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37 Cards in this Set
- Front
- Back
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Functions of nutrients
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*Serve as source of energy
*Support the growth and maintenance of tissue *Aid in the regulation of basic body processes |
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Nutrition and Cancer
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*Diet and the development of cancer
-diet is likely to influence the pre-malignant phase of cancer, but not frank tumor growth *Diet during treatment of cancer -Altered nutrition r/t anorexia, nausea & vomiting, diarrhea, stomatitis/mucositis, esophagitis, dysphagia and changes in taste, aeb.... |
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International Dietary Guidelines to Prevent Cancer
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*Diet should be based on plant products
*Diet should parallel the food pyramid *Food should be cooked at low temperatures *Alcohol should be limited to two drinks per day |
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Dietary Carcinogens
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*Cancer Promoters (favor the development of cancer)
-Linoleic Acid (fatty acid) -ETOH *Cancer Antipromoters (opposes the development of cancer) -Dietary Fiber -Plant Food -Antioxidants -Cruciferous Vegetables -Vegetarian Diets |
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Cancer Promoters
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*Linoleic Acid
-An essential fatty acid found in corn oil -Enhance the development of breast, colon, pancreas and prostate cancer in animals |
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Cancer Promoters
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*ETOH
-Increases the risk of cancers of the mouth, pharynx, larynx, esophagus, colorectal, liver and breast |
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Cancer Antipromoters
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*Dietary Fiber
-Promotes the excretion and speeds up intestinal transit time so that carcinogens are eliminated more rapidly -Reduces the risk of colon cancer |
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Cancer Antipromoters
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*Plant Food
-People who eat yellow and green fruits and vegetables have fewer cancers |
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Cancer Antipromoters
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*Antioxidants
-Found in fruits and vegetables -Protects the body against damage to tissues -Vitamin C & E, selenium and carotenoids |
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Cancer Antipromoters
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*Cruciferous Vegetables
-Cabbage, Broccoli, Brussel sprouts and cauliflower -Reduces the risk of cancers of the GI and Respiratory Tracts |
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Cancer Antipromoters
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*Vegetarian Diets
-Limits the consumption of animal fats to varying degrees -Low in saturated fat and high in fiber -Risk of inadequate protein intake |
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Nutrition for the Cancer Patient
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*Goal
-Maintain the client's strength to endure the treatment of cancer |
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Adequate Nutrition Necessary
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*To improve ability to tolerate demands of disease and therapies
*Prior nutritional status influences ability to tolerate therapy *Decrease complications of therapy *Improved quality of life and sense of well being |
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Nutritional Needs Will Change
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*During treatment--needs increase
*During Recovery *Advance Disease--Needs increase |
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Cancer Therapies
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*Chemotherapy
-Stomatitis and mouth ulcers make eating painful -Altered taste perception; strong aversion to foods, tastes, odors -Abdominal pain related to ulcers |
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Cancer Therapies
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*Radiation
-Head and neck radiation may cause altered taste perceptions, "mouth blindness" -Altered taste perception; strong aversion to foods -Thick saliva resulting in dysphasia |
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Radiation Effects on the Oral Cavity
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*Radiation to the head and neck can harm normal cells resulting in problems with your teeth, gums, mucous, and jaw bone
*Side effects can make it difficult to eat, talk and swallow |
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Radiation Effects on the Oral Cavity
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*Side effects
-Dry mouth -Cavities -Loss of taste -Sore mouth and gums -Infections -Jaw stiffness -Jaw bone changes *Need to think about pain meds* |
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Chemotherapy Effects on the Oral Cavity
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*Chemotherapy
-Neurotoxicity: persistent, deep pain which mimics a toothache -Bleeding: from neutropena or thrombocytopenia (platelets <50 spontaneous bleeding of gums) |
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Chemotherapy Effects on the Oral Cavity
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*Teach patient
-Go to dentist before starting treatment -Saliva substitutes -Nutrition is important to healing -Stay away from hot, spicy foods |
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*Treatment for mucocitis
