Beautiful Nursing

NUTRITION
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 Nutrition
T YPES OF NUTRITION
Carbohydrates Proteins

Carbohydrates provide ENERGY for the Proteins are formed by plants and animal
body and are made of carbon, hydrogen, and oxygen. sources with many functions. Protein has
many BENEFITs. Either considered
Carbs: 4 cals/g. Recommended daily intake is 228g/ complete or incomplete.
day and 45-65% of total calories to be Carbohydrates.
1) Complete: contains all 9
essential amino acids.
2) Incomplete: insufficient #
of amino acids. Ex: Hummus
with Crackers.

Proteins: 4 cal/g. Recommended daily intake is 0.8g/

kg for healthy adults and 10-35% of total calories.

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 Nutrition
T YPES OF NUTRITION
Lipids Vitamins, Minerals &
Electrolytes
Lipids are fats found in dark meat, poultry skin, Vitamins are organic substances used by the body to
dairy foods, and oils (butter) used for energy, body provide essential nutrition for cell function, growth, and
temperature insulation, hormones, and tissue development. Either water or fat soluble.
construction.
Minerals are inorganic substances used for metabolic
processes.
Fats: 9 cal/g. Recommended daily intake is
around 20-35% of total calories. <10% should
Electrolytes are electrically-charged minerals that
come from saturated fats.
help the body maintain homeostasis. Ex: Sodium,
Potassium, Chloride.

Water-soluble vitamins mean they

Water dissolve in water.
Soluble
“Come Bathe in the water”

Includes: Vitamin C+B

Fat-soluble vitamins dissolve in fat,

Fat NOT water.
Soluble
“Excess Adipose (fat) Does Kill”

Includes: Vitamins ADEK

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 Nutrition
VITAMINS
Folate: decreases
fetal birth defects,
new cell synthesis.

Found in: Liver,

Green Leafy
Veggies,
Legumes

Biotin: fatty acid synthesis,

amino acid metabolism and
formation of glucose.

Found in: Eggs, Milk, Dark

Green Veggies

Pantothenic Acid:
Metabolism of fats,
carbs, and proteins.

Found in: Meats, whole grain

cereals, and beans

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 Nutrition
MINERAL S & ELECTROLY TES
USE SOURCE ⬇ TOO LITTLE

Sodium Maintain Fluid Volume, Muscle

Salt
Muscle Cramping, Memory
(135-145) Contraction, Nerve Impulses Loss, Anorexia

Bananas, Oranges,
Heart Muscle Contraction, Fluid
Volume Maintenance Inside Cells Tomatoes, Avocados, Dried Dysrhythmias,

Potassium Peas, Broccoli, Confusion,

(3.5-5)
Dairy, Meats,
Muscle Cramps
Whole Grains

Intracellular and
Extracellular Salt 🧂 , Muscle Cramps,
Chloride Fluid Balance,
(95-105) Acid-Base Balance, Processed Food Anorexia
Digestion

Absorption of calcium
Calcium & phosphorus, and bone ☀ Sun, Fatty Fish, Eggs, Fragile bones,
(9-11) Milk, Cereal, Orange Juice rickets, osteomalacia
mineralization

Relaxes muscles, Bone formation, Green Leafy Vegetables,

Magnesium Weakness, Dysrhythmias,
catalyst for enzyme reactions, Nuts, Whole Grains, Tuna,
(1.5-2.5) Convulsions, Increased BP
nerve/muscle function Halibut, Chocolate

Energy transfer of RNA/DNA, acid-

Phosphorus Dairy, Peas, Meat, Eggs,
base balance, bone and teeth NA
(2.5-4.5) Legumes
formation

Sulfur Protein Metabolism Proteins NA

Synthesis of thyroxine (thyroid Thyroid Gland Enlargement

Iodine hormone) for metabolism
Seafood, table salt
(Goiter)

Oxygen distribution to Meat, Fish, Poultry, Grains, Fatigue, Pale Skin,

Iron hemoglobin and myoglobin Legumes Tachycardia, Dizzy

Mineralization of developing tooth

Fluoride enamel. 🦷
Toothpaste Dental Caries, Osteoporosis

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FLUID BALANCE
The body can only sur vive a f ew days wit hout water or hydration.

