nutritional needs of patient updated (1).pptx

nutritional needs of patient updated (1).pptx

• 1.
  Nursing foundation unit –3 Nutritional needs of patients
• 2.
  Objectives
• 3.
  Objectives Introduction Importance Factors effecting nutritionalneeds. Review : special diets Review : therapeutic diets
• 4.
   Care ofpatient – dysphagia ,anorexia , nausea , vomiting .  Procedure –insertion of ng tube and feeding  oral, enteral: nasogastric, orogastric .  Feeds  TPN.
• 5.
  ØIntroduction … It’s acritical part of health and development. It’s a process by which the body Uses food . Nutrients from foods and fluids are used by the body for growth and all body functions .
• 6.
  Definition of nutrition….  Nutrition is the study of nutrients In food , how the body uses them, and the Relationship between diet , health , and disease.
• 7.
  • Nutrition isa method in which the food is consumed by the organism into the body and utilizing the nutrients from the food
• 8.
  Importance of nutrition….  Good nutrition aids the immune system .  Proper nutrition provides with energy .  Good nutrition- good mood Good health .  Proper metabolism and Nourishment .  A longer life – healthy life .
• 9.
  Factors effecting nutritionalneeds....
• 10.
  •Age •Gender •Life style •Diet choices •DNA •Medication •Ethnicity, culture and religious practices
• 11.
  Assessment of nutritionalstatus ….
• 12.
  Nutritional status …. •It’s the current body status of a person • It expresses a degree to which the physiological needs and the nutrients are met .  Optimal.  Malnutrition.  Deficiency vs overload.
• 14.
  Methods to assessnutritional status …..  Food intake assessment  Physical assessment  Anthropometric tools  Clinical values
• 15.
  Food Intake Assesment
• 16.
  Physical assessment ….. Pale palm & conjunctiva or gets tired easily, loss of appetite indicates - anemia, deficiency of iron, folic etc.  Bitot spot ( whitish patchy triangular lesions on the side of the eyes) indicates - vitamin A deficiency.  Goitre ( swelling on the front of the neck) indicates - iodine deficiency disorder.  PEM (PROTEIN ENERGY MALNUTRITION) indicate protein deficiency.
• 17.
  Anthropometric tools....  Weightassessment .  Height assessment .  BMI. (Most important)
• 19.
  BMI CALCULATIONS
• 21.
  Review of specialdiets....​?  Solid diet  Liquid diet  Soft diet
• 22.
  Review of therapeuticdiets.... Therapeutic diets :-  Therapeutic diets are planned food routines to maintain or restore good nutrition in patient.  In most cases the therapeutic diet are used to supplement the medical or surgical treatment of the Patient  while in some instances like diabetes mellitus, a therapeutic diet is the most aspect of the patient's treatment rather the medical therapy
• 23.
  Review of therapeuticdiets.... Therapeutic Diets  Regular diet  Liquid diet  Soft diet  Diabetic diet  Calorie controlled diet  Low cholesterol diet  Fat restricted (low-fat) diet  Sodium restricted diet  Protein diet  Bland diet  Low residue diet
• 24.
  • Regular diet– i.e balanced diet • Liquid diet – consists of liquid contents , mainly given to the patient who is diagnosed with severe gastro conditions , first step -post operative patient to relive from NBM status. • Soft diet - consists of soft foods like mashed potato mainly given to the patient who is diagnosed with severe gastro conditions ,second step -post operative patient to relive from NBM status. • Diabetic diet - low sugar / high protein and / fibre content .etc
• 25.
  Written assignment on therapeuticdiet specific conditions n diet recall.....
• 27.
  Sample diet plan NUTRITIONFOR CARDIOVASCULAR DISEASES Name of the diet – low cholestrol / low fat High fibre diet is recommended Objectives:  To relieve strain to the heart  To prevent further damage to the heart  To restore the damage heart
• 28.
  Food recommended forcardiac patients :-  Skim milk  paneer from skim milk  Cereals and pulses  Whole grain  All vegetables and all fruits  High fiber and soluble fiber like oat meal,  egg white and fish  Vegetable oils, sugar and jaggery etc
• 29.
  Food to beavoided:  Cholesterol rich food  Whole cream  Butter & cream  cheese  Indian sweet meal like puddings  bakery products  Organ meat  Egg yolk, fish  oil seeds,  pickles  Fried food  Alcohol
• 30.
  Regular low cholesteroland low fat and high fiber diet:-  Energy- 1600 k cal  Fat- 40 g  Protein- 65 g
• 31.
  SAMPLE MENU FORCARDIOVASCULAR DISEASES MEAL FOOD EARLY MORNING LEMON WATER-1 GLASS BREAK FAST MILK(SKIMMED)-1 CUP, MISSI ROTI-1, CURD-1/2 KATORI, OR BOILED EGG- 1-2 AND BREAD- 1-2 SLICE MID - MORNING FRESH FRUIT- 1 LUNCH SALAD, CHAPAT-1-3, RICE- 60 G, VEGETABLE- 250G, CURD- 1 CUP EVENING TEA TEA, SPROUTED MONG OR BLACK CHANNA- 30 G, BISCUITS-3-4 DINNER VEGETABLE SOUP, CHAPATI-2, DAL, CHICKEN OR FISH-100G , COOKING OIL- 20G
• 32.
