Transcript The Relationship of Nursing to Nutritional Needs of Patients

Nursing
&
Nutritional Needs of Patients
LISA B. FLATT, RN, MSN, CHPN
Terminology
 Gastrointestinal system – GI system
 Alimentary canal – ‘tube’ that food/fluid follow from
the mouth to the anus
 Peristalsis – muscles of the alimentary canal move in
waves and push the food/fluid through
Follow the Path of the Alimentary Canal!
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Mouth
Esophagus
Stomach
Small Intestine
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Duodenum
Jejunum
Ileum
 Large Intestine
 Ascending colon
 Transverse colon
 Descending colon
 Sigmoid Colon
 Rectum
 Anus
Anatomy & Physiology
The Gastrointestinal (GI) System
 Mouth – dentition breaks down food into small
enough pieces that enzyme-containing saliva begins
breaking down the food (& fluids)
 Esophagus
 Stomach – secretes gastric acids to further
breakdown the food
 Small intestine – most of digestion happens here, the
villi and microvilli line the mucosal surface, from
which enzymes, acids and proteins are secreted and
nutrients are absorbed
And then there’s more…….
 Large intestine – water is absorbed and digestive
wastes are converted into feces
 Sigmoid (pelvic) colon – waste/feces travels through
to reach rectum
 Rectum – contains vertical folds (each contain an
artery and vein), these folds help hold feces in the
rectum
 Anus – internal sphincter muscles are stimulated by
the autonomic nervous system and external
sphincter muscles are stimulated by the somatic
nervous system
The Basic Four Food Groups
Eat Healthier!
 Grains Group – ½ of grains should be whole grains
 Fruits – Focus on fruits
 Vegetables – Vary your veggies
 Dairy – Calcium rich
 Protein - Go lean with your protein
 Go Red!
Daily Requirements
Servings per day
 Fruit &Vegetables 5-10
 Meat 2-3
 Dairy 2-4
 Grains 5-12
Sample diet
What do we eat to be healthy?
 Proteins  Carbohydrates
 Fats
 Vitamins
Grains
 Whole grains: Brown Rice: Buckwheat: Millet: Oatmeal:
Popcorn:Bulgur (cracked wheat): Whole-wheat cereal
flakes: Meuslix: Rolled oats: Quinoa: Wheat Pasta
 Refined grains: corn tortillas: grits: pasta: pita: noodles:
corn flakes
 Examples of refined grains you have eaten today/this week?
 Examples of whole grains you have eaten today/this week?
Fruits
 Apples, Apricots, Bananas, Berries, Cherries, Grapes, Melons, Fruit
cocktail, pears, mangoes, pineapple, peaches, plums, raisins, tangerines
 100% Fruit juices
 Can you think of some fruits you might want someone with low
potassium to eat?
 What are some fruits that are high in roughage?
 What does GO RED have to do with Fruits?
Vegetables
 Dark green: spinach: kale: Mustard/turnip/collard
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greens
Red & orange vegetables: acorn/butternut squash:
carrots: pumpkin:sweet potatoes: tomatoes
butternut squash
Beans and peas: lentils: kindey beans: soy beans
Starchy vegetables: corn: black-eyed peas (not dry)
Other Vegetables: beets: cucumbers: egg plant:
turnips
 People who are low in iron might eat which
vegetables?
Dairy
 Milk: Cheese: Ice Cream: Yogurt: soy milk (Calcium fortified)
 What are some dairy desserts?
 Why would you want to restrict dairy products with a patient
who is in kidney failure?
Protein
 Meats - lean
 Seafood/ Fish/ Shellfish
 Organ Meats
 Poultry
 Eggs
 Game Meats
 Soy products – bean curds
 Beans
 Nuts
Oils & Fats
 Oils are fats (they are liquid at room temperature). They may
come from plants and fish. They provide essential nutrients.
What are some examples of oils found in plants?
What are some nuts that may contain oil?
Oils found in plants do not contain cholesterol.
Most oils are low in saturated fats. They are high in
monounsaturated and/or polyunsaturated fats.
 Solid fats (solid at room temperature) for example butter and
shortening. These can be made through hydrogenation.
 Others are: lard, milk fat, chicken fat, meat/beef fat
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Empty Calories
Solid Fats
 Fats that are solid at
room temperature
Added Sugars
 Processed sugars
added to beverages and
syrups
Exercise
 What types of physical activity do you engage in?
 Give some examples that are ‘low impact’
 Give some examples of ‘aerobic’ exercises
 What are some things we can do in our daily
activities that are exercise?
 How many times a week and how much exercise is
recommended? Does it ever vary?
Name that Vitamin!
Vitamin = what do I do?
Where can I find it?
 A = growth & development, tooth

& bone development, epithelial tissue
functions
 B=
 C=
 D=
 E=
 K=
Egg yolks, butterfat from milk
What rises in the
east?
Sets in the west?
Has solar flares?
Creates energy?
Gives us light?
Is eclipsed by the
moon, on rare
occasions?
The ancients thought
this heavenly body
revolved around the
earth?
THAT’S RIGHT!
THE SUN!
It’s light is absorbed through the
skin and converted to which
vitamin?
Minerals
Fiber & Fluid
Influencing Factors
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Preferences
Socio-economic factors
Culture and Ethnicity
Spiritual Beliefs
Physical Activity
Work Habits
Cooking Habits
Health Habits
Psychological Factors
Peer pressure
Mental Status
Nutrition through the Ages
 Infant
 Pre-school-aged
 School aged
 Adolescents
 Young Adults
 Middle-aged adults
 Elderly
Nutritional Disturbances
 Pg 21
Nursing Promotions
Nursing Interventions
Special Diets
Laboratory Data
 Complete Blood Count (CBC)
 Hemoglobin (Hgb)
 Hematocrit (Hct)
 Total Iron Binding Capacity (TIBC)
 Blood Urea Nitrogen (BUN)
 Creatinine
 Lymphocytes
Applying the Nursing Process
Case Scenarios
Creating Care Plans
References