Chapter 19 Nutrition
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Chapter 19 Nutrition - Leaderboard
Chapter 19 Nutrition - Details
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| Benefits of good nutrition | Healthier Body and Mind, Greater Vitality and Energy, and Greater Resistance to Disease |
| Duties of the Nurse in Promoting Good Nutrition | Assisting in eating, recording intake, observing for signs of poor nutrition, and communicating dietary concerns to other involved health care team members |
| Evolution of Nutritional Guidelines | Began as Farmers bullentin over 100 years ago. The evolved to Basic 7, Basic Four, Food Guide Pyramid, MyPyramid and currently MyPlate |
| Who is responsible for developing MyPlate?When | US Department of Agriculture, 2011 |
| Purpose of MyPlate | To Promote proper portioning of food groups, and reduce the amount of sodium and sugar in the diet |
| What are the Dietary Guidelines for Americans | Guidelines which focuses on healthy eating patterns as a whole rather than on individual nutrients |
| What is the emphasis of Dietary Guidelines for America | Balancing calories with activity to manage weight; consuming a variety of fruits, vegetables and whole grains; Increasing fat free or low-fat dairy, lean meats and seafood. |
| According to the USDA consumption of what should be limited? | Sodium, Saturated Fat, Trans Fat, Cholesterol, Added Sugars and Refined Grains |
| Define DRI's? | Refers to a set of nutrient-based values for evaluating and planning diets |
| 5 Dietary Guidelines for America | 1)Follow a healthy eating pattern across the lifespan 2)Focus on variety, nutrient density, and amount 3)Limit calories for added sugars and saturated fats and reduce sodium intake 4)Shift to healthier food and beverage choices 5)Support healthy eating patterns for all |
| According to the Dietary Guidelines for America what entails a healthy eating pattern | -A variety of vegetables(Dark Green, Red and Orange, Legumes, Starches etc) -Fruits(Especially whole fruits) -Grains(At least half of which are whole grains) -Fat-Free or low-fat dairy(Milk, yogurt, cheese and/or fortified soy beverages) -A variety of proteins(seafood, lean meats, poultry, eggs, legumes, nuts, seeds and soy products |
| According to the Dietary Guidelines for America, a healthy eating pattern limits consumption of: | -Less than 10% of calories per day from added sugars -Less than 10% of calories per day from saturated fats -Less than 2300mg per day of sodium -Alcohol consumption limited to 1 drink per day for women and 2 drinks per day from men |
| Nutrients | A chemical compound or element necessary for good health that is found in food |
| Essential Nutrients | Nutrients that the body cannot make in the amounts essential for good health |
| 6 classes of essential nutrients | Carbohydrates, fats, proteins, vitamins, minerals and water |
| (3) major functions of nutrients | Providing Energy, Building and Repairing Tissue and Regulating Body Processes |
| (3) Essential Nutrients that provide energy | Carbohydrates, Fats and Proteins |
| Caloric Distribution | Recommended ratio of calories from carbs fats and protein. 45%-65% from carbohydrates, 20%-35% from fat and 10%-35% from protein |
| What are some nutrients that play a role in tissue building and repair and their roles? | Amino Acids found in protein are used in tissue building and repair, Calcium and Phosphorous are necessary to bone structure, Iron makes up a large part of hemoglobin in RBC and Fat also plays a role in tissue building an repair as it is found in all cell walls |
| Metabolism | Combination of all chemical processes that take place in a living organism |
| How are nutrients used to regulate body processes? | Carbohydrates must be present for fats to be used correctly and completely, B vitamins are necessary for the body to derive energy from foods, Water is integral to almost all chemical reactions in the body |
| Two key characteristics of nutrients | 1)Individual nutrients have many functions in the body 2) No nutrient works alone |
| When is greater nutrition necessary? | During times of great growth(Pregnancy, infancy and adolescents) and when ill or under great stress |
| What should be avoided during pregnancy? | Alcohol, smoking, caffeine |
| How does the DRI change during pregnancy and lactation? | Pregnant women should increase caloric intake by 300kcal/day in 1st trimester, 340kcal/day 2nd trimester and 450-500kcal/day in 3rd trimester. They should be nutrient dense foods. |
