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NUTRITION Nursing Implications

NUTRITION Nursing Implications. Nutrition. All of the processes involved in consuming and utilizing food for energy, maintenance, and growth. Physiology of Nutrition. Five processes are involved in the body’s use of nutrients: Ingestion. Digestion. Absorption. Metabolism. Excretion.

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NUTRITION Nursing Implications

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  1. NUTRITIONNursing Implications

  2. Nutrition • All of the processes involved in consuming and utilizing food for energy, maintenance, and growth.

  3. Physiology of Nutrition Five processes are involved in the body’s use of nutrients: • Ingestion. • Digestion. • Absorption. • Metabolism. • Excretion.

  4. Ingestion • The taking of food into the digestive tract, generally through the mouth.

  5. Digestion • The mechanical and chemical processes that convert nutrients into a physically absorbable state. Digestion includes: • Mastication (chewing). • Deglutition (swallowing). • Peristalsis (coordinated, rhythmic, serial contractions of the smooth muscles of the GI tract).

  6. Absorption • The process by which the end products of digestion pass through the small and large intestines into the blood or lymph systems.

  7. Metabolism • The body’s conversion of nutrients into energy. • Basal metabolism is the amount of energy needed to maintain essential physiologic functions when a person is at complete rest, both physically and mentally.

  8. Excretion • The process of eliminating or removing waste products from the body.

  9. Water Carbohydrates Fats Proteins Vitamins Minerals The Six Essential Nutrients

  10. Water • The Most Important Nutrient. • Daily requirements: 1,000mL of water to process 1,000kcal eaten.

  11. Solvent (dissolves substances to form solutions). Transporter (carries nutrients, wastes, etc. throughout the body). Regulator of body temperature. Lubricant (aids in providing smooth movement for joints). Component of all cells. Hydrolysis (breaks apart substances, especially in metabolism). Functions of Water

  12. Classification & Sources of Water • Liquids consumed (water, coffee, juice, tea, milk, soft drinks). • Foods consumed (especially fruits and vegetables). • Metabolism (produces water when oxidization occurs).

  13. Water: Digestion, Absorption and Storage • Water is not digested. It is absorbed and used by the body as we drink it. It cannot be stored by the body. The body loses water in four ways: • Urine. • Feces. • Perspiration. • Respiration.

  14. Water: Signs of Deficiency • Abnormal water losses include profuse sweating, vomiting, diarrhea, hemorrhage, wound drainage (burns), fever, and edema. • A deficiency of water is called dehydration. Prolonged dehydration results in death.

  15. Carbohydrates • The chief source of energy for the body. Made up of carbon, hydrogen, and oxygen. They are the major source of food for all people. • Daily requirements: 50% to 60 of an individual’s kcal intake per day.

  16. Functions of Carbohydrates Carbohydrates are... • The primary source of energy for the body. • Spares proteins from being used for energy, thus allowing them to perform their primary function of building and repairing body tissues. • Needed to oxidize fats completely and for synthesis of fatty acids and amino acids.

  17. Carbohydrates: Classification and Sources • Carbohydrates may be simple or complex. • Simple are single or double sugars. • Complex are composed of many single sugars joined together (starch, dietary fiber, glycogen).

  18. Carbohydrates: Digestion, Absorption and Storage • Digestion of cooked starches begins in the mouth. • Little digestion occurs in the stomach. • Carbohydrate digestion completed in the small intestine. • Carbohydrates are used completely, leaving no waste for the kidneys to excrete.

  19. Carbohydrates: Signs of Deficiency • Mild deficiency can result in weight loss and fatigue. • Serious deficiency can result in ketosis.

  20. Fats • The most concentrated source of energy in the diet. An essential nutrient, but too much can be a health hazard. • Daily requirements: should not exceed 25% to 30% of an individual’s caloric intake per day.

  21. Functions of Fats • Provides concentrated source of energy. • Assists in absorption of fat-soluble vitamins. • Is a major component of cell membranes and myellin sheaths. • Improves flavor of foods and delay’s stomach’s emptying time. • Protects and hold organs in place. • Insulates body, thus assisting in temperature maintenance.

  22. Classification of Fats • Triglycerides (true fats). • Phospholipids (lipoids, composed of glycerol, fatty acids, and phosphorus). • Cholesterol.

  23. Sources of Fats • Animal (lard, butter, milk, cream, egg yolks, and fat in meat, poultry, and fish). • Plant (oils from corn, safflower, peanut, palm, etc., as well as nuts and avocado).

  24. Digestion, Absorption and Storage of Fats • No chemical breakdown of fats occurs in the mouth and very little in the stomach. • Digestion occurs in small intestine. • Fats not immediately needed by the body are stored as adipose tissue.

  25. Fats: Signs of Deficiency and Excess • Deficiency occurs when fats provide less than 10% of daily kcal requirement. • Gross deficiency may result in eczema, retarded growth, and weight loss. • Excessfat consumption can lead to overweight and heart disease.

  26. Proteins • The only nutrient that can build, repair, and maintain body tissues. • Daily requirements: determined by size, age, gender, and physical and emotional conditions. • Daily protein requirement for average adults is 0.8g for each kilogram of weight.

  27. Functions of Proteins • To provide amino acids necessary for synthesis of body proteins, used to build, repair, and maintain body tissues. • To assist in regulating fluid balance. • Used to build antibodies. • Plasma proteins help control water balance between the circulatory system and surrounding tissues. • In event of insufficient stores of carbohydrates and fats, protein can be converted into glucose and used for energy.

