Nutrition and Dehydration Medical Terminology Textbook Notes

Nutrition and Dehydration • • • Describe the importance of proper nutrition and list the basic nutrients o Nutrition: how the body uses food to maintain health o Nutrient: necessary substance that provides energy, promotes growth and health and regulate metabolism o Water ▪ Essential ▪ Carbohydrates: supply energy and protein and help body use fat efficiently • Fiber • Complex carbs: found in bread, cereal, potatoes, rice pasta, vegetables, and fruits • Simple carbs: sugar sweets syrups and jellies • Protein: essential for tissue growth and repair, supply energy • Fats: store energy, add flavor • Saturated and trans inc cholesterol monosaturated an dpoly saturated can be helpful and dec cv disease • Vitamins: needed by body to function • Minerals: maintain body functions, build bones, hormones and help in blood formation, provide energy an control body processes, zinc, iron, calcium, magnesium USDA my plate o Vegetables and fruit make up half plate o Grains: ▪ Half whole grain ▪ Refine grain: endosperm, tissue in flowering plants ▪ Whole: rice, oatmeal, wheat, rye ▪ Protein: meat, chicken • Seafood eaten twice a week ▪ Dairy • Nutrients Identify nutritional problems of the elderly or ill o Metabolism slows o Loss of vision o Weakened senses of smell and taste o Less saliva o Dentures o Digestion takes longer o Certain medications o Unintended weight loss o Parenteral nutrition: solution of nutrients is administered directly into the bloodstream, bypasses digestive system, nutrients in most basic forms of carbohydrates, proteins, and fats o Nasogastric tube: unable to swallow, inserted into the nose and to the stomach Percutaneous endoscopic gastromy: placed into stomach through abdominal wall Gastromy: surgically created opening into the stomach Tube feedings ▪ Feeding tube should have the head of bed elevated 30 degrees, during feeding the should remain at 45 degrees Factors that influence food preferences o Culture, ethnicity, income, education, religion and geography Dietary department o Plan meals o Diet cards: list residents name and information about special diets, allergies, likes and dislikes and other dietary instructions Special diets o Therapeutic, modified or special diets o Low sodium diet ▪ Excess sodium: cause body to retain more water in tissues and in the circulatory system ▪ High blood pressure, coronary artery disease or kidney disease o Fluid restricted diet ▪ Amount of fluid consumed must equal amount of fluid that leaves the body through perspiration, stool, urine, and respiration ▪ Intake greater then fluid output tissues become swollen with ecess fluid ▪ Foods that count as fluids should not be taken o High potassium diet ▪ Certain bp meds and diuretics (reduce fluid volume) • Excreting so much fluid that their bodies could be depleted of potassium o Bananas, grapefruit, oranges, oj, o Low protein diet ▪ Kidney disease ▪ Breaks down into compounds that may lead to further kidney damage damage ▪ Vegetables and starches such as breads and pastas encouraged o Low fat/low cholesterol diet ▪ High levels of cholesterol in blood are at risk for heart attacks and heart disease o Modified calorie diet: ▪ Lose weight o Bland diet ▪ Ulcers can be irritated o Diabetic diet ▪ Calories controlled ▪ Right amount of right type of food ▪ Avoid high sugar o Low residue (low fiber diet): decreases amount of fiber, whole grains, raw fruits and vegetables, seeds, and other foods ▪ Bowel disturbances o o o • • • High residue (high fiber) diet ▪ Inc intake of fiber and whole grans ▪ helps with constipation and bowel disorders o Gluten- free diet ▪ Celiac disease ▪ Foods containing wheat flour, breads, dressings o Vegetarian diet ▪ Diabetes or obesity, or choice ▪ Lacto-ovo vegetarian diet: excludes all meats, fish, and poultry, allows eggs and dairy products ▪ Lacto-vegetarian: diet eliminates poultry, meats, fish, and eggs, but allows dairy products ▪ Ovo-vegetarian diet omits all meats, fish, poultry and dairy products allows eggs ▪ Vegan diet: eliminates poultry, meats, fish, eggs, and dairy products, along with foods that are from animals ▪ Pescatarian diet eliminates meats and