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Nutrition PPT #2
Diets
68
Health Care
Undergraduate 1
10/18/2007

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Cards

Term
What are the functions of nutrition?
Definition
  • Part of wellness, healing, and recovery
  • Provides energy-activity
  • Maintains body temperature
  • Provides raw materials for growth, replacment, and repair

ENERGY IS A CONSTANT NEED!

Term
Why do people eat?
Definition
  • Pleasure
    • tied to emotions
  • Social gatherings
  • Political statement
  • Religious symbol
  • Cultural emblem
  • Medical treatment-therapeutic
Term
What are the two types of nutritional deficiencies?
Definition
  • Primary- Not enough intake
    • anorexia (not the disorder)
    • Alcoholism
    • Poor habits ($, knowledge, ability to cook or shop)
    • Hospitalization (tests, pain, nausea)
  • Secondary- Increased needs
    • Burns, infections, wounds, fever, stress, elevated thyroid
      • also increase oxygen needs
    • Improper utilization of foods, ingestion, digestion, or malabsorption
      • cystic fibrosis, IBS, gluten and lactose intolerance
Term

Another nutritional problem is excessive amounts. There are two types, what are they?

Definition
  • Primary
    • eats too much
  • Secondary
    • Error in metabolism
    • Unable to use nutrients
      • PKU0 can't have alanine/can't process
Term
What are some of the drug interactions that can cause nutritional problems?
Definition
  • Anticoagulants & Vit K- antagonist (avoid leafy greens)
  • Tetracycline & minerals- antagonist (minerals bind to AB)
  • Antacids & nearly everything- blocks absorption
  • Diuretics & Potassium- depletes K
  • MAOI & aged foods and wine- can be deadly
  • Antiparkinson meds & Vit B6- antagonist
  • Antitubercular meds & Vit B6- B6 reduces side effects
Term
What are macronutrients? What are some of the macronutrients?
Definition
Nutrients that aid in supplying energy and build tissue.

Carbs, Protein, and Fats
Term

What are micronutrients? What are the micronutrients?

Definition

Nutrients that aide in regulation of body processes and are required in smaller amounts.

Vitamins and Minerals (deficits can cause macronutrient problems)

Term
Macronutrients provide ________ and Micronutrients _________?
Definition
Energy; Regulate
Term

What are therapeutic diets used for? Is a therapeutic diet as important as medications?

Definition
Treatment of disease; Yes (possibly more important)
Term
What are some considerations to take into account when placing a client on a therapeutic diet?
Definition
  • the disease process
  • social and religious considerations
  • patients likes and dislikes
  • allergies
  • client's condition (can they chew, swallow, ...)
  • purpose of diet and consequences of not following diet

Must make it work for the individual

Term
When placing a client on a special diet what are some things you would discuss with the client?
Definition
  • allowed and prohibited foods
  • reasons why food labels are important
    • educate them on how to read the labels
  • include significant others/family
    • who cooks/shops
  • refer to dietician or diet manual

EXPLAIN THE CONSEQUENCES AND APPEAL TO THE CLIENT

Term
What are some reasons to place a client on a therapeutic diet?
Definition
  • Increase or decrease body weight  by manipulating kcals
  • Reduce or prevent edema by limiting fluids/salt (CHF)
  • Aid in digestion by avoiding foods that irritate the GI
  • Eliminating a food that the body is unable to tolerate (lactose intolerance)
Term
What are some ways that the nurse can help a client accept and participate in a therapeutic diet?
Definition
  • clarify misinformation
  • individualize the diet
  • help them understand the relation between their disease and diet

Client should be educated on the benefits and consequences of not following the diet!

Term
What are some religious influences to take into consideration when planning a diet for a client?
Definition

Take into consideration the dietary restrictions of their religion.
Hindu- lacto-ovo vegetarians and no stimulants
Islam- No pork, slaughter laws, fasting
Jewish- No pork, fish w/o scales, slaughter laws, some fasting, meal preparation
Mormon- no stimulants
Catholic- no meat on Friday & Lent, some fasting, no food or drink except water before Holy communion
Seventh-Day Adventist- lacto-ovo vegetarians, no stimulants
Vegans- complicated diet (nothing with a face)

Term
What is your highest source of proteins?
Definition
Meats
Term
Look over the diagram below to help you understand how complicated a vegan diet may be.
Definition
[image]
Big arrows= good combos
Small arrows= fair combos
Term
What are the progressive diets?
Definition
  1. Clear liquid
  2. Full liquid
  3. Soft
  4. Altered consistency (mechanical soft)
  5. High residue/high fiber
  6. Regular diet
Term

Explain a clear liquid diet.

