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160 Cards in this Set
- Front
- Back
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What is Nutrition
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The process by which a living organism ingest, digest, absorbs, transports and uses and excrete nutrients
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What is an Optimal diet necessary for
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-promoting normal growth and development
-preventing deficientcy states -maintaining health -preventing disease -maintaining bodily functions and healthy tissue -promoting healing -building resistance to infection |
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Nutrients
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Biochemical substances obtained from ingested food and fluids
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What are the three nutrients that provide the body with energy
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Carbohydrates, protein, fats
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What are the nutrients that are essential in regulating body processes
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Vitamins, minerals, trace elements and water
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What are essential nutrients
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Nutrients that the body cannot synthesize in adequate amounts
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What does each cell in the body require to fullfill its daily task
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Energy
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What acts and reacts to regulate body processes
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Chemicals in the form of nutrients
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What is Metabolism
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The process by which cells use or store energy from nutrients
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Anabolic Processes
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Build up body substances and body tissue
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Catabolic Processes
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Break down substances or body stores
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How is energy obtained from food measured
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In the form of large calories or kilocalories
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What is a kilocalorie
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The amount of heat required to raise one kilogram of water 1 degree centigrade
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Carbohydrate: Simple Sugars
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Monosaccharides and disaccharides
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Carbohydrate: Complex sugars
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polysaccharrides
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What are carbohydrates composed of
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Carbon, Hydrogen, oxygen
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What are some food that are simple carbohydrates
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Sugars, honey, fruit, milk
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What are some food that are complex carbohydrates
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Bread, pasta, rice, pototoes
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What are the functions of carbohydrate
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-To provide energy (main function)
-important in oxidizing fats in normal fat metabolism -promote desirable bacterial growth in intestine -each gram of carb. yields 4 kcal |
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Carbohydrates: Polysaccharide
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not digested in the GI tract; one of the main components of dietary fiber
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Dietary Fiber
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Is a minimal source of energy, but is essential in stimulating peristalsis and maintaining normal bowel function
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Carbohydrate: Protein sparing function
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Use carbs rather than protein for energy; leaves protein available for function of tissue building
-supplies glucose to cells |
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Hyperglycemia
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Elevated blood sugar
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Hypoglycemia
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Lower than normal blood sugar
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Protein
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Organic compounds composed of polymers of amino acids connected by peptide bonds
-Contain carbon, hydrogen, oxygen and nitrogen |
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What are the protein that the body synthesizes
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Hemoglobin, insulin, albumins
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What are proteins necessary for
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growth and tissue building
-regulate body functions -play role in regulating immune system, digestion, absorption, metabolism and catabolism -protein catabolism supplies 4kcal/g |
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Complete proteins
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contain sufficient amounts of essential amino acids to maintain body tissues and to promote growth
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Partially complete proteins
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contain suffiecient amounts of amino acids to maintain life but not promote growth
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Incomplete proteins
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do not contain suffiencient amounts of all essentail amino acids to maintain life, build tissue or promote growth
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An adequate diet must contain a good supply of complete protein. What are some of the source of complete protein
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meat, fish, poultry, milk, cheese and eggs
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Fats
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organic subastances composed of carbon, hydrogen and oxygen