| What is the optimal weight gain in pregnancy? | If underweight 28-40 pounds If average weight 25-35 pounds If Overweight 15-25 pounds |
| Nursing Interventions for morning sickness | Allow time after eating before lying down to prevent epigastric distress Avoid high-fat or fried foods in excess Avoid letting stomach become empty Consume 5-6 small meals a day(liquids before or after to avoid feeling too full Drink plenty of fluids Limit consumption of foods with strong odor Eat soda crackers or other dry grains before getting in bed |
| Potential risks during pregnancy | Hypertensive disorders of pregnancy(chronic hypertension, preeclampsia, eclampsia and gestational hypertension), Gestational diabetes, Anemia |
| DRI in lactation | 500kcal/day more than prepregnancy intake |
| How does weight change from birth to 1 year of age? | It doubles at 6 months and triples at 1 year |
| How should diet be treated during first year of life? | Breast milk or iron fortified infant formula during initial 4-6 months At 4-6 months introduction to iron-fortified rice cereal is permitted at a few teaspoons and increased gradually Fruits are added next, then vegetables and then meats. Single ingredient foods introduced at weekly intervals to help detect food related allergies. |
| What should never be given to infants younger than 12 months old?Why? | Honey as it may cause botulism |
| What factors may contribute to adolescents making healthy dietary decisions | Contribution to skin appearance and health, Strength for athletics and ability to concentrate |
| Common Deficiencies in adolescents | Iron, calcium, Vitamin A, Vitamin C and folic acid |
| Why should iron intake be increased in women? | Iron deficiency and anemia is common in women following menstruation. |
| Promotions to prevent adolescent obesity | Promote limiting soft drink and junk food consumption Promote adequate physical activity Limit television and computer usage |
| Common age aggravated health conditions that may require special dietary considerations | Heart Disease, Arthritis, Osteoporosis, Diabetes, Kidney Disease |
| Contributory factors of malnutrition in SNF | -Cognitive or physical impairment, disease processes and emotional disturbance all affect nutritional intake -Need for encouragement to eat and drink -Restricted diets are commonly prescribed and may affect palatability of food, hindering intake -Inadequate fluid intake and dehydration may be secondary to decreased thirst sensation, decreased independence, dysphagia and incontinence -Pressure injuries may occur increasing kilocalorie, protein and nutrient needs |
| Nursing Interventions to promote improved nutrition | -Working together with nutritionist to communicate patient preferences and concerns with diet -Offering familiar foods and incorporating cultural needs into diet -Liquid nutritional supplements may help improve nutrition in a patient with suboptimal nutrition(Should not be used to substitute regular meals) -Offer fluids regularly and monitor for signs of dehydration -Involve family and make meals social in nature |
| Effects of caffeine on body | Caffeine is a CNS stimulant and diuretic. It has potential to cause nervousness, irritability anxiety, insomnia, heart dysrhythmias and palpitations |
| What are carbohydrates(CHO)? | Organic compounds containing carbon, hydrogen and oxygen. Its main function is to provide energy. They are also needed in adequate amounts to keep protein from being used as an energy source |
| Saccharides | Sugar Units |
| Simple Carbohydrates | Consist of Monosaccharides(One sugar unit) and Disaccharides(Two sugar units). |
| Examples of Monosaccharides | Fructose(found in fruits), Galactose and glucose |
| Examples of Disaccharides | Sucrose, Lactose and Maltose |
| Risk of high Simple Carbohydrates Consumption | Increased risk of obesity, Increased risk of dental caries |
| DRI's for simple carbohydrates | 45%-65% caloric intake from carbohydrates and only 8% added sugar |
| Complex Carbohydrates(Polysaccharides) | Long chains of glucose units |
| Polysaccharides(3) | Starch, Glycogen and Dietary Fiber |
| Examples of Starch | Grains, legumes and vegetables(Particularly corn and potatoes) |
| Glycogen | Stored form of carbohydrates, made from simple sugars and stored primarily in the liver and muscles. It is used when blood glucose levels are low |
| Dietary Fiber | Refers to food that humans cannot breakdown. It is usually excreted in feces and has no nutritional value |
