REPUBLIC OF THE PHILIPPINES

NORTHERN NEGROS STATE COLLEGE OF SCIENCE AND TECHNOLOGY

OLD SAGAY, SAGAY CITY, NEGROS OCCIDENTAL
(034)722-4169/www.nonescost.edu.com

COLLEGE OF NURSING
AND ALLIED HEALTH
SCIENCES
COURSE MODULE IN

NUTRITION AND
DIET THERAPY
1 Semester; A.Y. 2021 – 2022
st

COURSE FACILITATOR: LUDA G. SANTILLANA, RND, MBA

FB/MESSENGER: Ludababes Mercado Ganancial Santillana
Email: ludaganancial@gmail.com
Phone No: 09215163739

This document is a property of NONESCOST

Unauthorized copying, uploading, and / or editing is prohibited. (For Classroom Use Only)
MBA
MODULE
Module 3 | Page 1
Prepared by: Luda G, Santillana, RND,
Name: KIZA GRACE P. GAURANA Year & Section: BSN 2B - MERCER

Activity 1: What are the respective roles of the physician, nurse and dietitian in the dietary
care of the patient? Explain. (20 points).

 According to what I’ve learned, physician, nurses as well as dietitian work accordingly with joint
responsibility to promote good dietitian care. Physicians prescribed the good and healthy diet
needed for the patient to intake. Physicians being the game-changer, makes conclusions throughout
the sighted problem and give solutions afterwards. Physicians must remember that every patient
has food issues and from what I’ve read, individualization is the key to successful dietary
management. Nurses and dietitian work together to give nutrition intervention to the patient. The
process includes assessment, planning, implementation, and evaluation. Furthermore, assessing,
monitoring, and counselling activities are usually done in collaboration with every healthcare
department. Physicians, nurses, and dietitians not only need to encourage patients to make major
lifestyle changes, they have the obligation to do so, and must include in their consideration those
family members who may not be in the examination but who are put at risk by bad food habits. To
sum up, the nurse is often the coordinator between the physicians and other clinicians, because she
is always available to the patient 24/7 (24 hours every day of the week) and all year round. Nursing
staff implements physician orders and protocols in nutrition care, like diet orders, nutrition support,
and feeding of the patients. At the bedside, nursing staff observes the patient food intakes, response
to feeding methods, like complaints about meals and documentation as needed for intake and
output of food and liquids, and bowel movement. Orders for laboratory test (x-rays, blood chemistry,
urinalysis, etc.) are delivered to the department concerned. Nurses update the patient’s
binder/medical records which are legal documents. They perform initial assessment and daily vital
data like weights, pulse, body temperature, blood pressure, and blood glucose tests for persons with
diabetes. Because of their multiple tasks pertinent to diet therapy, nursing staff should know the
definitions of common terms and basic concepts used by the Registered Nutritionist and Dietitian.

ACTIVITY 2:
1. Describe how diets are modified. (10 points).
• Diets are modified based on the changes made during food preparation, processing, and
consumption to increase the bioavailability of micronutrients—and reduce micronutrient deficiencies—in
food at the commercial or individual/household level. According to Gibson (2014), one example of dietary
modification is the simultaneous consumption of iron-rich foods with ascorbic acid (vitamin C) which
increases the amount of iron absorbed by the body. Decreasing the amount of coffee and tea consumed
with meals containing iron-rich foods is another example of dietary modification, because coffee and tea
inhibit iron absorption.
2. Explain the basis of modification. (10 points)

• I think the basis would be the measurement of the food, the nutritional intake (Carbohydrates,
Proteins, and Fats), and the diseases involved. As what I’ve noticed in the tables shown above, the diets
are modified through the consistency whether it is liquid or solid, through composition whether it is calorie
deficiency, protein deficiency, the fats and the lipids and so on.