  Roll number 1-5 diet plan for diabetic patient . Roll number 6-10 diet plan for renal patient . Roll number 11- 15 diet plan for hypertension. Roll number 16 - 20 diet plan for constipation . Roll number 21- 25 diet plan for post operative patient. Roll number 26-30 diet plan for the patient diagnosed with severe diarrhea . Roll number 31- 34 diet plan for the patient who underwent abdominal surgery . Individual files should be submitted
• 33.
  Care of patients withspecific conditions
• 34.
  Care of patient– dysphagia.... • Swallowing disorder . • Difficulty is shallowing .
• 35.
  Care of patientwith dysphagia …..  Maintain the patient in high-Fowler's position with the head flexed slightly forward during meals.  Instruct the patient not to talk while eating.  Provide verbal cueing as needed.  Avoid milk and milk products  If the patient had a stroke, place food in the back of the mouth, on the unaffected side, and gently massage the unaffected side of the throat.
• 36.
   Observe foruncoordinated chewing or swallowing; coughing shortly after eating or delayed coughing. which may mean silent aspiration; pocketing of food; wet- sounding voice; sneezing when eating; delay of more than 1 second in swallowing; or a variation in respiratory patterns.
• 37.
   If anyof these signs are present, put on gloves, eliminate all food from oral cavity, end feedings, and consult with a speech and language pathologist and a dysphagia team.  Encourage high-calorie diet that involves all food groups, as appropriate.  Discuss the importance of exercise to enhance the muscular strength of the face and tongue to enhance swallowing  Educate patient, family, and all caregivers about rationales for food consistency and choices.
• 38.
  • Eating disorder. • Causes people to obsess over their weight leading them to starve to lose weight . • It's a serious psychological disorder. Care of patient - anorexia …..
• 39.
  Care of patientwith anorexia ….. NURSING MANAGEMENT:  Monitor the weight of client.  Correction of nutritional deficiency by providing nutritious diet.
• 40.
   Eating mustbe supervised by the nurse and provide balanced diet of at least 3000 calories should be provided in 24 hrs.  The goal should to be achieving weight gain of 0.5 to 1 Kg. per week.  Monitor the serum electrolysis levels.  Control vomiting by making bathroom inaccessible for at least 2 hrs. After food.
• 41.
  Care of patient– nausea and vomiting ….. • Nausea : sensation of urge to vomit. • Vomiting : forcible emptying of stomach . • It’s a symptom.
• 42.
  • Drink clearor ice-cold drinks. Eat light, bland foods (such as saltine crackers or plain bread)​. • Avoid fried, greasy, or sweet foods​. Care of patient with anorexia …...
• 43.
  • Do notmix hot and cold foods.​ • Drink beverages slowly.​ • Eat slowly and eat smaller, more frequent
• 44.
  • Avoid activityafter eating​ • Avoid brushing your teeth after eating • Choose foods from all the food groups as you can tolerate them to get adequate nutrition​
• 45.
  MEETING NUTRITIONAL NEEDS: PRINCIPLES & EQUIPMENTS,PROCEDURE INDICATIONS...... Oral nutrition Enteral nutrition
• 46.
   Oral nutrition​: The term 'oral nutrition is used here to denote eating and drinking.  Oral nutrition is the preferred and most palatable method of feeding.
• 47.
  ENTERAL NUTRITION :NASOGASTRIC/ OROGASTRIC Enteral nutrition refers to any method of feeding that uses the gastrointestinal (GD) tract to deliver nutrition and calories.
• 48.
  The term enteralfeeding is most often used to mean tube feeding. Enteral nutrition is indicated for patients who have a functioning GI tract but cannot ingest enough nutrients orally because they are unable or unwilling to take oral feedings. Nutrition is delivered using a flexible tube inserted through nose, or directly into stomach or small intestine.
• 49.
  Types :- 1. NASOGASTRICTUBE (NG) 2. OROGASTRIC TUBE (OG)
• 50.
  1. Naso-gastric Feeding Anasogastric tube (NG tube) is a special tube that carries food and medicine to the stomach through the nose. •It can be used for all feedings or for giving a person extra calories to the patient
• 53.
   Adult 16-22French  Child-10-14 French  Infant 4-10 French 50
• 54.
  2 .Oro-gastric tubeThe same type of tube as a nasogastric tube, the tube is inserted into the mouth, down the throat into the esophagus and rests in the stomach. This tube can also remain in place for up to two weeks when it must be removed or replaced with a permanent tube.​​
• 55.
  Procedures :- 1 .Ng insertion 2 .Ng tube feeding 3.Io chart 4.Gastrostomy and Jejunostomy
• 57.
  Total parenteral nutrition(TPN) is a way of supplying all the nutritional needs of the body by bypassing the digestive system and dripping nutrient solution/s directly into a vein. The administration of a nutritionally adequate hypertonic solution (consisting of glucose, protein hydrolysates, minerals, and vitamins) through an indwelling catheter into the superior vena cava or other main vein.
• 58.
  Normally TPN isadministered in a hospital, but under certain conditions and with proper patient and caregiver education, it may also be used at home for long- term therapy (HPA). Ideally, TPN provides all the nutrients in the correct quantities to ensure the body functions normally.​