nutrition and fluids copyright © 2012 by mosby, an imprint of elsevier inc. all rights reserved

Nutrition and Fluids

Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

Dietary Practices

The person’s diet affects physical and mental well-being.

A poor diet and poor eating habits:

Increase the risk for infection

Increase the risk of acute and chronic diseases

Cause chronic illnesses to become worse

Cause healing problems

Affect physical and mental function, increasing the risk for accidents and injuries

Culture, finances, and personal choice affect dietary practices.


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Basic Nutrition

Nutrition is the processes involved in the ingestion, digestion, absorption, and use of foods and fluids by the body.

Good nutrition is needed for growth, healing, and body functions.

A well-balanced diet and correct calorie intake are needed.

Foods and fluids contain nutrients.

Nutrients are grouped into fats, proteins, carbohydrates, vitamins, minerals, and water.


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Basic Nutrition (cont’d)

The Dietary Guidelines for Americans, 2010 is for persons 2 years of age and older.

The Dietary Guidelines help people:

Attain and maintain a healthy weight.

Reduce the risk of chronic disease.

Promote overall health.

The Guidelines focus on:

Consuming fewer calories

Making informed food choices

Being physically active


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Basic Nutrition (cont’d) The MyPtate symbol encourages healthy eating from

5 food groups. MyPlate, issued by the United States Department of

Agriculture (USDA), helps you make wise food choices by: Balancing calories Increasing certain foods Reducing certain foods

The USDA recommends that adults do at least one of the following: 2 hours and 30 minutes each week of moderate physical

activity 1 hour and 15 minutes each week of vigorous physical

activity Copyright © 2012 by Mosby, an imprint of Elsevier Inc. All rights reserved.

Slide 5


Nutrients

Protein is the most important nutrient.

It is needed for tissue growth and repair.

Carbohydrates provide energy and fiber for bowel elimination.

Fats provide energy.

They provide and help the body use certain vitamins.

Vitamins are needed for certain body functions.

Minerals are used for many body processes.

Water is needed for all body processes.


Slide 6


Food labels

Food labels are used to make informed food choices for a healthy diet.

Food labels contain information about:

Serving size and the number of servings in each package

Calories and calories from fat

Nutrients

How a serving fits into the daily diet is called the Daily Value (DV).

The DV is a percent based on 2000 calories daily.


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MEETING NUTRITIONAL NEEDS

A team approach is needed to meet a person’s nutritional needs.

The nutritional care plan involves the person’s:

Likes and dislikes

Lifelong habits


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Special Diets

Doctors may order special diets:

For a nutritional deficiency or a disease

For weight control (gain or loss)

To eliminate or decrease certain substances in the diet

The health team considers the need for dietary changes, personal choices, religion, culture, and eating problems.

Regular diet, general diet, and house diet mean no dietary limits or restrictions.


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Special Diets (cont’d)

The sodium-controlled diet Sodium causes the body to retain water.

The heart has to work harder. The extra workload can cause serious problems or death.

Sodium control decreases the amount of sodium in the body.

The doctor orders the amount of sodium allowed. Sodium-controlled diets involve:

Omitting high-sodium foods Not adding salt to food at the table Limiting the amount of salt used in cooking Diet planning


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Diabetes meal plan A meal plan for health eating is developed.

Consistency is key.

The meal plan involves: The person’s food preferences

Calories needed

Eating meals and snacks at regular times

You need to: Serve meals and snacks on time.

Always check what was eaten.

Report what the person did and did not eat.

Report changes in the person’s eating habits.


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The dysphagia diet Dysphagia means difficulty swallowing.

Food thickness is changed to meet the person’s needs. Doctor, speech-language pathologist, occupational

therapist, dietitian, and nurse choose food thickness. When feeding the person with dysphagia, you must:

Know the signs and symptoms of dysphagia. Feed the person according to the care plan. Follow aspiration precautions and the care plan. Report changes in how the person eats. Observe for signs and symptoms of aspiration:

choking, coughing, or difficulty breathing during or after meals, and abnormal breathing or respiratory sounds. Report these observations at once.


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Fluid Balance

Death can result from too much or too little water.

Fluid balance is needed for health.

The amount of fluid taken in (intake) and the amount of fluid lost (output) must be equal.

If fluid intake exceeds fluid output, body tissues swell with water. This is called edema.