Definition
Clear liquid diet is easily absorbed and does not overstimulate the digestive tract. They are liquid at room temperature. Decreases peristalsis. Clear liquid diets provide an oral source of fluids, small amounts of calories, and electrolytes, reduces colonic residue, and relieves thirst.
Term
Is it healthy for the GI tract to be empty?
Definition
NO
Term

What are some concerns with clients on a clear liquid diet and how long is a clear liquid diet "effective"?

Definition
  • monitor client for tolerance and oral intake
  • there is no nutritional value (no vitamins or proteins)
  • only adequate for 3 days max

Term
What are some of the items on a clear liquid diet?
Definition
  • clear consomme, bouillon, broth
  • tea, coffee
  • clear fruit juices: cranberry, apple, grape, NO OJ
  • Jell-o
  • carbonated beverages
  • popsicles
  • Honey, sugar, gumdrops, lemon for tea
Term
Can a client on a clear liquid diet have milk?
Definition
No
Term
Describe a full liquid diet.
Definition
Liquids that can be poured at room temperature.
Term
A full liquid diet can be easily swallowed and provides oral nutrion. If your client is on a full liquid diet for more than three days, what must be provided?
Definition
Supplements
Term
What are some concerns with a full liquid diet?
Definition
  • it can become monotonous
  • can be nutritionally inadequate
  • diabetics must be sugar-free
  • monitor for tolerance of feeding
Term
What are some items on the menu for a client on a full liquid diet?
Definition
  • any clear liquids
  • soups (creamed or strained)
  • milks, creams
  • sherbert, plain ice cream
  • custard, pudding, eggnog (yum)
  • all cooked cereals
  • vegetables and strained fruit juice
Term
A soft diet provides a transition point between a liquid and a regular diet. Are all the nutrients provided in a soft diet?
Definition
Yes
Term
A soft diet should contain minimum fiber. What food items should be omitted from a soft diet?
Definition
  • Fried
  • highly seasoned
  • flatus causing foods
  • no bran or unrefined grains
  • no seeds, nuts, fresh fruit, and coconut
  • no spiced lunch meat
Term
What would be on the menu for a client on a soft diet?
Definition
  • macaroni
  • soft chicken, turkey, fish fillet
  • mashed potatoes
  • Jell-o, custard pie, angel food cake
  • applesauce, ice cream, pudding
Term
An altered consistency or mechanical soft diet are considered a regular diet. What are some reasons that a client would be placed in a altered consistency or mechanical soft diet?
Definition
It is for those clients who cannot chew or swallow well
Term
Other than being called an altered consitency diet, what are some other names for this type of diet?
Definition
  • mechanical soft diet
  • pureed diet
  • ground diet
Term
Other than the fruits, vegetables, and meats, would it be appropriate to puree all of your clients meals?
Definition
No. Assess your client to see how well they tolerate (swallow/chew). Never alter the meal more than necessary
Term
Does a high residue/high fiber diet increase or decrease peristalsis?
Definition
Increases peristalsis
Term
What is the purpose of a high residue/high fiber diet?
Definition
To create mechanical stimulation of the GI tract, treat constipation, hemorroids, and diverticulitis
Term
What types of foods would you expect to see on a client's menu if they are on a high residue/high fiber diet?
Definition
  • fruits and vegetables
  • fruit juices
  • whole grain cereals, breads

This diet does not exclude any food BUT encouragment of foods high in fiber and increasing fluid intake is a must!