Activity 3:
1. What are the different methods of introducing nourishment to the body? Give advantages and
disadvantages of each. (5 points)
• Enteral Method
Advantages:
Intraluminal Effect or the presence of absorption of nutrients in the GIT help prevent atrophy of the
This document is a property of NONESCOST Module 3 | Page 2
Unauthorized copying, uploading, and / or editing is prohibited. (For Classroom Use Only)
Prepared by: Luda G, Santillana, RND, MBA
intestinal mucosa
Safety – there is less chance of infection
Normal insulin – glucagon ration
Reduced cost – feeding by the enteral route requires less staff and equipment
Disadvantages:
Diffuse peritonitis
Intestinal obstruction
Intractable vomiting
Severe diarrhea with or without malabsorption
Client does not desire aggressive nutrition support
• Parenteral Method
Advantages:
Help people with conditions that result from low blood flow to their bowels
Delivers nutrients such as sugar, carbohydrates, proteins, lipids, electrolytes, and trace elements to the
body
Vital in maintaining high energy, hydration, and strength levels
Disadvantages:
changes in heartbeat, confusion, convulsions or seizures, difficulty breathing, fast weight gain or weight
loss, essential to maintain clean tubing, needleless access ports, catheters, and other equipment to
minimize these risks
• Total Parenteral Nutrition (TPN)
Advantages:
Can help save the lives of underweight or sick infants who are unable to process food taken by mouth or
given by tube feedings to the GI tract
Offers a more effective way for these babies to meet their nutritional needs than through water-based IV
feedings
Disadvantages:
Parenteral nutrition should not be used routinely in patients with an intact gastrointestinal (GI) tract. It
causes more complications. It does not preserve GI tract structure and function as well. It is more
expensive.

2. List possible actions that might be taken to correct the following in a tube-fed patient: (10 points)
a. Hyperglycemia
- Regularly monitor fluid, electrolyte and metabolic parameters, and adjust formula accordingly
b. Dehydration
-Provide adequate fluids
c. Constipation
-Reduce feeding rate and determine the cause

3. Distinguished between: (10 points)

a. Blenderized vs. commercial prepared tube feedings.
- Blenderized tube feeding (BTF) is defined as the use of blended foods and liquids given directly via the
feeding tube, while commercial prepared tube feedings is the industry term used for a production-ready
beverage recipe. Commercializing your beverage recipe provides contract manufacturers with the
necessary details required to scale and produce your beverage in a consistent, efficient, and safe manner.
b. Parenteral vs. intravenous feedings
- Parenteral nutrition, or intravenous feeding, is a method of getting nutrition into your body through your
veins. Depending on which vein is used, this procedure is often referred to as either total parenteral
nutrition (TPN) or peripheral parenteral nutrition (PPN).

Activity 4:
This document is a property of NONESCOST Module 3 | Page 3
Unauthorized copying, uploading, and / or editing is prohibited. (For Classroom Use Only)
Prepared by: Luda G, Santillana, RND, MBA
 1. What are the basic principles of a sound food plan for weight control? (10 points)
 - Health risks of Overweight/Obesity

The greater the degree of excess body weight, the greater the:
• Risk of developing such diseases as hypertension, hyperlipidemias, cardiovascular disease,
osteoarthritis, diabetes mellitus, respiratory disease, cholecystitis, and certain forms of cancer.
• Surgical risk.
• Obstetrical risk (for women)
• Proneness to accidents
• Reduction in physical mobility and resistance to fatigue
• Reduction to life expectancy
 Health risk of Underweight
The greater the degree of underweight, the greater the:
• Predisposition to infectious diseases
• Likelihood of other nutritional deficiencies (e.g. protein, vitamins and minerals)
• Surgical and obstetrical risk
• Likelihood of low birthweight babies (in pregnant women)
• Reduction in physical work capacity
• Reduction in life expectancy

2. List guidelines for weight loss versus weight gain. (10 points)

WEIGHT LOSS

• Group therapy – has been found effective

• Formula diets. Nutritionally adequate formulas that provide the number calories required are
convenient but expensive and monotonous, hence suitable for long term management.
• Very low calories diets (VLCDs) – formula diets that provide only 400-600 kcal but otherwise
nutritionally adequate; useful when an immediate reduction in weight is necessary for medical purposes
(e.g. in preparation for surgery) but not for long term use. Side effects include ketosis.
• Herbal preparations. Touted as “natural”, actually, some of these natural substances in herbs may
be toxic if ingested in large amounts.
• Food diets. These are those that over emphasize one nutrient (e.g. high fat, high protein), unduly
restrict calories (zero calories; starvation diets), specify foods to eat each meal (3-day diet, no
substitutions), specify abnormal patterns (“nibbling diet: no food after 6:00 PM), are named after persons
(Atkin’s Diet), Clinics (Mayo) or places (Beverly Hills).
 Most are without scientific basis.
 Some produce short term effects but may have detrimental effects in the long run, including
nutritional deficiencies.
 Others are so restrictive and monotonous, making long term compliance difficult, if not impossible.
 People who try one fad after another (yoyo dieting) go on cycles of weight loss and weight gain
which is more detrimental to health.