  28. Classification & Sources of Proteins • Complete proteins contain all 9 essential amino acids. (All animal fats, except for gelatin, are complete. Only plant fat that is complete is soybeans). • Incomplete proteins have one or more essential amino acids missing (plant proteins).

  29. Digestion, Absorption and Storage of Protein • Digestion begins in the stomach. • Most digestion takes place in the small intestine. • Amino acids not used to build proteins are converted to glucose, glycogen, or fat and are stored.

  30. Signs of Deficiency and Excess of Protein • Muscle wasting. • Edema (swelling). • Lethargy and depression. • Excess can result in heart disease, colon cancer, osteoporosis.

  31. Vitamins • Essential organic compounds that regulate body processes and are required for metabolism of fats, proteins, and carbohydrates. • Needed in very small amounts.

  32. BODY WEIGHT/BODY MASS • Ideal body weight • Body mass index • Percent body fat

  33. FACTORS AFFECTING NUTRITION • Development • Gender • Ethnicity & culture • Beliefs about food • Personal preferences • Religious practices • Lifestyle • Medications & therapy – table 45-1

  34. FACTORS AFFECTING NUTRITION • Health • Alcohol abuse • Advertising • Psychologic factors

  35. NUTRITION THRU THE LIFE CYCLE – Young & Middle Adult • Lay foundation for lifetime nutrition pattern in young adulthood • Nutrient requirements change very little • Females need to maintain/increase intake of Vit. C , Vit D, & calcium; & maintain intake of iron • Basal metabolism decreases 2-3%/decade after age 25 • Obesity, HTN , & DM may begin to form

  36. NUTRITION THRU THE LIFE CYCLE – Older Adults • Physiologic, psychosocial, economic changes • Need fewer calories • Nutrient requirements basically the same • Variety & nutrient dense foods; water

  37. Factors Affecting Nutrition:Ethnicity & Culture • Native American • Starches: corn, rice • Fruits: berries • Veggies: rhubarb, mushrooms, roots • Meats: game, seafood, nuts • Milk: little used • High incidence of lactose intolerance • Encourage broiled, poached, steamed meats

  38. Factors Affecting Nutrition:Ethnicity & Culture • U.S. Southern • Starches: cornbread, biscuits, potatoes • Fruits: melons, peaches, bananas • Veggies: collards, okra, tomatoes, cabbage • Meat: pork, chicken, fish • Milk: milk, ice cream • Many foods fried, cooked with lard

  39. Factors Affecting Nutrition:Ethnicity & Culture • Mexican • Starches: tortillas, corn products • Fruits: few • Veggies: chili peppers, tomatoes, onions • Meat: beef, poultry, eggs, pinto beans • Milk: cheese; rarely drink milk

  40. Factors Affecting Nutrition:Beliefs & Preferences • Individual likes & dislikes • Beliefs about foods • Fad diets

  41. Factors Affecting Nutrition:Religious Practices • Christianity • Catholics • Eastern Orthodox • Mormons • Seventh Day Adventists • Islam • No pork or alcohol; daylight fasting during Ramadan

  42. Factors Affecting Nutrition:Lifestyle • Economic & social status • Work/activities

  43. Factors Affecting Nutrition:Medications, Therapy, & Health • Therapies • Chemo, radiation • Health • GI disorders, viruses, oral ulcers

  44. Factors Affecting Nutrition:Alcohol, Advertising, & Psych • Alcohol • Can depress appetite • Abuse can lead to malnutrition (esp Vit B) • Advertising • May influence food choices • Psych • Overeat vs. don’t eat when stressed, depressed

  45. DIETARY GUIDELINES • Eat a variety of foods • Maintain or improve your weight • Be physically active every day • Eat diet low in trans fat, saturated fat, & cholesterol • Eat plenty of vegetables, fruits, & grains • Use sugars in moderation • Use salt & sodium in moderation • If you drink alcohol, do so in moderation

  46. Food Guide Pyramid Fats, oils & sweets Use sparingly Milk, Yogurt & Cheese Meat, poultry, fish, dry beans, eggs & nuts 2-3 servings Vegetables & Fruits (2-5 servings) Bread, cereal, rice & pasta (6-11 servings)

  47. FOOD GUIDE PYRAMID • Healthy Eating Pyramid • Daily exercise & weight control • Whole grains at most meals • Vegetables in abundance • Fruits 2-3 times/day • Nuts, legumes 1-3 times/day • Fish, poultry, eggs 0-2 times/day • Dairy or calcium supplement 1-2 times/day • White rice, white bread, potatoes, pasta, sweets, red meat, butter sparingly • MVI for most • Alcohol in moderation

  48. ALTERED NUTRITION • Malnutrition – lack of necessary or appropriate food substances • Overnutrition – caloric intake in excess of daily energy requirements • Overweight – BMI 26-30 • Obese – BMI > 30 • Morbid obesity – interferes with mobility or breathing

  49. ALTERED NUTRITION • Malnutrition • Undernutrition – intake of nutrients insufficient to meet daily energy requirements as a result of inadequate food intake or improper digestion & absorption of food • Dysphagia – difficulty swallowing • Anorexia – loss of appetite • Protein-calorie malnutrition

  50. The Nursing Process: Assessment Two types of data: • Subjective. • Objective.

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