poultry but allows fish o Liquid diet ▪ Short time for medical condition or before or after a test or surgery, intestinal tract free of food ▪ Clear: juice full: soups milk ice-cream o Soft diet and mechanical soft diet ▪ Soft diet: soft in texture and soft or chopped foods easier to chew and swallow ▪ Mechanical soft: chopped or blended foods easier to chew and swallow • Does not limit spices, fat and fiber only the texture of foods is changed o Pureed diet ▪ To blend or grind it into a thick paste of baby food consistency Thickness o Nectar thick: thicker than water, thick juice, tomato juice, from cup o Honey thick: pour slowly, spoon o Pudding thick: semi solid, spoon stand straight up o Swallowing problems o Improves ability to control fluid in the mouth and throat o Oral care before if requested o Grooming before o Assistive devices o Noise o Conversation o 90-degree upright position How to serve meal trays and assist with eating o Serve all residents who are sitting together at one table before serving other tables o Remove food and drink and set it on table o Cut food into small bite sized portions o Cut food before bringing it to table o Open milk or juice cartons o • • • • • • Feeding a resident o Explain, diet card o Raise head of bed to 90 degrees o Adjust bed height to where you will be able to sit at the residents eye level o Place meal tray where it can be seen by the resident o Help resident clean hands o Sit facing residents eye level o Tell resident where foods are o Check temp of food o Offer beverage throughout the meal o Talk with resident during meal o Washcloths or wips to wipe food from residents mouth and hand as needed o Remove clothing protector o Remove food tray o Make resident comfortable o Return bed to lowest position Describe how to assist residents with special needs o Dining techniques ▪ Assistive devices, grips, plate guards ▪ Physical or verbal cues ▪ Open cartons and insert straw, butter as much as possible ▪ Visually impaired: items on a clock ▪ Place food stronger side of mouth ▪ Parkinsons: place food and drink close ▪ Poor sitting balance: push chair under table and forearms on table ▪ Neck control: neck brace ▪ Bites down on utensils open mouth ▪ Pockets food” use tonged to get food and push food toward teeth ▪ Trigger swallowing: press down on the tongue when taking the spoon out of the mouth Dysphagia o Trouble swallowing o Stroke of cva, Parkinson's, cancer, MS o Soft foods or thickened liquids o Aspiration: inhaling food or foreign material into the lungs and can cause pneumonia or death ▪ Preventing aspiration: position residents properly for eating and drinking. They must sit upright at a 90 degree angle ▪ Small food ▪ Stronger side ▪ Mouth empty before next bit ▪ Keep resident up for 30 minutes after eating Explain intake and output o Semi liquid: gelatin, soup, ice cream, pudding, yogurt 64 oz of fluid each day Output: urine, feces, vomit, perspiration, would drainage Fluid balance: maintaining equal input and output or taking in and eliminating equal amounts of fluid o Fluids measured in mL o One ounce equals 30 mL o Convert ounces to mL, number of ounces must be multiplied by 30 o One oz= 30mL o ¼ cup= 2 oz o 1 cup = 8 oz =240 mL Measuring intake and output o Measure intake first ▪ Name, hands, explain, privacy ▪ Note amount of fluid served on paper ▪ Measure left over fluids after eating and subtract the leftover amount from the amount served ▪ Document amount of fluid consumed o Measureing output ▪ Pour bedpan or urinal into graduate ▪ Time and amount o Resident eats less then 75 percent of meal: report it to nurse o 64 oz of water a day to prevent constipation and urinary incontinence ▪ Without fluid, urine can become concentrated, with higher risk for infection • Thirst lessens in people as they age o NPO: nothing by mouth o Dehydration symptoms: drinks less than 6 8 oz glasses of liquid per day, drinks little or no fluids at meals, needs help drinking from a cup, trouble swallowing liquids, dry mouth, cracked lips, sunken eyes, dark urine Fluid overload o Swelling of extremities, weight gain, dec urine output, shortness of breath, inc hear rate, anxiety, tight smooth and shiny skin o o o • •