WEIGHT GAIN

 Increase food intake gradually to avoid gastric upsets and spells of discouragement.
 Emphasize calorie-dense foods so as not to unduly increase the bulk of the diet.
 A well selected varies diet will provide adequate vitamins and minerals but supplementation is
desirable in cases of deficiencies.
 Three meals with light snacks (so as not to impair appetite at the next meal) are desirable to
establish a normal eating pattern. However, some patients do better on small frequent feedings.

This document is a property of NONESCOST Module 3 | Page 4

Unauthorized copying, uploading, and / or editing is prohibited. (For Classroom Use Only)
Prepared by: Luda G, Santillana, RND, MBA
Activity 5: Plan a Menu for a day for a low-fiber, high-protein, high-calorie diet (100 g protein,
2800 Kcal). What illness will benefit from this diet? Use Food Exchange List for your
menu. (25 points).

NO. OF APPROXIMATE SIZE

FOOD EXCHANGES EXCHANGES SAMPLE MENU
PER SERVING
Breakfast

Fruit 2 Papaya 2 slice (10x6x2cm)

Milk 1 Low fat, powdered milk ¼ cup or 4 tablespoon or
30 g.
Rice or substitute 5 Cooked Rice 1 cup or 80 g
Meat, Fish or substitute 2 Longganisa 2 pcs. (7x3x0.5cm)

Fat 1 Scrambled egg cooked 1 tablespoon

with oil
Mid – AM Snack

Rice or substitute 2 Budbod 1 cup or 80 g

Sugar 1 For budbod 4 tablespoon or 30 g
Lunch

Soup
Veg. A 2 Squash, Eggplant, String 1 cup, pinakbet cooked
Beans,Okra, Upo for
Pinakbet
Veg. B
Fruit 1 Ripe, Mango 1 slice

Rice or substitute 3 Cooked rice 1 cup, packed or 80 g

Meat, Fish or substitute 2 Fried Tilapia 1 medium (50g)
Fat
Mid – PM Snack

Rice or substitute 2 Cassava cake 80 g

Sugar
Dinner/Supper

Soup
Veg. A
Veg, B 1 Radish, Eggplant, string 1 cup or 80 g
Beans for Sinigang
Fruit
Rice or substitute 3 Cooked rice 1 cup
Meat, Fish or substitute 2 Pork sinigang 1 cup of soup; 1 slice of
pork
Fat
Bed-Time Snack

Milk 1 low fat, powdered milk ¼ cup or 4 tablespoon or

30 g
Rice or substitute 1 Kamote delight 50 g
Sugar

This document is a property of NONESCOST Module 3 | Page 5

Unauthorized copying, uploading, and / or editing is prohibited. (For Classroom Use Only)
Prepared by: Luda G, Santillana, RND, MBA
 Diet Rx = 2,7999 Kcal; 433 g CHO, 103 g CHON, 80 g Fats

NO. OF CHO CHON FATS

FOOD Kcal
EXCHANGES (g) (g) (g)
Veg. A 2 3 1 - 16
Veg. B 1 3 1 - 16
Fruit 3 30 - - 120
Milk (low fat) 2 24 16 10 250
CHO Partial sum = 60

(prescribed CHO) 420 g

(partial sum CHO) -60 g
360g ÷ 23
no. of rice exchanges =16

Rice 16 368 32 - 1600

CHON Partial sum = 50g

(prescribed CHON) 100 g

(partial sum CHON) -50 g
50g ÷8
no. of meat exchanges = 6

Meat
High Fat 6 - 48 60 732
FATS Partial sum = 70 g

(prescribed FATS) 80 g
(partial sum FATS) -70 g
10 g ÷ 5
no. of fats exchanges = 2
Fat 2 - - 10 90

