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Nelly Guerrero

on 4 June 2014

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Transcript of Nutrition

Optimal nutrition during pregnancy to reduce risk for complications of premature deliveries, decreased birth weight, and neural tube defects ex. Spina bifida.
Increase nutrient dense food rather than calories.
Increase folic acids and fortified foods.
Role of the Nurse in Promoting Nutrition
Help the pt understand the importance of the diet and encourage dietary compliance.
Serve meal trays to pt in prompt and positive manner.
Assist some pts with eating.
Take and record pts weight.
Record pts intake.
Observe clinical signs of poor nutrition and report them.
Serve as a communication link among the pt, dietician, physician, and other members of the health care team.
Apply nutrition knowledge in your own personal life.
Nutrition is the total of all processes involved in taking in and using food substances for proper growth, functioning, and maintenance of health.
Basic Nutrition
Fluid needs are increased and it is possible to obtain through the consumption of water, juice milk, and other beverages.
Adequate nutrition is key, improper intake will decrease the quality of milk produced.
Birth to 1yr.
Breast milk or iron fortified formula recommended for first year.
No other juice water or other solid foods is necessary
Introduction of foods too early can increase food allergies and choking
Essential Nutrients
Six Classes of essential nutrients
Nutrition is vital for the proper functioning of the cardiovascular, renal, pulmonary, nervous, digestive, and immune systems, among others.
Never overlook its importance
My Pyramid
Key Concepts
The U.S. Department of Health and Human Services and the USDA have developed dietary guidelines specifically for the U.S. population.
These guidelines directly affect federal nutrition programs such as food stamps, school breakfast and lunch programs, and WIC.
The Government developed these guidelines to address importance of adequate nutrition,as well as the prevention of overnutrition and chronic disease.
Dietary Guidelines For Americans
is a chemical compound or element found in food that is necessary for good health
Essential Nutrients
are those that our bodies are not able to make in the amounts essential for good health, and that are therefore necessary to obtain through diet or other sources.
The basic functions of nutrients include
Provide Energy
Build and repair tissue
Regulate body processes
Provide energy
Simple carbs are found in fruits, table sugar, honey, found naturally in milk
Complex carbs are found in grains, legumes, vegetables, particularly in starchy vegetables like corn and potatoes
Recommended daily intake is 45%-65%
Provide 4Kcal/g
Dietary Fibers
Generic term for non digestible chemical substance found in plants.
Insoluble fibers help soften stool and speed food through digestive tract.
Water Soluble fibers act to decrease cholesterol levels by binding with bile acids and cholesterol

Provide most concentrated source of energy.
Dietary fat provides satiety, adds flavor and aroma to foods.
Carries fat soluble vitamins A, D, E, & K.
Saturated Fats
Generally from animal origin and are solid at room temperature
Increase blood cholesterol levels
R/F Atherosclerosis
Saturated fats are found in egg yolk, fats on & in meats & poultry, butter, cream, milk fat, cocoa butter, olive oil
Unsaturated Fats
Usually from a plant source and are liquid at room temperature.
Are thought to have a blood cholesterol lowering affect.
Are found in canola oil, peanuts and peanut oils, most other nuts, avocados, corn oil, most fish oils
Trans Fatty acids are synthetic unsaturated fats and are known to increase blood cholesterol levels.
Are necessary for tissue growth, repair, and wound healing.
Proteins are made up of amino acids
Out of 20 amino acids used by the body only 9 are considered essential.
Recommended daily intake is 10%-35%
Complete Proteins
Contains all 9 amino acids
Generally of animal origin
Meat, poultry, fish, milk, cheese, eggs, & soy
Incomplete Proteins
Are those lacking in one or more of the essential amino acids
Are of plant origin
Includes protein in grains, legumes, nuts & seeds.
Protein Energy Malnutrition
Occurs from lack of energy or protein intake
Two types of PEM exist
Marasmus is a chronic condition characterized by wasting of body tissues, leaves the victim with "skin and bones" appearance.
Kwashiorkor occurs a result of severe protein restriction in the presence of other calories, characterized by edema in the feet, legs and often the abdomen, face and hands.
Child appears to be "fat"
Vitamins are an organic compound that are essential for physical and metabolic functioning.
The two main types of vitamins
Water soluble vitamins are B, and C. Excess are excreted in the urine(B&C make you pee)
Fat soluble vitamins are A, D, E, and K. Excess are stored in the body. (ADEK)
Vitamin C
Food sources
Citrus fruits and juices, kiwi, melons, brocolli, peppers, tomatoes, fortified beverages
Antioxidant; wound healing, tissue growth and maintenance, proper immune function, absorption of iron
Signs & symptoms
Deficiency: Scurvy, gingivitis, bleeding gums, easy bruising, increased infections, poor wound healing,rough skin, fatigue
Toxicity: Abdominal cramps and diarrhea
Vitamin D
Food Sources
Fortified milk, fortified margarine, egg yolks, liver, fish oils
Sunlight on skin
Maintain blood calcium and phosphorus balance
Signs & symptoms
Deficiency: Rickets (children): abnormal shape and structure of bones. Osteomalacia (adults): weakening and softening of bones
Toxicity: Calcification of soft tissues
Vitamin K
Food sources
Green leafy vegetables, milk, dairy products, liver, meat, egg yolks, green tea.
Formation of blood clotting factors
Signs & symptoms
Deficiency: Increased prothrombin time; in severe cases hemorrhaging
Toxicity: None exhibited
Folic Acid
Food sources
Liver, green leafy vegetables, legumes, fruits, enriched grain products
Nucleic acid synthesis, amino acid metabolism
Signs & symptoms
Deficiency: Macrocytic anemia, elevated homocysteine
Toxicity: will sometimes mask vitamin B12 deficiency
Food source
Meat, poultry, enriched and fortified grains and cereals
General Metabolism
Signs & symptoms
Deficiency: Pellagra: dermatitus, constipation, or diarrhea, dementia, depression
Toxicity: Nausea, vomiting, flushing, pruritus of the skin, abnormal liver function
Antioxidant Vitamins
Antioxidants function by delaying or preventing the destruction or breakdown of cell membranes in the presence of oxygen.
Have been linked to reduce risk of certain cancers and heart disease.
Minerals are inorganic single element compounds
Classified as either major or trace minerals
Major minerals are needed in amounts greater than 100mg/day
Trace minerals are needed in much smaller amounts
Food source
Milk, cheese, milk products, green leafy vegetables, broccoli, legumes
Formation and maintenance of bones and teeth, blood clotting, nerve conduction, muscle contraction
Signs & Symptoms
Deficiency: Osteoporosis in adults, stunted growth in children
Toxicity: Constipation, reduced absorption of iron and zinc
Food sources
Sweet potatoes, fruits, vegetables, fresh meat, legumes milk
Nerve conduction; muscle contraction, including the heart; fluid and acid base balance
Signs & Symptoms
Deficiency: severe: cardiac dysrhythmias, muscle weakness, glucose intolerance. Moderate: increased blood pressure, risk of kidney stones, increased bone turnover
Toxicity: Cardiac Arrest
Food Sources
Clams, liver, oysters, meat, poultry, fish, legumes, whole and enriched grains
Part of hemoglobin and myoglobin; necessary for oxygen transport and use in the body; part of some enzymes
Signs & Symptoms
Deficiency: Anemia: fatigue, weakness, headache, apathy, pale skin, decreased immune function. In children: reduced attention span, decreased ability to learn.
Toxicity: tissue damage, constipation, decreased zinc absorption
Food Sources
Red meat, liver, eggs, seafood, cereal, whole grains, legumes
Part of many enzymes involved in metabolism
Signs & Symptoms
Deficiency: loss of appetite, growth retardation, skin changes, immune system dysfunction
Toxicity: impaired immune response, impaired copper status, reduced HDL cholesterol
Water is the nutrient most vital to life.
Makes up approximately 60% of adult body weight & 80% of infants body weight.
Provides form and structure to body tissues.
Acts as a solvent, and is necessary for most of the bodys chemical processes.
Lubricates food and aides in digestion.
Suggested Daily intake 9 cups (women), to 13 cups (men)

