NURSING "MEETING NUTRITIONAL NEEDS- INTRODUCTION "

1. NUTRITION

2. NUTRITION
Nutrition is the science of food and
nutrients and it includes the process of
utilizing it by the humans

3. IMPORTANCE
– Food is one of the fundamental needs of all
living organisms
– Food is important for human beings through
out wellness-illness continuum
– Diet therapy is a major treatment for disease
control (Eg: HTN , DM)

4. NUTRITIONAL STATUS
Is the state of body resulting from the use
of nutrients available in the body
• Food is composed of nutrients necessary for
the body process and functions
– Carbohydrates Macronutrients
– Proteins
– Fats
– Vitamins and minerals
– Water Micronutrients

5. NUTRIENTS
–Carbohydrates: Energy
–Proteins :Body building
–Fats :Energy
–Vitamins and minerals: Normal
metabolic process including acid base
balance
–Water :Solvent for metabolic processes

6. Sources

7. Factors affecting nutritional needs
• Anorexia :loss of appetite
• Psychosocial problems:
(Fear ,Anxiety, Depression and Pain)
• Problems in the sense of smell and taste
• Secondary effects of drug therapy or treatment
• Patient with difficulty in swallowing and chewing
• Chronic GI problems
• Post-operative patients
• Patient from low socioeconomic status
• Certain beliefs of patients

8. Factors affecting nutritional intake
• Decreased food intake
– Anorexia
– Psychosocial factors
– Impaired ability to smell and taste
– Can develop secondary effect to drug therapy or
medical treatments
– Swallowing difficulty
– GI problems
– Surgery
– Poverty
– Consciousness

9. General assessment of
nutritional status

10. • Components
– Health history
– Evaluation of food
intake
– Physical
examination
– Diagnostic tests

11. Methods
•24 hr recall method
•Food frequency questionnaire
•Food diary
•House hold food consumption
Dietary history

12. 24 hr recall method

14. Food diary

15. House hold food consumption

16. Methods
– Food group method
– Nutrient composition
method
– Calorie count
Evaluation of food intake

17. Physical examination
• Anthropometric measurements
– Height and weight
– BMI : 18.5-24.5
– Body composition
• Triceps skin fold measurement
• Mid-arm circumference

18. Triceps skin fold measurement

19. Mid-arm circumference

20. Diagnostic tests
• Serum prealbumin
• Albumin
• Transferrin
• Lymphocyte count
• Hemoglobin
• Haematocrit
• Urine specific gravity
• 24 hr urine tests

21. Signs of poor nutrition
• Hair : thin, coarse, lacking luster, breaks easily.
• Skin : excessive bruising, bleeding, pressure
sores, poor wound healing.
• Muscles : wasting, lack of growth
• Skeletal : poor posture, painful joints, bowed
legs, increase in bone fracture
• Mental: confusion, motor weakness

22. Diagnosing
• Imbalanced Nutrition: More Than
Body Requirements
• Imbalanced Nutrition: Less Than
Body Requirements
• Readiness for Enhanced Nutrition
• Risk for Imbalanced Nutrition: More
Than Body Requirements

23. Diagnosing
• Diagnostic label used as etiology
– Activity Intolerance
– Constipation
– Low Self-Esteem
– Risk for Infection

24. Planning
• Maintain or restore optimal
nutritional status
• Promote healthy nutritional practices
• Prevent complications associated
with malnutrition
• Decrease weight or regain specified
weight

25. Planning
• Planning for home care
– Provide aid with eating, purchasing
food, and preparing meals
– Instruct about nutrition therapy
– Assess client and family's abilities for
self-care, financial resources, and need
for referrals

26. Implementing
• Hospitalized client
– Provided in collaboration with the
primary care provider and the dietitian
– Reinforce information presented by
dietitian
– Create an atmosphere that encourages
eating
– Provide and assist with eating as
needed
continued on next slide

27. Implementing
• Hospitalized client
– Monitor the client's appetite and food
intake
– Administer enteral and parenteral
feedings
– Consult with primary care provider and
dietitian about nutritional problems

28. Implementing
• Assisting with special diets
– Altered diets used to treat disease,
increase/decrease weight, restore
nutritional deficit, allow organ to
rest/heal
– Diets modified in texture, kilocalories,
specific nutrients, seasonings,
consistency
continued on next slide

29. Implementing
• special diets
– Clear liquid diet
• Fluid and carbohydrates
• No adequate protein, fat, vitamins,
minerals, calories
– Full liquid diet
• Liquids or foods that turn liquid at body
temperature
• Clients with GI disturbances
continued on next slide

30. Implementing
• special diets
– Soft diet
• Low residue (low-fiber)
– Diet as tolerated
• Advance the diet if the patient is responding
as expected
continued on next slide

31. Implementing
• Assisting with special diets
– Modification for disease
• Altered metabolism
• Diabetic diet is a lifetime diet.
– Dysphagia
• Older clients, clients with cancer
• Nurses may be first to detect.
• Levels of liquid foods are thin, nectar-like,
honey-like, and spoon-thick liquids

32. Implementing
• Stimulating the appetite
– Decrease in food intake often
accompanied by decrease in fluid
intake.
– Short-term decrease not a problem, but
over time it leads to nutritional
problems.
– Determine reason for lack of appetite,
then deal with problem

33. Implementing
• Assisting clients with meals
• Be sensitive to client's feelings of
embarrassment
• Help client to feed self
• Ask order in which client would like to eat
• Use normal utensils whenever possible
• Special community nutritional services
• Meals on Wheels

34. Implementing
• Enteral nutrition
– Enteral
• Through the GI system
– Enteral access devices
• Nasogastric tube
• Nasoenteric (nasointestinal) tube
• Gastrostomy and jejunostomy devices
continued on next slide

35. Implementing
• Enteral nutrition
– Enteral access devices
• Percutaneous endoscopic gastrostomy (PEG)
• Percutaneous endoscopic jejunostomy (PEJ)

36. Conclusion