Sugar 1 5 5 5 20
TOTAL: 433g 103 g 80 g 2,799 Kcal

This document is a property of NONESCOST Module 3 | Page 6

Unauthorized copying, uploading, and / or editing is prohibited. (For Classroom Use Only)
Prepared by: Luda G, Santillana, RND, MBA
Activity 6:
1. Point out the similarities in the dietary principles for pre-operative and postoperative care. (5 points).
The principles of both pre-operative and post-operative care are maintaining the nutrition of the patient,
to improve nutriture of the patient and to prepare him/her for nutrients loss during surgery. Furthermore, the
pre-operative nutrition points out to ensure adequate energy stores to meet the demands of the stress
state, while the post-operative nutrition is to promote nitrogen balance, reduce the loss of lean mass, and
facilitate rapid healing and recovery.

2. Cite specific vitamins and minerals and their respective roles in post-surgical rehabilitation. (5
points)
 Your ability to heal after surgery will depend on having proper blood flow to the surgical site. Vitamin
C will help you heal from the trauma that is part of your surgery. Vitamin C allows blood vessels to be
relaxed and open. You will deliver the most amount of blood to your injured tissues if you have enough
vitamin C. Blood flow to injured areas is central to how well we heal. After surgery your circulation will be
slowed by inactivity. If you have atherosclerosis or hardening of the arteries, your blood vessels are less
able to relax. This adds to the challenge of recovering after an operation.

 Vitamin E has been shown to improve immune system functions that decline as people age. It helps
increase blood flow. It does this by preventing blood clots and relaxing blood vessel walls. Doctors want
their patients to take vitamin E supplements for optimal recovery after surgery.

Activity 7:
For 20 points.
Give 5 functions in each metabolic functions of the Liver:
a. Ensures a constant supply of energy to living cells
b. Interconversion of Carbohydrates
c. Breaks down glucose via glycolysis
d. Helps maintain a constant blood sugar level
e. Maintains Glucose levels on a normal range
1. Carbohydrates Metabolism.
a. Ensures a constant supply of energy to living cells
b. Interconversion of Carbohydrates
c. Breaks down glucose via glycolysis
d. Helps maintain a constant blood sugar level
e. Maintains Glucose levels on a normal range

2. Fat Metabolism

a. Breaks down Fat

b. Contributes in increased endurance
c. Prevents fat absorption
d. Increases capacity to utilize energy from fats
e. Synthesizes new lipids from smaller constituent molecules

3. Protein Metabolism
a. Synthesizes Proteins and Amino acids
b. Breakdown proteins by Catabolism
c. Removes Nitrogenous waste products
d. Balance the protein needed in the body
e. Synthesizes new proteins for Fluid and Electrolyte balance

This document is a property of NONESCOST Module 3 | Page 7

Unauthorized copying, uploading, and / or editing is prohibited. (For Classroom Use Only)
Prepared by: Luda G, Santillana, RND, MBA
4. Other Related Functions
a. Converts excess carbs and protein into fatty acids and triglycerides
b. Forms lipoproteins for transport of fatty acids
c. Synthesizes cholesterol from acetyl CoA
d. Beta oxidation
e. Converts excess acetyl CoA to ketone bodies for release to tissue cells.

Activity 8 : For 20 points.

CASE: A rural farmer is obese by 20 kilos, has high blood pressure and eats lot of rice, salted egg and fish,
and dips his vegetables in patis and bagoong.
How will you as nurse to motivate him to comply with a low sodium diet (500 mg/day)?

As a student nurse, I will improve the farmer’s capacity to understand about the possible risk the farmer
might get if he continues his food lifestyle. Knowing that he is obese, ensuring him that the more he weigh,
the more blood he need to supply oxygen and nutrients to his tissues. As the amount of blood flow through
your blood vessels increases, so does the pressure on the artery walls. To add up, the farmer must
comprehend that too much sodium in his diet can cause his body to retain fluid, which increases blood
pressure. If possible, he will avoid or limit excessive intake of sodium, instead I will introduce him a meal
plan which has more protein, vitamins, and mineral contents and has a restricted carbohydrate and sodium
consumption with a maximum of 500 mg/day, it is one of the different ways in which it can help him to
reduce the risk of chronic lifestyle diseases.

