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Nutrition (Definitions (anorexia - lack or loss of appetite for food,…

- - - - dietary dara (24 hour recall, food frequency record, food diary/calorie count
    - - anthropometric and clinical data, height and weight, aphasia, difficulty swallowing, access to food -- measure waist circumference @ belly button line
    - - protein status, body vitamin, mineral, and trace elements status
  - - - Clear - not nutritionally sound -- broth, gelatin, popsicles, carbonated beverages, coffee and tea
      - Full - clears plus milk, pudding/custard, w/ liquid supplements
  - - - small, frequent meals
      - determine favorite foods, but consider needs
      - consider environment and plate
      - manage nausea, pain, and depression
    - - involve pt
      - provide assistance only to level needed (supervise, open containers, cut food, actually feed
    - - NG or NI route
        
        CONFIRM PLACEMENT
        
        radiographic exam
        
        measure aspirate pH and visual assessment
        
        measure tube length and marking
        
        CO2 monitoring
        
        confirm NI tube placement
    - - enterostomal tube may be placed
      - gastronomy is preferred route to deliver enteral nutrition in comatose pt
      - Complications of TPN
        
        insertion problems
        
        infection/sepsis
        
        metabolis alterations
        
        fluid, electrolyte, and acid-base imbalances
        
        phlebitis
        
        hyperlipidemia
        
        liver and gallbladder disease
  - - - liquid diet, isotonic, nutritionally complete -- GOES DIRECTLY INTO STOMACH OR JEJUNUM
      - Access indirectly through nose or mouth or directly -- can be temporary or permanent
      - high risk for aspiration or inadvertent extubation
- - - - Infants
        
        most rapid growth -- solid foods not until 6 months, cows milks not until 1+ -- 1 year should eat table food
      - Toddlers/preschool
        
        muscle mass and bone density increase -- appetite decreases and is erratic -- attitudes (likes/dislikes) develop
      - School-aged
        
        uneven growth pattern - body accumulates reserves to prep for adolescents - increased energy balanced with high nutrition foods
      - Adolescents
        
        rapid physical, emotional, social, and sexual maturation -- weight consciousness (anorexia nervosa, bulimia, drug abuse
      - Adults
        
        decline in BMR w/ each decade -- nutritional needs level off
      - Pregnant/Lactating women
        
        weight gain and GI changes -- nutrient needs increase esp in 2nd and 3rd trimester
      - Older adults
        
        decrease in BMR, physical activity, and mass -- loss of taste, decrease in peristalsis, -- caloric needs decrease but certain nutrients increase -- prone to dehydration
    - - men need more than women
    - - eating disorders, stress
    - - affects liver which affects metabolism -- drinks instead of eats