Term
Nutrient modification is often necessary for the wellness of the client. What is the purpose of an ADA diet?
Definition
An ADA diet is used to control the amount of carbs consumed by distributing them through the day to achieve a constant blood glucose level
Term
Who might you expect to see on an ADA diet?
Definition
Clients with:
Diabetes Mellitus (Type I & II)
Dumping syndrome
Hyperinsulinism
Term
Is an ADA diet a weight control diet or a carb control diet?
Definition
Carb control diet
Term

As you are assessing your client you find that he has hot dry skin, is c/o frequent urination, thirst, and hunger. What might be the cause of his symptoms?

Definition
Hot and Dry sugar high!

Your client has all the s/s of hyperglycemia
Term
While assessing your client you see that she is lethargic and sweating. You take her pulse and find that she is tachycardic and you notice slight tremors. She c/o a headache and anxiety just before she passes out. What might be the cause of her symptoms?
Definition
Tachycardic, Cold, and Clamy need some Candy.

You client has all the s/s of hypoglycemia!
Term

As you enter the room you notice that your client "appears" to be drunk. Well, there isn't any alcohol allowed in the hospital. What could be the cause of their "drunken" behavior?

Definition
Hypoglycemia- danger to the brain!
Term
What should you do for a client experiencing hyperglycemia?
Definition
Check the blood sugar and provide insulin if ordered (if not, contact the doctor)
Term
What should you do for a client that has hypoglycemia?
Definition
  • Candy (not really, we crush glucose tabs)
  • OJ
  • Dextrose IV per doctor's order
  • follow with carb/protein drink
  • give them their snack and make sure they eat meals
Term
What is the purpose of a controlled mineral or electrolyte (sodium) diet?
Definition
  • HTN
  • edema
  • renal disease
  • liver disease
  • CHF

Diet restricted in sodium but still contains essential nutrients

Term
What are some things you want to do to maintain a controlled mineral or electrolyte (sodium) diet?
Definition
  • encourage fruits and vegetable
  • increase use of other seasonings and spices that do not contain sodium
  • be aware of foods that are hiding sodium
Term
What are some foods that have hidden sodium?
Definition
  • soups
  • snacks
  • sauces (soy sauce, ketchup)
  • sauerkraut
  • smoked meats
  • seasonings
  • sweetners
  • sodium processed meats (kosher meats)
Term
What are some types of sodium restrictive diets?
Definition
  • Strict: 500mg/d
  • Moderate: 1000mg/d
  • Mild: 2000mg/d
  • NAS: no food restrictions BUT do not add salt at the table or the stove
Term
What are some foods to avoid that are high in sodium?
Definition
  • MSG
  • bacon/sausage, ham, cold cuts, hot dogs, polish sausage
  • canned soups, canned veggies, canned meats
  • water softners
  • processed or prepared foods
  • baking powder/soda
  • butter, cheeses, butter milk
  • olives, pickles
  • catsup, soy and worchester sauces
Term
What are some medications to avoid if on a sodium restricted diet?
Definition
  • Antacids
  • Antibiotics
  • Cough medicines
  • Laxatives

Term
What is the purpose of a high potassium diet? What are some things a client on a high potassium diet can consume?
Definition
  • To prevent the depletion of body potassium reserves.
  • Increase intake of fruits and vegetables, oranges, raisins, bananas,spinach, squash, carrots, meats,  poultry, fish, salt substitutes contain potassium
Term
What is the purpose of a low potassium diet? What should you avoid?
Definition
  • Prevent the potentially fatal build up of potassium in those who cannot excrete it as in renal failure
  • Avoid salt substitutes