-component for all body cells and ideally makes up approximately 20% of body weight -supply 9 kcal/g of oxidized fat -provide a feeling of satiety because they remain in the stomach longer than carbs or protein -may be saturated or unsaturated depending on the number of hydrogen molecules bound to the fat |
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What are fats necessary for
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cellular transport, insulation, protection of organs, provision of energy, absorption an transport of some vitamins
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Unsaturated Fat
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Liquid at room temperature
-sources: plant origin (corn, olive, safflower, soybean and sunflower oils) and nuts |
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Saturated Fats
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Solid at room temperature
-sources: animal products (meat, poultry), whole milk, cheeses, cream and plant sources (coconut oil, cocoa butter) |
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Vitamins
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Organic compounds that are essential to the body in small quantities for growth, development, maintenance and reproduction
-most cannot be synthesized by the body |
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Fat soluble vitamins
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A, D, E, K - body does not excrete excess amounts
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Water soluble vitamins
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B complex and C
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Vitamin A
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-maintainance of normal vision
-maintainance of healthy epithelium -promotion of normal skeletal and tooth development -promotion of normal cellular proliferation |
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Signs and Symptoms of Vitamin A deficiency
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-night or total blindness
-epithelial changes (degeneration of cells leading to infections or eyes, ears, nasal passages) -skin changes (dry, rough, scaly skin) -inadequate tooth and bone development |
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Food Source of Vitamin A
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yellow vegetable, peaches, cantaloupe, fish oils, fortified milk and dairy products
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Vitamin D
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changed to an active form by exposure of the skin to ultraviolet light
-necessary for: --intestinal absorption of calcium --mobilization of calcuim and phosphorus from bone --renal transport of calcium |
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Vitamin D Diffiency
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-rickets i children
-poor dental health -tetany (abnomal muscle contraction and spasm -osteomalacia (soft bone) |
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Food sources for Vitamin D
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fortified milk, margarin, cereals
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Vitamin E
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Has a role as an antioxidant, in which it assists in maintaining the integrity of cellular membranes
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Signs of Vitamin E deficiency
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increased hemolysis of red blood cells
-poor reflexes and impaired neuromuscular functioning |
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Food sources of Vitamin E
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Vegetable oils, soy beans, corn, peanuts
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Vitamin K
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Adequate intake is needed in the liver for the formaiton of prothrombin and other clotting factor
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Signs of Vitamin K deficiency
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increased tendency to hemorrhage
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Food sources for Vitamin K
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green leafy vegetables, cabbage, cauliflower, egg yolk and liver
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Vitamin B-1 (thiamine)
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Necessary for carbohydrate metabolis and adequate nerve functioning
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Sign of Vitamin B-1 deficiency
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poor appetite, apathy, mental depression, fatigue, constipation and neuritis
-Beriberi (adversely affects the cardiac, nervous and GI systems) |
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Food sources of vitamin B-1
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organ meats, pork, whole and enrcihed grains, nuts, potatoes, eggs and milk
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Vitamin B-2 (riboflavin)
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functions in protein an carbohydrate metabolism
-contributes to healthy skin |
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Signs of Vitamin B-2 deficiency
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crackin and fissures on sides of the mouth (cheilosis)
-vision irregularities |
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Food sources of Vitamin B-2
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Milk, dairy, eggs, organ meats, green leafy vegetables
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Vitamin B-3 (Niacin)
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involved in glycogen metabolism, tissue regenaration and fat synthesis
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Deficiency of Vitamin B-3
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Pallagra:niacin deficiency disease
-fatigue, headaches, loss of appetitie, weight loss, diarrhea, neurologic degeneration and dematitis |
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Food sources for Vitamin B-3
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kidney, liver, poultry, lean meat, fish, yeast, peanut butter, dried peas and beans
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Vitamin B-6 (pyridoxine)
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necessary for amino acid metabolism, blood formation and maintenance of nervous tissue
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Deficiency of Vitamin B-6