Activity 9: For 5 points each.

1. Explain briefly how the metabolism of protein, fat and carbohydrate is altered in
diabetes.
o The main effect of diabetes to the metabolic functions of the liver is the decrease in insulin levels
which prevents the body in storing energy from foods for later use.

2. Enumerate the outstanding symptoms of diabetes. Give the different laboratory test
that may help in the diagnosis of the disease condition.
o Often Urination

o Thirst

o Weight loss without exercise

o Blurry vision

o Numbness of hands and feet

o Feeling Tired

o Dry Skin

Lab Tests:

 Fasting Plasma Glucose Test (FPG)

 Hemoglobin A1c Test

 Oral Glucose Tolerance Test (OGTT)

This document is a property of NONESCOST Module 3 | Page 8

Unauthorized copying, uploading, and / or editing is prohibited. (For Classroom Use Only)
Prepared by: Luda G, Santillana, RND, MBA
 3. What are the main objectives to be considered in the management of diabetes?
o The main objectives are to avoid acute decompensation, prevent or delay the appearance of late
complications, decrease mortality rate, and maintain a good quality life.

4. Differentiate hypoglycaemia from diabetic ketoacidosis. What are their characteristics

symptoms?
a. Hypoglycemia is the condition where the blood glucose levels are too low and the insulin levels are
too high while the Insulin levels of DKA (Diabetic Ketoacidosis) are low also known as insulin
deficiency. Symptoms of hypoglycemia are feeling tired, dizziness, sweating, hunger, tingling lips, and
trembling. Symptoms of DKA are excessive thirst, frequent urination, stomach pain, and shortness of
breath.

Activity 10: For 10 points

Due to potassium and sodium restrictions on renal diseases, give cooking tips as many as you can, to
reduce potassium and sodium content of food.

Answer: To reduce the potassium and sodium content of the food you'll need to know which food have
high potassium and sodium. However, we can't totally choose what food not to eat because other food has
high potassium but still it carries different supplements that needed in our body. Instead blanching is the
best way in preparing good to reduce the potassium. Also, instead of making dishes as stir fries, pies and
others you can use a mixture of lower potassium vegetables with a small amount of onion and mushrooms.
Blanching your vegetables in boiling water for 1 minute before using in cooking will also help reduce the
potassium content. Aside from that grilling, braising, roasting, searing, and sautéing can reduce sodium
content because it will bring out natural flavors.

Activity 11: For 10 points.

Proposed a Guide to Lower Cancer Risk.

Answer: To lower the cancer risk, we must be conscious of the food we’ve consumed and have a healthy
diet. We must consider the following:
 Eat plenty of fruits and vegetables. Based your diet on fruits, vegetables, and other foods from plant
sources such as whole grains and beans.
 Maintain a healthy weight. Eat lighter and leaner by choosing fewer high-calorie foods, including
refined sugars and fat from animal sources.
 If you choose to drink alcohol, do so only in moderation. The risk of various types of cancer,
including cancer of the breast, colon, lung, kidney, and liver, increases with the amount of alcohol you drink
and the length of time you've been drinking regularly.
 Limit processed meats. A report from the International Agency for Research on Cancer, the cancer
agency of the World Health Organization, concluded that eating large amounts of processed meat can
slightly increase the risk of certain types of cancer.
 Furthermore, a Mediterranean diet supplemented with extra-virgin olive oil and mixed nuts may
lower the incidence of breast cancer in women. Plant-based foods, such as fruits and vegetables, whole
grains, legumes, and nuts, are the mainstays of the Mediterranean diet. Healthy fats such as olive oil are
preferred over butter by Mediterranean dieters, while fish is preferred over red meat.

Specified the Five Nutritional Guidelines for the Prevention of Cancer among
Filipinos.

Answer:
1. FNRI-DOST, Pinggang Pinoy "Healthy food plate for Filipino adults"
2. Stages of Cancer Therapy and Nutritional Objectives
3. Dietary Management of Cancer/ American Society Guideline for Diet and Physical Activity
This document is a property of NONESCOST Module 3 | Page 9
Unauthorized copying, uploading, and / or editing is prohibited. (For Classroom Use Only)
Prepared by: Luda G, Santillana, RND, MBA
4. General Guidelines in Feeding Cancer Patients
5. Dietary Recommendations for Reducing Cancer Risk

Activity 12: For 10 points.

