Module J Nutrition PT 2

 Nutrition
Dietary Planning
 Nur 102
 Module J
 Nov 18, 2009
 Guidelines for Dietary Planning
 A number of guidelines have been established to help in planning for optimal nutrition.
 The Four Basic Food Groups- milk, meat, fruits and vegetables.
 The Food Guide Pyramid- expanded basic four and added fats, oils and sweets.
 Food Pyramid
 Food Pyramid
 Breads, Cereal 6 to 11 servings
 Vegetables 3 to 5 servings
 Fruit 2 to 4 servings
 Milk and Cheese 2 to 3 servings
 Meats and Beans 2 to 3 servings
 Fats, Oils, Sweets Sparingly
 My Pyramid
 Menu Choices
 1. Potato, broccoli with cheese sauce, lettuce salad, tea.
 2. Turkey / cheese sandwich, carrots with dip, apple / raisin salad, milk
 3. Pastry, sausage, hot chocolate.
 Nutrition During Human Growth and Development
Healthy eating is a life long commitment!!
 INFANTS
Trust vs.. Mistrust
 Rapid growth
 Greater water requirements
 Iron supplements
 Toddler
Autonomy vs.. Shame
 Growth rate slows
 Increase protein and minerals
 Bite size pieces
 Preschool
Initiative vs.. Guilt
 Physical activity needs increase
 Protein needs increases
 Likes single foods
 Prone to food jags
 School Age
Industry vs.. Inferiority
 Growth rate slows
 Inconsistent meal pattern
 Adolescent
Identity vs.. Role Confusion
 Rapid growth
 Increase protein and carbohydrates
 Calcium
 Iron
 Adolescent
Identity vs.. Role Confusion
 Rapid growth
 Increase protein and carbohydrates
 Calcium
 Iron
 Adult
 Balanced diet
 Moderation
 Decrease fats
 Increase
complex carbohydrates
 Adult
 Balanced diet
 Moderation
 Decrease fats
 Increase complex carbohydrates
 Adult
 Balanced diet
 Moderation
 Decrease fats
 Increase complex carbohydrates
 Goals
 Fluid Balance
 Knowledge of treatment regimen
 Electrolyte Balance
 Safety
 Sleep
 Adequate Neurological Status
 Effective Bowel Elimination
 Nutritional Assessment
 Diet history / health history
 Physical measurements
 Lab test
 Patient inspection and observation
 Patient Inspection and Observation
Signs of poor nutrition
 Posture
 Weight
 Overall appearance
 General vitality
 Diet History
Meals and snacks per day
Preparation of meals
Food preferences
Food allergies
Food aversions
Bowel habits
Exercise pattern
Knowledge of food groups
 Assessment
 Subjective
 Past Medical History

 Nutrition History
 Elimination History
 Social History
 Neurological History
 Physical Measurements
Height
Weight
Body fat composition
 Assessment
 Objective
 Weight
 Head
 Eyes
 Throat & Mouth
 Cardiovascular
 Urinary System
 Gastrointestinal
 Respiratory
 Neurological
 Skin
 Lab test
Urinary creatinine
Blood urea nitrogen
Albumin levels
 Labs
 Hematocrit (HCT)
 Male: 40-54% Female: 37-47%
 Urine Specific Gravity
 1.010-1.030
 Blood Urea Nitrogen (BUN)
 10-20 mg
 Labs
ELECTROLYTES
CATIONS in mEq/L
 NA+ ---135-145 meq/L
 K+ ----- 3.5-4.5 meq/L
 Ca+2 ---- 4.3-5.3meq/L or 10.5-11 mg/dL
 Mg+2 ---1.5-2.0 meq/L
ANIONS in mEq/L
Cl- ----- 95-108 meq/L
HCO3- - 24-30
PO4-3 --- 1.7-4.6
 Factors Affecting Eating
 Culture/Religion
 Money
 Personal Preference Emotions
 Disease
 Dental Care
 Trauma
 Religious Considerations
 Jewish:
 Don’t mix meat & dairy products at the same meal
 Prohibited Foods:
 All products obtained from pigs: i.e.: pork, bacon, ham, animal shortening, marshmallows
(gelatin)
 Religious Considerations (con’t)
 Catholic:
 Abstain from eating meat & from eating between meals on Ash Wednesday & Good
Friday
 Observe periods of fasting
 Seven-Day Adventist:
 Prohibited Foods: Pork products & shellfish
 Alcoholic beverages
 Church of Jesus Christ of the Latter-Day Saints (Morman):
 Christian:
 Factors Affecting Eating (Cont.)
 Social factors
 Food fads
 Decrease knowledge of nutrition
 Vegetarian
Define
Types
Problems
 Nursing Diagnosis
 Imbalanced Nutrition: less than body requirements
 Imbalanced Nutrition: more than body requirements
 Gas Exchange, Impaired
 Nursing Diagnosis
R/T
 Confusion, Acute or Chronic
 Diarrhea
 Hyperthermia
 Hypothermia
 Impaired Oral Mucous Membranes
 Impaired Skin Integrity
 Fatigue
 Nursing Care Plan
Assessment
Nursing Diagnosis
Goal
Implementation
Evaluation

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 Nutrition

 Nov 18, 2009

 Guidelines for Dietary Planning

 Breads, Cereal 6 to 11 servings

 Milk and Cheese 2 to 3 servings

 Meats and Beans 2 to 3 servings

 Fats, Oils, Sweets Sparingly

 1. Potato, broccoli with cheese sauce, lettuce salad, tea.

 3. Pastry, sausage, hot chocolate.

 Nutrition During Human Growth and Development

Healthy eating is a life long commitment!!

 Greater water requirements

 Growth rate slows

 Increase protein and minerals

 Bite size pieces

 Physical activity needs increase

 Protein needs increases

 Likes single foods

 Prone to food jags

 Growth rate slows

 Inconsistent meal pattern

 Increase protein and carbohydrates

 Increase complex carbohydrates

 Increase complex carbohydrates

 Knowledge of treatment regimen

 Effective Bowel Elimination

 Diet history / health history

 Patient inspection and observation

 Patient Inspection and Observation

Signs of poor nutrition

Meals and snacks per day

Knowledge of food groups

 Past Medical History

Body fat composition

 Throat & Mouth

Blood urea nitrogen

 Male: 40-54% Female: 37-47%

 Urine Specific Gravity

 Blood Urea Nitrogen (BUN)

 NA+ ---135-145 meq/L

 K+ ----- 3.5-4.5 meq/L

 Ca+2 ---- 4.3-5.3meq/L or 10.5-11 mg/dL

 Mg+2 ---1.5-2.0 meq/L

Cl- ----- 95-108 meq/L

PO4-3 --- 1.7-4.6

 Factors Affecting Eating

 Personal Preference Emotions

 Don’t mix meat & dairy products at the same meal

 Religious Considerations (con’t)

 Observe periods of fasting

 Prohibited Foods: Pork products & shellfish

 Church of Jesus Christ of the Latter-Day Saints (Morman):

 Factors Affecting Eating (Cont.)

 Decrease knowledge of nutrition

 Imbalanced Nutrition: more than body requirements

 Gas Exchange, Impaired

 Confusion, Acute or Chronic

 Impaired Oral Mucous Membranes

 Impaired Skin Integrity

 Nursing Care Plan

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