CNA Information regarding nutrition and hydration

1. Nutrition & Hydration
Chapter 15
*Information is primarily based from Hartman’s
Nursing Assistant Care/Long term Care textbook,
4th edition.

2. What is Nutrition?
Nutrition is how the body uses food to maintain health. Bodies need a well-balanced diet containing
essential nutrients and plenty of fluids. This helps the body grow new cells, maintain normal body function,
and have energy for activities.
Proper nutrition in childhood and early adulthood helps in ensure health later in life. For the ill and elderly,
a well- balanced diet helps maintain muscle and skin tissues and preventing preventing pressure injuries. A
healthy diet promotes a healing of wounds. It also helps a person cope with physical and emotional stress.
A WELL BALANCED, HEALTHY DIET PROMOTES HEALING.

3. Are these food nutritious?

4. What is a Nutrient?
A nutrient is a necessary substance that provides energy, promotes growth and health, and helps regulate
metabolism. There are 6 nutrients that the body needs.
1. Water
2. Carbohydrates
3. Proteins
4. Fats
5. Vitamins
6. Minerals

5. Water
1. Water is the most essential nutrient for life
2. Water is needed by every cell & system in the body
3. Water assists with digestion and elimination
4. Water helps maintain normal body temperature
5. Some foods are also sources of water……..
● Watermelon, strawberries, cantaloupe, peaches, oranges, skim milk, cucumbers, lettuce,
broths/soups, zucchini, celery, plain yogurt, tomatoes, bell peppers, cauliflower, cabbage, grapefruit,
coconut water, cottage cheese
A general recommendation for daily fluid intake is 64 ounces ( or 8 eight-ounce glasses).

6. Carbohydrates Proteins
● Provide energy and extra protein
● Helps the body use fat efficiently
● Provide fiber
1. Complex Carbs
2. Simply Carbs
● Are a part of every body cell
● Are essential for tissue growth & repair
● They also supply energy
Whole grains also contain some protein

7. Fats Vitamins, Minerals
● Fats help store body energy
● Fats assist with absorption of certain
Vitamins (A, D, E & K)
● Fats add flavor to food
● Animal sources - butter, beef, dairy, fish,
fowl and pork
● Plant sources - olives, nuts and seeds
EXCESS FAT IN THE DIET IS STORED AS FAT IN
THE BODY
● Vitamins are substances needed by the body
to function
● YOU MUST CONSUME VITAMINS
● Minerals maintain body functions. Minerals
help build bones, make hormones, & help in
blood formation. They provide energy and
control body processes

8. USDA MyPlate
The MyPlate replaces the food pyramid.

9. Fruits & Vegetables
Vegetables and fruits should account for half of your daily intake, in other words half of what you eat
everyday should be fruits and vegetables. Fruits and vegetables are low in fat, sodium and calories. They
are high in vitamins and fiber.
The best fruits & vegetables are FRESH, FROZEN, CANNED
The best vegetables are colorful!!!!

10. Grains
Common grains are wheat, oats, rice, cornmeal and barley
Grains can be divided into 2 groups, whole grains (natural state) and refined grains (modified or altered)
Whole grains Refined grains
Brown rice, wild rice, white rice, white bread, white pasta
Bulgar (cracked oats), oatmeal, whole wheat, corn, oats and rye
WHOLE GRAINS ARE RICH IN FIBER WHICH HELP REDUCE THE RISK OF HEART DISEASE.

11. Proteins
Beans, peas, seeds, nuts, tofu and soy are sources
of plant protein.
Meat, poultry, seafood, eggs are all sources of
animal protein.

12. Dairy
● Milk
● Yogurt
● Cheese

13. Healthy food choices
● Balance calories
● Enjoy your favorite food, but eat less
● Choose small portions
● Prioritize your calories
● Monitor your sodium intake

14. The Geriatric population and Nutrition
● Weakened sense of smell and vision
● Decreased motor skills
● Poor dental health, dentures
● Decreased saliva production
● Decreased activity, the less you move the less calories you may require
● Certain medications can decrease your appetite
● Certain medications can cause constipation.