An individual was diagnosed of osteoarthritis. The doctor recommends NSAID. What other information do
you need? What kind of nutrition management does this individual need?

Answer:
Non-steroidal anti-inflammatory drugs (NSAIDs) are medicines that are widely used to relieve pain, reduce
inflammation, and bring down a high temperature. It is not possible for specific foods or nutritional
supplements to cure osteoarthritis, but, certain diets can improve people’s symptoms. Some foods have
anti-inflammatory capabilities which can help reduce symptoms while other foods may amplify them.

The right diet can help to improve osteoarthritis in the following ways:

 Reducing inflammation and preventing damage.

A balanced, nutritious diet will give the body the tools it needs to prevent further damage to the joints,
which is essential for people with osteoarthritis. Some foods are known to reduce inflammation in the body
and following an anti-inflammatory diet can improve symptoms. Eating enough antioxidants, including
vitamins A, C, and E, may help to prevent further damage to the joints.

 Reducing cholesterol
People with osteoarthritis are more likely to have high blood cholesterol and reducing cholesterol may
improve the symptoms of this disease. On the right diet, people can quickly improve their cholesterol
levels.

 Maintaining a healthy weight

Being overweight can put extra pressure on the joints, and excess fat stores in the body can cause further
inflammation. Maintaining a healthy weight can lessen the symptoms of osteoarthritis. Keeping to a healthy
weight can be difficult for some people, especially those who have a medical condition that reduces their
mobility, such as osteoarthritis. A doctor or dietitian will be able to provide advice.

 Dairy
Milk, yogurt, and cheese are rich in calcium and vitamin D. These nutrients increase bone strength, which
may improve painful symptoms. Dairy, also contains proteins that can help to build muscle. People who are
aiming to manage their weight can choose low-fat options.

 Dark leafy greens

Dark leafy greens are rich in Vitamin D and stress-fighting phytochemicals and antioxidants. Vitamin D is
essential for calcium absorption and can also boost the immune system, helping the body to fight off
infection. Dark leafy greens include spinach and broccoli because it can slow down the progression. Of
osteoarthritis.

Activity 13: For 10 points.

What are the causes of COPD and the measures to prevent it?

Answer: COPD is caused by several factors, including unhealthy habits like smoking and exposure to
pollutants in the air. Additionally, pulmonary dysfunction is exacerbated by insufficient or inappropriate
dietary intake. To avoid this, we must recognize that, while nutritional intervention cannot prevent
pulmonary disease, it can improve pulmonary function by providing nutrients required for respiratory
function in a way that puts the least amount of stress on respiratory capacity, implying that dietary
management could be one of our disease prevention strategies.

Activity 14: For 20 points.

This document is a property of NONESCOST Module 3 | Page 10
Unauthorized copying, uploading, and / or editing is prohibited. (For Classroom Use Only)
Prepared by: Luda G, Santillana, RND, MBA
What is the difference between Alzhiemer’s Disease and Parkinson’s Disease in their nutrition intervention
(nutrition therapy).

Answer:
Alzheimer's disease is primarily a dementia-related disorder from progressive cognitive deterioration and
memory impairment, while Parkinson's disease is primarily a movement disorder illness having movement
disorder symptoms, bradykinesia (slowness of movements), hypokinesia (reduction of movement
amplitude), and akinesia (absence of normal unconscious movements) along with muscle rigidity and
tremor at rest. People with AZ need to eat high caloric diet and they can still eat without strict way of
serving foods such as proper slicing of ingredients. On the other hand, people with PD may eat less and
lose weight because of difficulty swallowing, nausea from medications or movement symptoms that make it
difficult to eat and they are advised to use special utensils while eating. A person can try the following to
help prevent Parkinson’s diseases include eating foods containing vitamin D and eating foods containing
niacin, which is a form of vitamin B, eating foods containing niacin, which is a form of vitamin B. While a
person with alzheimer's disease cannot be reversed with diet. However, the KetoFLEX 12/3 diet shows
promise in slowing cognitive decline and early stages of dementia. Avoid most carbohydrates (sugars,
grains) and focus on healthy fats and non-starchy veggies.