| Sources of dietary fiber | Whole grains, legumes, fruits, vegetables, nuts and seeds |
| Examples of maltose | Malted grain products |
| Examples of lactose | Dairy and milk products |
| Examples of sucrose | Table sugar, sugarcane, beet sugar, powdered and brown sugar, fruit |
| Examples of Glucose | Dextrose, Corn Syrup |
| Examples of Fructose | Fruits, Honey, High Fructose Corn Syrup |
| Examples of Galactos | Milk(Only found in Lactose) |
| How do complex carbohydrates provide energy longer? | Because they are longer chains of glucose units and it takes longer for the body to break them down |
| Where is glycogen stored? | The liver and muscles |
| Types of Fiber | Water Soluble and insoluble fiber |
| Examples of insoluble fibers | Wheat bran, vegetables, whole grains and fibrous fruits |
| Examples of water soluble fibers | Fruits, Oats, Barley, and Legumes |
| Benefits of Insoluble Fibers | Soften Stool, Speed Transit of Foods Through the digestive Tract and Reduces Pressure in the Colon |
| Water-Soluble Fibers action | Binds with Bile Acid and cholesterol in the digestive tract to prevent their absorption. |
| Benefits of Water Soluble Fiber | Helps lower cholesterol levels, and reduces risk of cardiovascular disease, attracts water and turns to gel during digestion thus slowing digestion, providing a feeling of fullness |
| DRI's for Complex Carbohydrates | 45%-65% total caloric intake |
| Fiber Intake amount | 38g/day(Dependent on gender and age |
| Effects of excessive fiber in diet | Bloating, gas and constipation, mineral absorption, osteoporosis and anemia |
| Interventions for excess fiber ingestion | Increase water intake |
| Stages of Digestion | 1)Carbohydrates are chewed in mouth beginning mechanical digestion 2)Carbohydrates are broken down further as it combines with gastric secretions in the stomach 3)Carbohydrates enters the small intestine beginning chemical digestion. Enzymes in the intestinal wall and the pancreas aid in digesting the carbohydrates. 5)All Carbohydrates are broken down into monosaccharides before being absorbed and eventually converted into glucose 6)Glucose circulates in bloodstream and is used by cells for energy 7)Excess glucose is converted into glycogen and stored in the liver and muscle. Once full remaining carbs are converted into fat and stored as adipose tissue |
| Adipose Tissue | Helps insulate the body from extreme temperatures, and acts as cushion for organs and other tissues to prevent bumping or jarring. |
| Lipids | Organic substances of a fatty nature that are insoluble in water and necessary for good health. EG Fats and Cholesterols |
| Bodily Function of Lipids | Provide the most concentrated source of energy of all the nutrients(9kcal.g) and can be used either directly from the fat in food or from adipose tissue. |
| Fat soluble vitamins | A,D,E and K |
| Lipid composition | Carbon, Hydrogen, Oxygen, Fatty acids and glycerol |
| Why are lipids also called triglycerides? | Because they most of the fat in the body is a combination of three fatty acids that combine with one glycerol unit |
| Saturated Fats | A fatty acid whose chemical bonds are filled completely with hydrogen |
| Unsaturated Fats | A fatty acid whose chemical chain has one or more places in which hydrogen is missing |
| Risk of saturated fats | Increased blood cholesterol levels, and increased risk of atherosclerosis and heart disease |
| Food sources of saturated fats | Coconut, palm and palm kernel oils, Fat in and on meats and poultry, Egg yolk, butter, cream, mild fat, cocoa butter, olive oil and olives |
| Two types of unsaturated fats | Monounsaturated fats and polyunsaturated fats |
| Food sources of monounsaturated fats | Canola oil, peanuts and peanut oil, most nuts, avocados |
| Food sources of polyunsaturated fats | Safflower oil, sunflower oil, cottonseed oil, soybean oil, corn oil, most fish oil |
| DRI for saturated fats | 5%-6% dietary intake |
| Hydrogenated fats | Unsaturated fats in which hydrogen has been added to make it more saturated |
| Food sources of hydrogenated fats | Most vegetable spreads(EG corn oil margarine) |
| Trans fatty acids | Unsaturated fats which have been completely hydrogenated. |
| Food sources of trans fatty acids | Partially hydrogenated plant and fish oils, stick margarine and shortening, commercial fats used for frying and baking |
| Risks of trans fatty acids | Increase blood cholesterol levels, increased risk of atherosclerosis and heart disease |
| DRI trans fatty acid | Less than 1% |
| DRI fats | 25%-35% total dietary intake |