15. Dysphagia
Dysphagia - difficulty swallowing
Some signs and symptoms
● Watering of the eyes when eating or drinking
● swallowing several times per mouthful
● eating slowly
● Choking, coughing during meals,
● Food or fluid coming up into the nose,

16. Diseases that may cause eating &
swallowing difficulties.
● Stroke, or CVA, which can cause facial weakness and paralysis
● Nerve and muscle damage head and neck cancer
● Multiple sclerosis
● Parkinson disease
● Alzheimer’s disease
● Cancer

17. Aspiration
Inhaling food, fluid or foreign material into the lungs is called aspiration
Some signs & symptoms of Aspiration
● Sit the patient upright at 90 degrees
● Offer small pieces of food or small spoonfuls
● Feed patients slowly, do not rush them
● Place food in the stronger side
● Make sure mouth is clear before offering another bite
● Keep patient upright for 30 minutes after eating or drinking

18. Alternative nutrition methods
Tube feedings
Nasogastric tube- tube inserted through the nose and goes to the stomach.
Percutaneous endoscopic gastrostomy (PEG) - a tube is placed through the abdominal walls and goes
directly to the stomach.
REMEMBER CNAs are not responsible for any tubes, they do not insert or remove tubes, do the feeding or
irrigate or clean the tubes.
OBSERVE & REPORT ANY PROBLEMS WITH TUBE FEEDINGS!

19. Special diets
Residents who do not have any health problems that require a change in diet often eat a REGULAR DIET.
However residents or patients who have certain illnesses may be placed on a therapeutic, modified, or
special diet.
● Low-Sodium
● Fluid restriction
● Low-fat
● Bland
● Diabetic

20. Special diets
● Low residue
● Vegetarian
● Vegan
● Clear liquid
● Full liquid
● Puree

21. Special liquid orders
● Thin/regular liquids
● Nectar thick
● Honey thick
● Pudding thick

22. Input & Output
● Input - fluids the patient consumes
● Output - fluids that are eliminated
● Fluid balance - is maintaining equal input and output, or taking in and eliminating equal amounts of
fluid
1 ounce equals 30ml/cc
To convert ounces to ml/cc, the # of ounces must be multiplied by 30
Be sure to accurately record I & O

23. Preventing dehydration
Dehydration occurs when a person does not have enough fluid in the body.
● Offer fluids often, every time you see the patient
● Offer preferred fluids
Remember gelatin, freeze pops, soups, ice cream, ice chips are considered fluids

24. S & S of Dehydration
● Fluid input is less than 6 eight-ounce glasses of liquid per day
● Pt drinks little or no fluids at meals
● Pt needs help holding cups
● Pt has trouble swallowing
● Pt is confused
● Pt has frequent vomiting, diarrhea or fever
● Dry mouth, cracked lips, sunken eyes, dark urine, strong smelling urine, wt loss, ℅ abd pain.

25. Mealtime - the environment
● Mealtime should be pleasant and enjoyable, a time for socializing
● Staff should provide cheerful conversations and positive interactions

26. Mealtime - serving the food
● Wash your hands
● Diet cards and identifying the patient
● Offer clothing protection
● Serve each person at the before moving on to the next table
● Provide help/assist and encourage independence as instructed

27. Mealtime - assistingfeeding the patient
● Verify the patient
● Provide food choices
● Ensure the patient is sitting upright (90 degrees), sit down at the patient’s eye level
● Allow patient to observe religious/cultural rituals
● Do not treat the patient as a child while assisting
● Test the temperature of the food
● Cut up food as ordered, allow patient to choose which food they prefer to start with
● Alternate food and drink
● Hand over hand approach
● Do not rush

28. Nutrition Terminology
Diuretics
Dysphagia
Aspiration
Intake
Output
NPO

29. Nutrition Terminology
Dehydration
Edema
Fluid balance

30. Conclusion
Remember, your residents dietary needs may vary.
Be sure to read and follow the dietary care plan of each resident and offers alternatives as needed.
Report all changes in diet, appetite, chewing and swallowing ability to the nurse.