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dermatitis, convulsion and anemia
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Food sources for Vitamin B-6
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Chicken, fish, wheat germ, organ meats, egg yolk, whole grains, potatoes and bananas
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Vitamin B-12
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Functions in the formation of healthy red blood cells and synthesis of RNA & DNA
-Requires intrinsic factor for absorption |
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Deficiency in Vitamin B-12
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Pernicious anemia
-pallor, dyspnea, weakness, fatigue and palpitations |
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Food Sources of Vitamin B-12
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Liver, kidney, shrimp, meats, milk and cheese
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Vitamin C
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Protects against infection, provides for adequate wound healing, promotes iron absorption and collagen formation
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Signs of deficiency of Vitamin C
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poor wound healing, joint pain, anemia, increased susceptibility to infection
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Food sources for Vitamin C
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citrus fruits, brocolli, green peppers, strawberries tomatioes and cabbage
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Calcium
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-most abundant mineral in the body
-necessary for: conversion of prothrombin to thrombin and other steps of the coagulation process -nerve impulse transmission -regulation of materials in and out of the cell -contaction and relaxation of muscles, most importantly in the cardiac muscle -bone and tooth formation -adequate amounts of vitamin D, parthyroid hormone, ascorbic acid, lactose and physical activity assis in calcium absorption |
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Deficiency of Calcium
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stunted growth, rickets, osteomalacia, osteoporosis and tetany
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Iron
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most iron in the body is found in hemoglobin
-required for oxygen transport |
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Deficiency of Iron
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anemia
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Food Source of Iron
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Liver, lean meats, dried beans, fortified cereals
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Sodium
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Found primarily in the extracellular fluid
-helps maintain fluid and acid base balance -often restricted in the diet when pt. has heart disease, hypertension, renal disorders, liver disease -only 10% sodium intake is from natural sources -75% comes from processed foods -15% from diecretional salt addition |
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Potassium
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found primarily in the intracellular fluid
-furnctions in protein synsthesis, fluid balance and regulation of muscle contraction -deficiency can occur w/ vomiting, diarrhea, non-pottassium sparing diuretics and ketoacidosis -sources: yellow fruits, bananas, cantaloupe, oranges ,some vegetables |
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Deficiency of Vitamin B-6
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dermatitis, convulsion and anemia
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Food sources for Vitamin B-6
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Chicken, fish, wheat germ, organ meats, egg yolk, whole grains, potatoes and bananas
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Vitamin B-12
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Functions in the formation of healthy red blood cells and synthesis of RNA & DNA
-Requires intrinsic factor for absorption |
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Deficiency in Vitamin B-12
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Pernicious anemia
-pallor, dyspnea, weakness, fatigue and palpitations |
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Food Sources of Vitamin B-12
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Liver, kidney, shrimp, meats, milk and cheese
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Vitamin C
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Protects against infection, provides for adequate wound healing, promotes iron absorption and collagen formation
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Signs of deficiency of Vitamin C
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poor wound healing, joint pain, anemia, increased susceptibility to infection
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Food sources for Vitamin C
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citrus fruits, brocolli, green peppers, strawberries tomatioes and cabbage
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Calcium
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-most abundant mineral in the body
-necessary for: conversion of prothrombin to thrombin and other steps of the coagulation process -nerve impulse transmission -regulation of materials in and out of the cell -contaction and relaxation of muscles, most importantly in the cardiac muscle -bone and tooth formation -adequate amounts of vitamin D, parthyroid hormone, ascorbic acid, lactose and physical activity assis in calcium absorption |
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Deficiency of Calcium
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stunted growth, rickets, osteomalacia, osteoporosis and tetany
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Iron
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most iron in the body is found in hemoglobin
-required for oxygen transport |
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Deficiency of Iron
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anemia
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Food Source of Iron
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Liver, lean meats, dried beans, fortified cereals
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Sodium
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Found primarily in the extracellular fluid