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-gel clear-coats inside of mouth also vitamin E oil coats mouth
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Metabolic Alterations of the Cancer Client
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*Altered Energy Metabolism
*Protein Metabolism *Carbohydrate Metabolism *Lipid Metabolism |
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Cachexia
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*A state of malnutrition and wasting
-Resulting from a combination of anorexia and accelerated metabolism -Leads to muscle wasting and general poor health -Major cause of morbidity & mortality |
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Common Nutritional Problems
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*Early satiety and anorexia
*Taste alterations *Local effects on the mouth *Nausea, vomiting & diarrhea *Altered immune response |
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Common Nutritional Problems
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*Abnormal blood glucose regulation
*Protein-calorie malnutrition *Inability to take/digest food Teach patient to eat 6 small meals a day |
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Common Nutritional Problems
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*Satiety
-The feeling of being full after eating; the sensation of satisfaction -Physical pressure from the tumor (obstructions) or fluid accumulation (ascites) may give the feeling of fullness *Anorexia -Loss of appetite -Control of the disease process improves appetite |
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Common Nutritional Problems
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*Taste Alterations
-Decrease threshold for bitterness -Decrease sensation of sweet, sour or salt (crave salt) *Local Effects in the Mouth -Mucositis/Stomatitis, Esophagitis, Dysphagia *Nausea, Vomiting and Diarrhea -Radiation enteritis *Altered Immune System -Suppression of the immune system increases the risk of infection from fresh fruits, vegetables and yogurt (neutropenic diet - no fresh fruit, or salad) |
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Nutritional Support
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*Helps client enjoy a better quality of life
*Stabilizes or reverses weight loss if cachexia is diagnosed early *May improve resistance to infections and response to therapies *Aids in healing |
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Nursing Process: Nursing Diagnosis
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*Alteration in nutrition, less than body requirements r/t anorexia, nausea, vomiting, diarrhea, stomatitis/mucositis, esophagitis, dysphagia, changes in taste
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Altered Nutrition: Anorexia
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*Assessment Data:
-Assess contributing factors: *inactivity *medications *inability to ingest/digest food -Weight loss -Fatigue *Nursing Considerations: -Teaching -Assess the loss of appetite -Always teach client the importance of nutrition and maintaining weight |
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Expected Outcomes
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*Patient and family will understand the need to maintain adequate nutrition
-Will identify ways to maintain adequate nutrition *Client will maintain or return to ideal body weight |
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Alteration in Nutrition: Nausea & Vomiting
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*Assessment Data:
-Occurrence and pattern -General appearance -Skin turgor -Diet history -Medication -Ascultate bowel sounds -Evaluate labs *Nursing Considerations: -Dietary modifications -Teaching |
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Altered Nutrition: Esophagitis and Dysphagia
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*Assessment Data:
-Difficulty swallowing -Pain c/o "lump in throat" *Occurs with chest radiation *Begins around 2-3 weeks after the start of treatment *Nursing Considerations: -Diet -Pain management (Take 1 hour before meals) -Teaching |
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Altered Elimination: Diarrhea
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Assessment Data:
-Determine frequency and character of stools -Stools loose, watery with cramping -Determine usual bowel pattern -Assess hydration -Assess labs *Nursing Considerations: -Diet modifications -Minimize diarrhea -Skin care -Medications -Teaching |
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Altered Mucous Membranes: Stomatitis/Mucositis
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*Assessment Data:
-Tenderness -Mild-moderate erythema -Whitish pseudomembrane on mucosa -Edema of mucosa -Bleeding with severe stomatitis, neutropenia -Assess ability to swallow -Assess for superinfection *Nursing Considerations: -Mouth care -Pain management -Diet -Treat infections |
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General Dietary Strategies
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*Use nutritional supplements: Carnation Instant Breakfast, Ensure or Sustacal
*Eat what you like when you feel like it *Small frequent meals of soft, creamy foods *Add calories when possible *Thick liquids are easier than thin *Lubricate foods with butter or gravies *Keep food cool or at room temperature *Offer favorite foods *Avoid fried, spicy, crunchy, low nutrient foods *Lemon juice, onion, mint and basil can improve the metallic taste of meats |
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Pharmacological Interventions
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*Lack of appetite (Megace, antidepressants)
*Dry mouth *Stomatitis *Emesis (Antiemetics) *Pain *Diarrhea *Constipation |
