ex. Insulin Immune system response Fluid and electrolyte regulation Acid-base balance Transportation Carbohydrates (CHO) CHO we consume are primarily form plant sources. Energy is the only real nutrient function of CHO When adequate amounts of CHO ae available, both Cho and small amounts of fats are used for energy. food sources include the following: Grains: Cereals, breads, crackers, rice, or pasta, at least half as whole grains (see following chart) Vegetables: Fiber-rich vegetables, starchy vegetables such as carrots, sweet potatoes, white potatoes, peas; legumes or dry beans such as kidney beans, chickpeas, and black-eyed peas Fruits: Fiber-rich fruits, most fruits especially bananas, grapes, pears, apples Milk: Fat-free or low fat milk, yogurt, and other milk products containing lactose (does not include most cheeses) Meats and beans: Replace animal sources with servings of legumes or dry beans Fats refers to the chemical group called lipids. Lipids are divided into three classifications: fats (or triglycerides), and the fat-related substances of phospholipids and sterols. Approximately 95% of the lipids in foods and in our bodies are in the triglyceride form of fat. The other two lipid classifications are the fat-related substances of phospholipids and sterols. Lecithin is the best-known phospholipid Cholesterol is the best-known sterol. Function Source of Energy Palatability Fat makes food smell and taste good Satiety and Satiation helps prevent hunger between meals Food Processing Nutrient Source Stored Energy Organ Protection Insulation Essential fatty acid deficiency A, pt receiving fat-free parenteral nutrition has developed biochemical abnormalities and skin lesions as shown here. B, Resolution in same patient after 2 weeks of tx. Vitamins Functions Food Sources Blood Health In almost all foods, yet no Bone Health one food group is a good source of all vitamins. It is always best to consume vitamins from food sources Fresh fruits and vegetables are particularly rich sources. Fluid and Electrolyte Balance Minerals prime sources of minerals include both plant and animal foods. Valuable sources of plant foods include most fruits, vegetables, legumes, and whole grains. Animal sources consist of beef, chicken, eggs, fish, and milk products. Fiber All the health benefits of fiber improve the physical functioning of the human body. The benefits are not directly nutritional but instead allow the body to function at a more efficient level. consists of substances in plant foods that, for the most part, cannot be digested by humans.We do not produce digestive juices strong enough to break down the bonds that hold the simple carbohydrates of most plant fibers, so fiber “passes through” our bodies without providing kcal or nutrients. Its texture provides bulk and eases the work of the GI muscles that regulate movement of the food mass Water We can live several weeks without food but can survive only a few days without water or fluids. Although our bodies use stored nutrients to fuel energy needs, a minimum intake of water is required for cell function and as a solution through which waste products of the body are excreted in urine. The Adequate Intake (AI) recommendations for water are about 13 cups a day for men and 9 cups a day for women. This amount is in addition to fluids from foods consumed throughout the day, such as fruits and vegetables. Although the minimum amount needed by healthy adults may be about 4 cups, higher amounts are optimum considering an individual's physiologic status and energy output. Consequences: Malnutrition Each macronutrient and micronutrient has specific functions Protein Carbohydrate Fatty acids Vitamins Minerals Fiber* Water* Effects of deficiency or excess relate to the functions * not Macro or Micro nutrients, but important to discuss. Deficiencies and Excess Intake Identify the function of each macronutrient listed and the consequences of its deficiency and excess intake. Macro- nutrient Protein Carbohydrate Fatty acids Physiologic Function Effects of Deficiency Effects of Excess Intake Notice Risk factors that place individuals at risk for Nutrition problems Risk Factors: Populations at Greatest Risk All individuals are potentially at risk Socioeconomic status and race or ethnicity can influence risk Populations at greatest risk for problems with nutrition are Very young children Elderly adults Individual Risk Factors Collaborative Learning Discuss how the following risk factors link to nutrition problems. Risk Factor Genetics Lifestyle Inconsistent eating patterns Conditions that affect oral intake Conditions associated with impaired digestion Conditions associated with impaired metabolism Link to Nutrition Problem