-helps maintain fluid and acid base balance -often restricted in the diet when pt. has heart disease, hypertension, renal disorders, liver disease -only 10% sodium intake is from natural sources -75% comes from processed foods -15% from diecretional salt addition |
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Potassium
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found primarily in the intracellular fluid
-furnctions in protein synsthesis, fluid balance and regulation of muscle contraction -deficiency can occur w/ vomiting, diarrhea, non-pottassium sparing diuretics and ketoacidosis -sources: yellow fruits, bananas, cantaloupe, oranges ,some vegetables |
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Water
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Necessary to maintain cell function
-obtained through dring fluids and eating foods with a high water content -thirst signals the need for water -thirst is usually diminished in the aged |
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The Food Pyramid
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-developed by the department of agriculture
-provides a guide for planning nutritious meals -emphasizes food from five major food groups |
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What are the five food groups
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-bread, cereal, rice, grain
-vegetable -fruit -meat, poultry, fish, dry beans and eggs -milk, yougurt and cheese -fats, oils and sweets |
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Bread, cereal, rice, pasta
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6-11 servings recommended
-provide sources of thiamine, iron, niacin, and riboflavin -good source of carbs, low in fats -many foods are enriched with vitamins and minerals |
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Vegetable
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5 servings recommended
-provide sources of vitamin A and C and minierals |
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Fruit
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2-4 servings recommened
-source of potassium, vitamin A and C, low in fat and sodium, high in water |
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meat, pultry, fish, drybeans and eggs and nuts
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2-3 serving recommend
-source of protein, B vitamins -may contain large amounts of fats and cholesterol |
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Milk, yougurt, and cheese
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Adults: recommended 2-3 servings
- source of calcium and riboflavin, and many other vitamins and minerals -contains no iron |
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Fats, oils and sweets
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should be used sparingly
-minimize the intake or saturated fats |
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Digestion
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Process by which foods ae broken down for the body to use in growth, development, healing and prevention of heart disease
-includes mechanical and chemical processes necessary to convert foods into their physically absorable states |
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Mechanical Processes of Digestion
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Mastication: food particles are reduced in size and mixed with enzymes in saliva
-Swallowing: mouth-->pharynx-->esophagus -Churning and peristalsis mix and move the ingested material through stomach and into the duodenum -further churning occurs in small intestine, food mixed w/ enzymes, food comes in contact w/ intestinal mucosa to allow for absorption -Peristalsis moves material to large intestine -further churning, peristalsis and absorption move residual mass along the large intestine where it is stored untial it is evacuated from the body |
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Chemical Processes of digestion
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ensymes are an essential component of the chemistry of digestion
-ensymes are protein like substances that act as catalyst to speed up chemical reactions -each enzyme functions best as a specific pH -saliva is neutral, gastric juice is highly acidic and small intestin is alkaline |
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Chemical processes: Saliva
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contains pytalin (salivary amilase), which begins to digest cooked starch
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Chemical processes: Stomach
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Pepsinogen is secreted and then activated by HCL (hydrochloric acid) to pepsin, a protein splitting enzyme
-parietal cells secret intrinsic factor (necessary for absorption of vitamin B12 |
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Chemical Processes: Small Intestine
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Chyme (liquified food) mixes w/ bile, intestinal jices and pancreatic secretions
-Bile manufacured in the liver and acts as a detergent, as it emulsifies fat to permit enzyme action while suspending fatty acids in solution -Pancreatic secretions contain six enzymes: amlase (starch), lipase(fats), trypsin, elatase, chymotrypsin and carboxypeptidase (protiens) |
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Metabolism: Carbohydrate
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-the liver cells change short term glucose excesses into glycogen in the presence of insulin (Glycogenesis)
-glycogen is stored in the liver and skeletal muscles until needed, when it is converted back by glyogenolosis -longer term storage of glucose in the presence of insulin takes th form of adipose tissue |
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Metabolism: Fat
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converted to adipose tissue and stored
-makes up the bodies largest reserve of energy |
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Metabolism: Protein
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Anabolism builds tissue, produces antibodies, replaces bloo cells and repairs tissue
-temporary excesses or protein are stored in the liver and skeletal muscle or converted to fat |
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Characteristics of Nutritional Status: BMI
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-measure that describes a person's relative weight by height
-correlated w/ total body fat content and is recommend for use to asssess overweight, obesity and to keep tract of weigth changes -Ideal Body Weight -weight appropriate for height and frame |
