Fundamentals of Nursing

Nutrition

Physiology of Nutrition
Nutrition is the process by which the body
metabolizes and utilizes the nutrients from
food.
Nutrients are digested by the GI system and
then absorbed by the blood or lymphatic
system, and transported to the bodys cells.

Physiology of Nutrition
Digestion is the process by which ingested
foods are broken down in the GI tract to
smaller segments in preparation for
absorption.
The end products of digestion are
monosaccharides (simple sugars), amino
acids, glycerol, fatty acid chains, vitamins,
minerals, and water.

Physiology of Nutrition
Absorption : is the process by which the end
products of digestion pass through the
epithelial membranes in the small and large
intestines into the blood or lymph systems.

Physiology of Nutrition
Metabolism is the aggregate of all chemical
reactions and processes in every body cell,
such as growth, generation of energy,
elimination of wastes, and other bodily
functions as they relate to the distribution of
nutrients in the blood after digestion.
Metabolic rate refers to the rate of heat
liberation during chemical reactions.

Metabolism
Energy
A calorie is the unit of measurement used to
express the quantity of energy released
during metabolism.
Energy is expressed in terms of kilocalories.
Basal metabolic rate (BMR) represents the
energy needed to maintain essential
physiological functions.

Metabolism
Excretion
Digestive and metabolic waste products are
excreted through the intestines and rectum.
Other excretory organs are the kidneys,
sweat glands, skin, and lungs.

Nutrients

Water
Vitamins
Minerals
Carbohydrates
Proteins
Lipids

Nutrients
Water
Accounts for 60% to 70% of an adults total
body weight and 77% of an infants weight.
Water and electrolytes are substances that
must be acquired from the diet.
Body water requirements are met through
consumption of liquids and foods and the
oxidation of food.

Nutrients
Vitamins
Organic compounds that aid in the
regulation of cellular metabolism and assist
in the biochemical processes that release
energy from digested food
Vitamins are classified as fat-soluble or
water-soluble.

Nutrients
Carbohydrates
Organic compounds composed of carbon,
hydrogen, and oxygen
Primary source of energy for the brain and
the preferred fuel for the body

Nutrients
Carbohydrates
Monosaccharides (simple sugars) include
glucose, galactose, and fructose.
Disaccharides (double sugars) include
sucrose, lactose, and maltose.
Polysaccharides (complex sugars) include
glycogen, cellulose (fiber), and starch.

Nutrients
Proteins
Organic compounds that contain carbon,
hydrogen, oxygen, and nitrogen atoms
combine to form proteins.
Essential for almost every bodily function.

Nutrients
The end products of protein digestion are
amino acids which categorized to:
Nonessential amino acids: can be
synthesized in the body.
Essential amino acids must be ingested in
the diet because they cannot be
synthesized in the body.

Nutrients
Lipids (fats)
Organic compounds are the only essential
nutrients that cannot mix with water and
therefore, must be emulsified by molecules
to be absorbed.
Fats are lipids that are solid at room temp.
Oils are lipids that are liquid at room temp.

Nutrients
Most Important Lipids
Triglycerides are composed of three fatty
acid cells attached to a glycerol molecule.
Phospholipids are composed of one or more
fatty acid molecules and one phosphoric
acid radical; they usually contain a
nitrogenous base.
Cholesterol is produced by the body and is
considered a fat; it is also found in whole
milk and egg yolk.

Promoting Proper Nutrition

The Food Guide Pyramid outlines six groups of
food and the number of servings based on
dietary guidelines and the basic four food
groups.

Promoting Proper Nutrition

Societal Concerns
One-third of the U.S. population is
considered overweight.
Obesity is becoming an epidemic.
Undernutrition is a specific problem for the
elderly and for people with eating disorders.

Weight Management
Overweight is an energy imbalance in
which more food is consumed than needed.
An underweight person expends more
calories than are consumed.

Factors Affecting Nutrition

Age
Lifestyle
Ethnicity, Culture
Religious Practices
Economics
Gender
Medication

Assessment
Nutritional History

24-hour recall
Difficulty eating
Changes in appetite
Diet history & preferences
Changes in weight
General health & medical history

Assessment
Physical Examination
Intake and Output (I & O)
Anthropometric Measurements
- Skinfold measurements: used to determine fat stores
- Mid-upper-arm circumference: measures fat, muscle
& bone
- Abdominal-girth measurement

Assessment
Measuring the midupper-arm
circumference

Nursing Diagnoses
Imbalanced Nutrition: Less Than Body
Requirements
Imbalanced Nutrition: More Than Body
Requirements or Risk for More Than
Body Requirements

Other Nursing Diagnoses

Activity Intolerance
Acute Pain
Ineffective Health Maintenance
Constipation
Impaired Swallowing

Implementation
Monitoring Weight and Intake
Diet Therapy

Nothing by Mouth (NPO)

Clear-Liquid diet
Full-Liquid diet
Soft diet
Diet as tolerated

Implementation
Diet Therapy

Low-residue
High-fiber
Liberal bland
Fat-controlled
Sodium-restricted
Lactose intolerance

Implementation
Assistance with Feeding
Providing Nutrition Support
Nutrition Support Teams

Implementation
Providing Enteral Nutrition: is an
alternative method to give adequate
nutrition used when the client is unable to
ingest foods or the GI tract is impaired.
Feeding tubes (e.g nasogastric tube)
Insertion of enteral feeding tubes
Enteral formulas

Enteral Feeding Routes

Implementation
Administration of Enteral Feedings

Can be intermittent or continuous

Safety considerations
Potential complications
Removal of a nasogastric tube

Implementation
Administering Medication through a
Feeding Tube

Types of feeding tubes

Checking for tube placement
Checking the patency of tube
Clearing the tubing of formula
Flushing the port
Measuring intake and output

Implementation
Providing Total Parenteral Nutrition (TPN)
Intravenous infusion of a solution directly into
a vein to meet the clients daily nutritional
requirements
Used to treat malnourished clients or clients
who have the potential for becoming
malnourished and who are not candidates for
enteral support.

Implementation
Components of Parenteral Nutrition
Carbohydrates found primarily in form of
dextrose
Amino acids
Lipids (fat emulsions)

Implementation
Complementary Therapy
Nutrition is integrated as part of the
therapeutic regimen of numerous types of
complementary therapies.
Diet and nutrition are used by many
alternative modalities for the prevention and
treatment of chronic diseases.

Evaluation
Current data is used to measure
achievement of goals and outcomes.
The plan of care is modified to maximize the
clients response to therapy.