Chapter 34 Nutrition Copyright 2011 Delmar Cengage Learning

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

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

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

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

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

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

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

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

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

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

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

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

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