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Characteristics of Nutritional Status:Physical Status
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-general appearance should reflect alertness and responsiveness
-normal skin tone and turgor -mouth, gums and lips pink and moist -hair and nails appear healthy -normal reflexes, muscle tone -body should appear erect |
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Characteristic of Nutritional Status: Laboratory Values
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-Hemoglobin: women 12-16 g/dl, men 14-17.4 g/dl
-Hematocrit: women 36-48%, men 42-52% -Plama protein -Albumin: 3.5-5 g/dl |
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Factors Affecting Nutrition: Physiologic factors
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-diseased teeth or gums
-diseased GI system -hormone production (insulin) |
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Factors Affecting Nutrition: Inability to acquire or prepare food
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-immobility
-inadequate energy -inadequate resources |
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Factors Affecting Nutrition: Knowledge defice
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lack of information about nutrition
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Factors Affecting Nutrition: Sallowing impairment
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-neurologic dysfunction
-muscle weakness |
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Factors Affecting Nutrition: Discomfort during or after eating
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-acid reflux
-sore throat |
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Factors Affecting Nutrition: Anorexia
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-depression
-GI dysfunction -side effect of medication |
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Factors Affecting Nutrition: Nausea and vomiting
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-motion sickness
-infections -GI disorders |
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Factors Affecting Nutrition: Excessive intake or calories and fat
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overeating
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Factors Affecting Nutrition: metabolic demand
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-periods of rapid growth
-conditions taht increase BMR -stress (physiologic and psychological) |
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Factors Affecting Nutrition: Ability to use ingested nutrients
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-inflammation of the gastrointestinal tract
-obstruction of the GI tract -malabsorption of nutrients (eg. ciliac disease) -diabetes mellitus |
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Factors Affecting Nutrition: Life style and habits
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-food patterns usually set during childhood
-peer pressure -food fads -active verses inactive life style |
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Factors Affecting Nutrition: Cultural and beliefs
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-dietary preferences and law vary among cultures
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Factors Affecting Nutrition: Drug and nutrient interactions
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-ingestion of cerain foods interfere with drug actions (vitamin K and coumadin)
-some drugs may deplete certain nutrients (diuretics and potassium) |
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Factors Affecting Nutrition: Gender
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nutritional requirements vary between men and women
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Factors Affecting Nutrition: Surgery
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-increases risk for nutritional deficits due to increased metabolic demands related to stress of normal healing
--Cancer and cancer treatment -: cancer increases metabolic demands -treatment causes anorexia, nausea, vomiting, mouth ulcers |
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Factors Affecting Nutrition: Alcohol and drug use
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excessive alcohol intake limits the intake of other nutrients
-heroin and cocaine can decrease the user's desire for food because of preoccupation w/ need to by drugs --Psychological state -mental illness -anorexia nervosa, bulimia |
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Manifestations of altered nutrition
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-overweight: (BMI 25-29.9 kg/m2)
-Obesity: 30 kg/m2 or more) -Underweight: (15-20% below weight standards -recent significant weight gain or loss -decreased energy -altered bowel patterns -altered skin, teeth, hair and mucous membranes |
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Assessment: Subjective Data
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-normal eating patterns
-24 hour diet recall -food likes and dislikes -food allergies -presence of anorexia, nausea, vomiting, diarrhea, constipation -any dysphagia -changes in appetitie *History of GI disorders *Ability to prepare food *economic resources *medication history *any significant weight loss or gain *any chronic illness *alcohol intake *cultural and social influences |
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Assessment: Objective Data
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-General appearance
-measurements -calorie count -mouth inspection -swallowing evaluation (gag reflex) *Diagnostics -hgb and hct (aid in determining presence and severity of anemia) -Serum albumin (relfexs protein intake or absorption -Serum Fe |
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Nursing Diagnosis: Altered Nutrition -less than body requirements
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-state in whih a person's intake of nutrients is insufficient to meet metabolic needs
*Related Factors: inability to absorb nutrients, increased body require ments, difficulty swallowing, muscle weakness *Defining characteristics: loss of weight, food intake less than adequate |
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Nursing Diagnosis: Altered Nutrition -more than body requirements
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State in which a person's intake of nutrient exceeds metabolic needs
*Related Factors: sedentary lifestyle, dysfuncctional eating patterns, emotional distress *Defining characteristics: body weight more than 10-20% ideal |