What is alcohol addiction? Compare with the allowed amount of alcohol drinking in moderation.

Answer:
Alcohol addiction is a state of intoxication in which a person's physical, physiological, and psychological
well-being are harmed. And the liver is responsible for around 90% of total alcohol oxidation. It has a
calorie content of 7 kcal/gm. A protracted period of heavy drinking leads to chronic alcoholism. It starts with
social drinking and then progresses to larger amounts. Memory lapses, unsteady stride, blackouts, and
skipping meals because he/she falls asleep are all early indicators of alcohol consumption. Personality
changes, uncontrollable aggression, and moodiness are all common symptoms. A task's performance (in
occupations) is threatened. Relationships within the family are strained. An alcoholic is unconcerned with
his or her personal hygiene and looks.

Activity 15: For 15 points.

Give the role of these nutrients in hematopoiesis:
Answers:
1. Iron - it gives hemoglobin the strength to “carry” (bind to) oxygen in the blood, so that oxygen gets to
where it needs to go. People who become iron deficient aren't getting enough iron in their diet. This means
that the body can't make hemoglobin, so it makes fewer red blood cells.
2. Folate - folic acid, a B vitamin, is required for the synthesis of heme in red blood cells, the pigmented,
iron-containing part of hemoglobin (erythrocytes). Anemia is caused by a lack of folic acid, which prevents
the maturation of immature red blood cells.
3. Vitamin B12 - it is needed to make red blood cells, which carry oxygen through the body. Not having
enough B12 can lead to anemia, which means the body does not have enough red blood cells to do the
job.
4. Protein - is essential for the proper production of hemoglobin and red blood cells.
5. Vitamin C - is necessary for the absorption of iron and the conversion of folic acid to its biological active
form,
folic acid.
6. Copper - it is essential for the formation of hemoglobin and mobilization of iron from its storage sites to
the plasma. Iron can’t be released if copper is deficient.
7. Vitamin E - it is a highly effective fat-soluble vitamin with a variety of cellular membrane stabilizing-
antioxidant and non-antioxidant functions. Vitamin E has been suggested to prevent the oxidation of
polyunsaturated fatty acids in red blood cell (RBC) membrane, thus inhibiting the premature erythrocyte
lysis.

Activity 16: For 20 points.

Give sample menus and recipes to meet existing conditions:
This document is a property of NONESCOST Module 3 | Page 11
Unauthorized copying, uploading, and / or editing is prohibited. (For Classroom Use Only)
Prepared by: Luda G, Santillana, RND, MBA
Answers:
1. No Fuel, No Water.
-Poached egg
- Whole wheat bread
- Sweet potato
-oranges
-fried chicken

2. Fuel Available, No Water

- Egg bread
- Spaghetti
- Potato fries
- Hamburger
- Cake
3. Water Available, No Fuel
- Chapsuey
- Laswa
- Cordon Bleu
- Beef stew
- Watermelon smoothie
4. Water and Fuel Available
- Yogurt
- Milk
- Pancit chicken soup
- Bacon
- Whole-grain cereals

Activity 17: For 10 points.

As a health care staff, discuss how you will prevent iatrogenic malnutrition in patients admitted in the
hospital.
Answer:
Iatrogenic malnutrition is a condition that can be caused by a variety of medications or by a complication of
a medical treatment or procedure. Iatrogenic malnutrition may be caused by negligence among medical
personnel, including doctors, nurses, therapists, or caregivers who are attending to a particular patient. To
prevent iatrogenic malnutrition are to Redefine clinician's roles to include nutrition. To address malnutrition
fully and consistently, all members of the clinical staff should be engaged with patient nutrition. Nurses
must be allowed to provide complete nutrition care, including measuring body weight and initiating calorie
counts. Recognize and diagnose all patients at risk and communicate nutrition care plan, this includes
prescribed nutrition intervention and planned goals. Rapidly implement interventions and continued
monitoring also it is to ensure that the patient is monitored his/her dietary intake.

This document is a property of NONESCOST Module 3 | Page 12

Unauthorized copying, uploading, and / or editing is prohibited. (For Classroom Use Only)
Prepared by: Luda G, Santillana, RND, MBA