Recognize when an individual has problems with Nutrition Recognizing Optimal Nutrition Discuss general clinical findings you would expect to see in a wellnourished individual across the lifespan. Age-Group Infants and children Adolescents Adults Older adults Expected Clinical Findings Common Diagnostic Tests Laboratory tests Albumin; blood glucose; hemoglobin A1C; lipid profile; electrolytes; blood urea nitrogen (BUN); tests to rule out anemia; calcium, phosphorus, and vitamin D levels Radiographic scans DXA scans (done density) Provide appropriate nursing and collaborative interventions to optimize Nutrition Clinical Management: Primary Prevention Healthy diet 2015 Dietary Guidelines for Americans ChooseMyPlate http://www.choosemyplate.gov/ Physical activity Physical exercise for 30 minutes most days of the week "On average, the U.S. diet is low in vegetables, fruit and whole grains and too high in calories, saturated fat, sodium, refined grains and added sugars,“ Americans eat too little vitamin D, calcium, potassium and fiber and eat way too much fat and salt. “About half of all Americans—117 million individuals — have one or more preventable chronic diseases that relate to poor dietary patterns and physical inactivity, including cardiovascular disease, hypertension, type 2 diabetes and diet-related cancers, "More than two-thirds of adults and nearly one-third of children and youth are overweight or obese." http://www.nbcnews.com/health/health-news/newdiet-proposals-eat-your-veggies-have-some-coffeen309026 Clinical Management: Screening Screening at Birth Screening During Pregnancy Genetically linked metabolic disorders Glucose Screening for Adults Lipids Anemia Body mass index Gestational diabetes HgbA1C General Discussion Questions What are examples of genetically linked metabolic disorders for which screening is done at birth? At what age should adults start having lipid screens? How often should lipid screening be done? What factors inhibit lipid screening from being done? At what time in the pregnancy is the mother checked for gestational diabetes? What is a HgA1C? BMI <19 Underweight; severe level <15 indicative of anorexia 19-24.9 Optimal body weight composition. Elderly persons should strive for BMI >21 25-29.9 Overweight; may be appropriate given health status 30-34.9 Class I obesity; slow weight loss advised to promote permanent weight loss Not appropriate for elder population to lose weight 35-39.9 Class II obesity; slow weight loss advised May be a candidate for bariatric surgery if comorbidities present and not able to achieve long-term weight loss through diet and exercise ≥40 Class III or “extreme” obesity (formerly known as morbid obesity) May be a candidate for bariatric surgery based on health status, age, and level of obesity and history of not being able to achieve long-term weight loss through diet and exercise Clinical Management: Collaborative Interventions Treatment strategies depend on the underlying condition The most common strategies include Dietary interventions Pharmacotherapy Surgery Dietary Interventions Medical nutrition therapy provided by registered dietitians (RDs) Basic therapeutic diets No Added Salt diet (3 to 4 g of Na+) 2 g of Na+ diet Consistent or Controlled Carbohydrate diet (Diabetic diet) Renal diet typically implies restrictions in phosphorus, sodium, and potassium. (low protein) Dietary Supplements Oral supplements Ready to use formulas (powdered form or liquid form) Specific types based on nutrient source, essential nutrients is specified volume, elmental formulas, and disease specific formulas. Surgical Interventions Bariatric surgery Nonmalabsorptive procedures Malabsorptive procedures Common complications Surgical complications Nutrient deficiencies Pharmacologic Agents Weight loss medications Antilipid agents Micronutrient supplements Parenteral nutrition Quick Quiz! 1. A 22-year-old new mother is breastfeeding.You ask her if she is taking the correct quantities of nutrients.Which statement reflects that she understands the dietary guidelines? A. “I am not concerned with what I am eating.” B. “I am taking vitamin doses based on TV.” C. “I am taking a daily MVI.” D. “I am making eating choices according to the recommended dietary allowances and intakes.” Interrelated Concepts General Discussion Question Why does the figure show overlapping of the concepts of glucose regulation and nutrition? Ans: dependent on caloric intake and is critical to adequate metabolism of nutrients; in fact, glucose regulation can also be considered a subconcept of nutrition. For this reason, an overlap exists between these two concepts Reference Giddens, J.F. (2012) Concepts for Nursing Practice. St. Louis: Elsevier.