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Nursing Diagnosis: Impaired swallowing
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Abnormal functioning of the swallowing mechanisms associated with deficits in oral, pharyngeal, or esophageal structure or function
*Related FactorsL neuromuscualr impairment, decreased or absent gag reflex, mechanical obstruction (edema), fatigue *Defining Characteristics: stasis of food in oral cavity, coughing, choking |
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Planning
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Develop goals and outcome related to:
-achieving and maintaining optimal weight -ingesting nutritionally sound food to meet body requirements and to promote health -developing adequate knowledge of nutrition -intake adequate to meet body's energy expenditures |
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Implementation: Types of Diets - NPO: withholding food
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-to rest the GI tract and promote healing
-to clear the GI tract of contents before surgery or a procedure -to prevent aspiration during surgery -to give normal intestinal motility time to return -to treat severe vomiting or diarrhea -to treat medical problems such as bowel obstruction or acute inflammation of the GI tract |
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Implementation: Types of Diets - NPO: Nursing Measures
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-provide frequent oral hygiene
-give ice chips, hard, candy, or gum if permitted -avoid exposing client's to others eating, food odors or advertisements for food **In NPO for longer than a few days, alternate forms of nutritional support may be necessary |
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Implementation: Types of Diets - Clear Liquid
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includes liquids that lack residue, such as juices without pulp, tea, gelatin, soda, clear broth
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Implementation: Types of Diets - Full Liquid
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Includes all fluids and foods that become liquid at room temperature (ice cream, sherbert)
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Implementation: Types of Diets - Soft
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Soft foods that have been furhter chopped or pureed for those who have difficulty chewing
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Implementation: Types of Diets - Diet as tolerated
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Ordered when a clients ability to tolerate foods is like to change, i.e. during the postoperative period
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Implementation: Types of Diets - Restrictive Diet
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Sodium, fat, calories
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Implementation: Nutritional Supplements
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-may be necessary during periods of increased metabolic demands
-provide necessary nutrients -available in milk shake type drinks, pudding, or powders to add to food or fluids |
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Implementation: Enteral tube feedings
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Provides direct delivery of food to stomach, bypassing the mouth
-nutritionally balanced preparations -provide nutrition to clients who canno swallow -may be fed continuous or intermitently **Types of tubes: -nasogastric -gastronomy |
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Enteral tube feedings: Hazards and Complications
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-aspiration (pt. should be elevated when feeding)
-vomiting -diarrhea -obstruction of the tube -hyperglycemia |
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Evaluation
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Does the client behaviors match the behavior in the stated goals and outcomes
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Gastritis
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Inflammation of the mucosal lining of the stomach
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Gastroenteritis
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inflammation of the stomach and intestinal tract caused by vomiting, diarrhea
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Gastrostomy
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surgical creation of a gastric fistula throughthe avdominal wall for the purpose of introducing food into the stomach
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Gingivitis
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Inflammation of the gums; characterized by redness, swelling or bleeding
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Hepatitis
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Inflammation of the liver caused by exposure to an infectious agent or drug
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Abdominal
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Pertaining to the abdomen
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Dysphagia
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Inability to swallow or difficulty in swallowing
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Dyspepsia
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Upper abdominal discomfort, often chronic or persistent (referred to as indigestion)
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Nasogastric
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Pertaining to the nasal passages and the stomach, esp. relating to intubation
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Peritioneal
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concerning the peritoneum
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Reflux
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A return or backward flow
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Flatus
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gas in the gastrointestinal tract
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Gavage
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liquid food instilled in the stomach through the nasogastric tube: also called enterral nutrition
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Sublingual
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under the tongue
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Hematemesis
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vomiting of blood
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