If fluid output exceeds intake, dehydration occurs.


Slide 13

Fluid Balance (cont’d)

Normal fluid requirements

An adult needs 1500 mL (milliliters) of water daily to survive.

About 2000 to 2500 mL are needed for normal fluid balance.

The water requirement increases with:

Hot weather

Exercise

Fever and illness

Excess fluid losses


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Common special fluid orders are:

Encourage fluids: the person drinks an increased amount of fluids.

Restrict fluids: fluids are limited to a certain amount.

Nothing by mouth (NPO): the person cannot eat or drink anything.

Thickened liquids: all fluids are thickened, including water.


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Intake and output (I&O) records The doctor or nurse may order (I&O) measurements.

I&O records are kept: To evaluate fluid balance and kidney function

To help in planning medical treatment

When the person has special fluid orders

The following fluids are measured and recorded: All fluids taken by mouth

Foods that melt at room temperature

IV fluids and tube feedings

Output includes urine, vomitus, diarrhea, and wound drainage.


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Measuring intake and output

Intake and output are measured in milliliters (mL).

A measuring container for fluid is called a graduate.

The measuring device is held at eye level to read the amount.

An I&O record is kept at the bedside.

Amounts are totaled at the end of the shift.

The purpose of measuring I&O and how to help are explained to the person.

The urinal, commode, bedpan, or specimen pan is used for voiding.


Slide 17

Meeting Food and Fluid Needs

The following can affect appetite and ability to eat:

Weakness, illness, and confusion

Unpleasant odors, sights, and sounds

An uncomfortable position

The need for oral hygiene

The need to eliminate

Pain


Slide 18

Meeting Food and Fluid Needs (cont’d)

Preparing for meals

To promote comfort when preparing patients and residents for meals:

Assist with elimination needs.

Provide oral hygiene.

Make sure needed dentures are in place.

Make sure eyeglasses and hearing aids are in place (if worn).

Make sure incontinent persons are clean and dry.

Position the person in a comfortable position.

Assist the person with hand washing.


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Serving meals

You serve meals after preparing patients and residents for meals.

Some agencies have “room service” meal programs.

Serve meals in the assigned order.

If food is not served within 15 minutes, re-check food temperatures.


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When feeding the person: Serve food and fluids in the order the person prefers.

Offer fluids during the meal.

Use teaspoons to feed the person.

Let the person do as much as possible.

Always tell the visually impaired person what is on the tray.

When feeding visually impaired persons, describe what you are offering. For persons who feed themselves, describe foods and fluids and their

places on the tray.

Use the numbers on a clock for the location of foods.


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Allow time and privacy for prayer.

Engage the person in pleasant conversation.

Allow time for chewing and swallowing.

Sit facing the person.

You can see how well the person is eating.

You can also see if the person has problems swallowing.


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Between-meal nourishments Snacks are served upon arrival on the nursing unit.

Follow the same considerations and procedures as for serving meals and feeding persons.

Calorie counts On a flow sheet, note what the person ate and how much.

A nurse or dietitian converts the portions into calories.

Providing drinking water Patients and residents need fresh drinking water each shift and

whenever the pitcher is empty.

Follow the agency’s procedure for providing fresh drinking water.


Slide 23

Foodborne Illnesses

A foodborne illness (food poisoning) is caused by pathogens in food and fluids.

Report signs and symptoms to the nurse at once.

Food is not sterile.

Pathogens are present when food is purchased.

Foods can become contaminated from other foods.

Food handlers with poor hygiene can contaminate the food.

Pathogens grow rapidly between 40 F and 140 F.

This range is called the danger zone by the USDA.


Slide 24

Foodborne Illnesses (cont’d)

To keep food safe, the USDA recommends these 4 safety tips. Clean.

Wash hands, utensils, and counter tops often.

Separate. Avoid cross-contamination.

Cook. Cook food to a safe internal temperature.

Re-heat cooked food to 165 F.

Chill. Refrigerate or freeze food within 2 hours.

If the air is 90 F or above, chill food within 1 hour.


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nutrition and fluids copyright © 2012 by mosby, an imprint of elsevier inc. all rights reserved

Documents

imprint of elsevier

body processes

healthy diet

certain body functions

poor diet

daily diet

certain vitamins

good nutrition