Critical time to instill good dietary habits
Meal time should be relaxed, positive,
Provide options and include all 6 food groups.
Offer new foods, but do not bribe with candy or sweets
Keep nutritious snacks available


Physical and emotional growth.
Peer pressure influences food choices
Diet usually filled with kilocalorie rich and nutrient poor snacks
Inadequacies in iron and calcium (mainly in girls) vitamin a and c and folic acid
Obesity is common problem in u.s society.

Energy needs decrease
Physical activity is decreased resulting in weight gain
Important to eat nutrient dense-foods
Place an emphasis on maintaining an active lifestyle.

Eating Disorders
Anorexia Nervosa
Self imposed starvation
Develops usually in early to middle stages of adolescence.
Characteristics and behaviors of intense drive for thinness, intense fear of gaining weight, becoming fat and have distorted body image.
Exhibit over compulsive behaviors towards food.
Physical symptoms include cessation of menstruation, loss in sexual drive, cold intolerance, lanugo, hypotension and heart irregularities. Decrease in bone density, severe constipation, flatulence, diarrhea, & depression
Bulimia Nervosa
Periods of binge eating followed by purging, self induced vomiting and the misuse of laxatives, diuretics emetics, enemas and the misuse of diet pills.
Usually pt is with in normal weight range and is aware that eating pattern is abnormal
Experience fear of not being able to stop eating , depression, guilt, and remorse after a binge.
This disorder tends to occur with other psychiatric disorders: depression, OCD, substance abuse, and self injurious behaviors.
Physical symptoms are possible tooth erosion, calloused knuckles , swollen parotid glands, broken blood vessels in the eyes or face. Stomach lacerations and esophageal and sinus infections from excessive vomiting.

Is a recognized disorder sometimes referred to as compulsive over eating.
Characterized by frequent , recurrent episodes of eating larger then normal amount of food during a short period of time (2hr period)
Physical symptoms are obese .
Modified Diets
Diabetes Mellitus:Requires a carbohydrate modified diet.
Fat modified: Help reduce the risk of atherosclerosis, heart disease, hyperlipemia and certain cancers.
Low fat diets: Used to treat GI diseases that involve malabsorption of fat. Include cystic fibrosis, inflammatory bowel system, pancreatitis, and short bowel syndrome.
Protein restricted: Often considered to promote healing but exception is for chronic renal failure and cirrhosis of the liver.

Sodium Restricted Diet: This treats a number of medical conditions. Cirrhosis accompanied by ascites, chronic renal failure. Hypertension is often responsive.It is often restricted when edema and water retention are present.
Potassium Modified Diet: Helps with blood pressure control and is used at end stage renal disease and other kidney diseases.
Fluid Modified Diet: Used during end stage renal disease and other kidney disease with low urine out put, CHF,after a myocardial infarction hepatic come or ascites.


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