Also, cook fresh vegetables in lots of water and then discard the water

Term
A low protein diet is used in clients with renal failure and liver dysfuntion. Proteins consumed must be of high quality. What is the perfect food that contains all of the essential amino acids?
Definition
Eggs
Term
What are some things that might alter a clients nutritional intake while in the hospital?
Definition
  • meals are delayed
  • procedures
  • surgery
  • N/V
  • labs
  • diagnostic tests
  • PAIN
Term
What are some things the nurse can do to stimulate a clients appetite?
Definition
  • assess the cause and eliminate the reason
  • small frequent meals, attractive, small servings
  • pt choice of foods- may bring from home
  • seasoning to taste
  • liquid supplements
  • exercise throughout the day
  • oral hygiene before meals
  • sitting position for meals
  • pain medication
Term
What is the difference between anorexia and anorexia nervosa?
Definition
  • Anorexia- lack or loss of appetite
    • cancer, chemo, post-op, viral illness, SOB
  • Anorexia nervosa- aversion to food
    • psych disorder
    • do not want food
    • altered body image
    • don't encourage them
Term
What are some things you can do to provide a comfortable environment for the client?
Definition
  • provide oppurtunity to void
  • wash hands, face, and provide chance for oral care before meals
  • avoid unpleasant and painful treatments before or after meals
  • avoid unpleasant tasting medications before and during meals
  • If in pain, medicate 1/2 hour prior to meals
  • remove unpleasant oders and litter
  • cover unpleasant things (really just remove them)
  • allow time and offer assistance
  • assist to fill out menu
  • room temperature- cooler temps stimulate appetite
  • clients do not like to eat alone!
Term
When serving the meal, what are some things you can do to make the experience more pleasant?
Definition
  • SIT THEM UP!
  • let them void
  • glasses and dentures
  • wash hands, face, oral hygiene
  • CHECK TRAY AND DIET ORDER,check for utensils, condiments
  • make sure client is not NPO
  • check allergies and name band
  • serve hot foods hot and cold foods cold
  • fill bowls and glasses 3/4 full
  • be pleasant
  • check on client to make sure eating (if not find out why)
  • document amount consumed (food and liquid) in mL's
Term
Clients who are confused, very young, helpless, sick, or immobile require assistance. What are some things you should and can do?
Definition
  • wash hands
  • provide comfor measures
  • napkin/towel
  • arrange tray
  • don't rush
  • sit down and visit
  • use a spoon and straw for liquids (shorten straw)
  • give small bites
  • alternate food with liquids (wipe chin, do not use utensil to scrap)
  • ask client how they like to eat (what order)
  • warn of hot or cold
  • allow client to do as much as possible
Term
What are some assistive devices for feeding?
Definition
  • plate with guard
  • wide handled spoons
  • bowel with stable base
  • cup with a cut out for the nose
Term
When assisting a client that is visually impaired, what are some things you can do to have a successful meal?
Definition
  • tell them where the food is located (describe the location using a clock)
  • guide hand to reinforce
  • tell them what food they are being served
  • may need some assistance especially is they are new to it
Term
When assisting a client with dementia, what are some things that you can do?
Definition
  • maintain continuity
    • same time and place and assistant
  • reduce or eliminate distractions
  • place plate close to patient
  • remove unecessary clutter
  • milk and other fluids in a glass
  • guide hand to mouth
  • reinforce positive
  • finger foods for the wanderer
  • nutrient packed foods (no empty calories)
Term

Assisting a client with a sore mouth at meal times would include...

Definition
  • avoid dry, acidic, spicy, and salty foods
  • moisten foods
  • offer moist, soft foods
  • cold water, ice chips, ice cream, sherbert
  • saliva subs
  • good oral hygiene (no ETOH in mouthwash)
Term
When assisting a client with dysphagia, what ar some things you should do?
Definition
  • have suction readily available
  • assist to sitting position
  • oral hygiene before feeding
  • smi solids with some texture
  • quarter size bites
  • observe for swallowing
  • tuck chin, remind to swallow 2-3 times
  • check mouth for food/fluids still in cavity
  • keep sitting, HOB up 30 degrees after meals for 30 minutes
  • watch for coughing and choking
  • always place food on unaffected side
Term
What is the biggest risk of dysphagia?
Definition
Choking is number one followed by aspiration
Term
To remind you and others that your client has dysphagia, what can you do besides post a sign?
Definition
Leave the Thick-it, spoons, and cups at bedside
Term
What are some causes of dysphagia?
Definition
  • poor, loose fitting teeth
  • CVA
  • tracheostomy
  • paralyzed vocal cords
  • tumor in mouth, throat, or esophogus
  • surgery to head,neck, or esophogeal areas
Term
What are the s/s of dysphagia?
Definition
  • drooling
  • feeling that food is sticking in throat during or after meal
    • sensation of a "lump" in throat
  • weight loss
  • poor nutritional intake
  • choking and coughing with eating
  • frequent respiratory infections
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