Download Nutrition

JUDITH M. WILKINSON LESLIE S. TREAS
KAREN BARNETT MABLE H. SMITH
FUNDAMENTALS OF
NURSING
Chapter 27:
Nutrition
Copyright © 2016 F.A. Davis Company
Nutrition (cont’d)
• Study of food: how it affects the body and
influences health
• Adequate nutrition: essential to wellness
Nutrients
• Building blocks for cells and tissues
– Supply energy
– Help manufacture, maintain, and repair cells
• Found in foods
• Changed and used in the body
through metabolism
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Types of Energy Nutrients
Carbohydrates
• Primary energy source
• Sugars
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Types of Energy Nutrients (cont’d)
Proteins
• Tissue building
• Nitrogen balance
• Amino acids
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Types of Energy Nutrients (cont’d)
Lipids
• Lay term = fat
• Key component of lipoproteins
• Back-up energy source
• Organ insulation/protection
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Other Nutrients
Micronutrients
• Needed only in small amounts
• Regulate body functions
– Vitamins
– Minerals
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Other Nutrients (cont’d)
Water
• Makes up large percentage of body weight
• Solvent for chemical processes
• Transports substances
• Form for tissues
• Maintains body temperature
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Energy Balance Concepts
• Energy in nutrients measured in calories
• Calories “in” must equal calories burned
• Too few calories/nutrients = undernourished
• Too many calories = obesity
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Energy Balance Concepts (cont’d)
BMR
• Amount of energy required at rest
Total energy needs
• Replacing calories used for BMR + physical activity
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Factors That Affect Nutrition
• Developmental stage
– From infants to elders
– Includes lactating women
• Educational level
• Knowledge of nutrition
– Includes concepts of access
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Factors That Affect Nutrition (cont’d)
• Lifestyle choices
– Dietary patterns
– Vegetarianism
– Dieting
• Ethnicity/culture
• Religious practices
• Disease processes
• Functional limitations
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Alterations in Nutrition
Overweight/obesity
• Consuming nutrients
– In excess of metabolic demands
– More than needed for activity, gender, height,
and weight
• Overweight = body mass index >25 but <29.9
• Obesity = body mass index >30
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Alterations in Nutrition (cont’d)
Underweight/undernutrition
• Insufficient intake of protein, fat, vitamins, minerals
• Consuming less calories than needed according to
activity, gender, height, and weight
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Screening for Nutritional Problems
• Obtain a diet history
– 24-hr recall
– Food frequency
questionnaire
– Food record
• Nutrition
screening initiative
• Body composition
• Subjective global
assessment
• Mininutritional
assessment
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Identifying Nutritional Imbalances
• Complete physical examination
–
–
–
–
–
General survey
Alterations in vital signs
Poor skin turgor, wound healing
Concave abdomen/ascites
Change in muscle mass
• Laboratory results
– Changes in blood glucose, serum albumin,
creatinine, hemoglobin
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Managing Nutritional Imbalances: Planning
Key point
• Must identify the etiology of the imbalance
Examples of etiologies for undernutrition
• Difficulty chewing/swallowing; alcoholism;
metabolic disorders
Examples of etiologies for overnutrition
• Overeating; lack of exercise; endocrine problems
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Managing Nutritional Imbalances: Planning
(cont’d)
Outcomes based on Healthy People 2020
• Promotes health and reduction of chronic disease
associated with diet and weight
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Managing Nutritional
Imbalances: Interventions
Client/family teaching related to
• Vitamin and mineral supplements
• Obtaining nutritious foods on a limited budget
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Managing Nutritional Imbalances:
Interventions (cont’d)
Supporting special clients’ nutritional needs
• Clients who are NPO (nothing by mouth)
• Older adults
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Managing Nutritional Imbalances:
Interventions (cont’d)
Assisting clients with meals
• Inpatient: delegating feeding
• Home care: refer to agency for help obtaining food
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Managing Nutritional Imbalances:
Interventions (cont’d)
Some interventions for obesity
• Assist with calorie calculations and meal planning.
• Encourage exercise/lifestyle changes.
• Weigh weekly; suggest food diary.
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Managing Nutritional Imbalances:
Interventions (cont’d)
Some interventions for undernutrition
• Encourage client to seek counseling
for eating disorder management
• Devise strategies to improve
client’s appetite
• Enteral nutrition
• Parenteral nutrition
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Think Like a Nurse
How does your diet compare to the USDA Choose
MyPlate in terms of
a.
b.
c.
d.
e.
f.
Servings of bread, cereal, rice, and pasta
Servings of vegetables
Servings of fruits
Servings of milk, yogurt, and cheese
Servings of meat, poultry, fish, dry beans, eggs, and nuts
Servings of fats, oil, and sweets
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