Water Output: urine, sweat, feces, respirations E de m a =

F l u i d Accu m u l at i o n
Amount output should EQUAL Amount input

Body is made up of 60-70% water

Hydration Assessment: skin turgor, mental status, orthostatic BP, urine output, moistness of mucus membranes.

Metabolic Rate
Metabolic Rate is the speed at which food energy is used.

Basal Metabolic Rate (BMR): amount of energy used in 24 hrs

for involuntary activities of the body (body temp/HR/BP/RR).
Determined at rest following a 12 hr fast.

Resting Metabolic Rate (RMR): calories needed for involuntary

activities of body at rest.

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WEIGHT MEASUREMENTS

BMI: body mass index t hat measures weight against height.

BMI Calculation = weight (kg) ➗ height (㎡)

Waist Circumference for Obsese Patients: Weight Change Calculation:

Females: >35 inches (88.9 cm) Patient’s weight is monitored to prevent malnutrition during illness.

Males: >40 inches (101.6 cm) % Weight Change = (Usual Weight - Present Weight) X 100
______________________________
Usual Weight

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TYPES OF DIETS

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 Nutrition
HOSPITAL DIETS
DISORDER RECOMMENDED DIET

Burns ⬆ Protein, ⬆ Calorie

Celiac Disease Gluten Free Diet: No BROW

Cons t ipat ion ⬆ Fluids, Fruit, Fiber

C OPD ⬆ Calorie, ⬆ Fat, Small Frequent Feedings

Diabet es Mellitus ⬇ Fat, ⬇ Calories, ⬆ Fiber

Diarrhea / Vomit ⬇ Fiber, Fluid & Electrolyte Replacement

Gallbladder Disease ⬆ Protein, ⬇ Fat

Hear t Failure Fluid Restriction

Hyperlipidemia ⬇ Fat, ⬇ Calories

Hyper t ension DASH Diet

Kidney Disease ⬇ Protein, ⬆ Calorie, Fluid Controlled

Pancreat it is ⬇ Fat, Small Frequent Feedings

Stroke Mechanical Soft, Regular, or Tube Feeding

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ENTERAL NUTRITION
Enteral Parenteral
Enteral nutrition is used when client has a Parenteral nutrition is used when the GI tract does not function.
partially functioning GI tract. A An IV is inserted into a peripheral vein to supply nutrients.
feeding tubes is placed into the stomach or
intestine through the nasal route or with an
ostomy. Parenteral Nutrition Solutions:

Includes amino acids, dextrose,

Nasoenteric Tubes:
Nasogastric (NG) tube: nose to electrolytes, vitamins, sterile water,
stomach and lipids (fats) are added to the solution.
Nasoduodenal: nose through stomach
and ends in duodenum.
Nursing Actions:
Nasojejunal: nose through stomach and
ends in jejunum. ✓ If PN solution in fridge, allow it to adjust to room temperature
for 1 hr prior to administration.
Ostomies: ✓ Use sterile technique when changing a central line dressing and
Gastrostomy: a percutaneous endoscope tubing or aseptic for other IV tubing or changing a site dressing.
gastrostomy (PEG) tube.
✓ Change bag and IV tubing Q24 hrs.
Jejunostomy: surgical insertion into
jejunal portion of the small intestine ✓ Monitor Blood Glucose Carefully.
(jejunum).
Enteral: Parenteral: tubing
tubing through nasal through vein
Enteral Feeding Formula: passage
Standard “Polymeric”: whole proteins
(milk, meat, eggs). Provide 1-2 cal/mL.
Elemental: nutrients that are partially or
full hydrolyzed.Provide 1-1.5 cal/mL.

Feeding Delivery Methods:

Continuous Infusion: 24 hr period.
Cyclic Feeding: Every 8-20 hrs
Nasogastric
Intermittent Feeding: Every 4-6 hrs
Bolus Feeding: Large volume infused Nasoduodenal Gastrostomy
over 5-30 minutes.
Jejunostomy
Nasojejunal
💦 Flush with 20-50 ml warm water Q4 hrs.
🤮 Check Gastric Residual Q4-6 hrs

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