Nutrition

Introduction
• Healthy people in general are becoming
increasingly selective about the quantity and
quality of their daily food intake
• Syndrome can lead to cardiovascular disease
and type 2 diabetes mellitus are:
• Cardio metabolic syndrome , also know as
metabolic syndrome , syndrome X , insulin
resistance syndrome are diagnostic terms is a
cluster of risk factors
 Overview Of Nutrition
• Eating is a basic need
• It is the mechanism by which nutrients are
obtained
• Optimal nutritional status provides :
• 1-Sufficient energy for daily activity
• 2-Maintainence and replacement of body cells
and tissues
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• 3-Restoration of health following illness or
injury

• Chronic , inadequate nutrition lead to

MALNUTRITION

• Inadequate nutritional intake include the

following:
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• 1-Older adults who are socially isolated or
living on fixed incomes
• 2-Homeless people
• 3-Poor income
• 4-Pregnant teenagers
• 5-Alccoholism
• 6-Disoreders such as: Anorexia nervosa and
Bulimia nervosa
 Human Nutritional Needs
• All human have basic nutritional needs ,
through scientific study , researchers have
determined standards for recommended daily
amounts of the following:
• 1-Calories that provide the body with energy
• 2-Proteins , Carbohydrates and fats that
supply calories and are substances needed for
growth and repair of body structures
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• 3-Vitamins and Minerals that are not supply

calories but are essential for regulating and
maintaining physiologic processes necessary
for health
• 4-Water which is necessary for life
 These nutritional Needs are Influenced by
and require Adjustment
• Adjustment according to the following:
• 1-age
• 2-Weght & Height
• 3-Growth periods
• 4-Activity
• 5-Health Status
 Calories
• Source of energy
• Using calorimeter device for measuring heat
the nutrients in food are burned in a
laboratory and then analyzed to quantity their
energy value
• The energy or heat equivalent of food is
measured in calories
 Calorie

• A calorie ( cal) the amount of heat that raises

the temperature
• Sometimes the energy equivalent of food is
expressed un kilocalorie ( Kcal ) 1000 cal or the
amount of heat that raises the temperature of
1kg of water by 1c
 Calorie
• The number of calorie the person needs
depends on age , body size , physical condition
and physical activity
• For example consuming 2400 calorie of
chocolate exclusive of any other food is not
adequate to sustain a healthy state
• Most food contain a variety of nutrients ,
vitamins and minerals
 Proteins
• Is a component of every living cell
• Nutrient composed of Amino-Acid composed
of nitrogen , carbon , hydrogen and oxygen
• Amino-acids are responsible for building and
repairing cells
• There are 21 amino-acids
• 9 referred to as : Essential Amino-Acid
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• Essential amino – acid which are protein
components that must be obtained from food
because the body cannot synthesize them
• Nonessential amino-acid are protein
components manufactured within the body ,
nonessential refers to the fact that these
amino-acid are not dependent on dietary
intake , not that they are unnecessary for
health
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• Uses of proteins primarily is to built , maintain
and repair tissues
• Food in animal , plant , milk , meat , fish ,
poultry , eggs , soy , legumes , nuts…
• Complete Proteins found in animal there are
adequate amount and proportions of essential
amino acid
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• Incomplete proteins source in plant which
there is insufficient quantity of one or more
amino acid

• Protein complementation is a combination of

plant and animals
• See figure 15-1 page 280
 Carbohydrate
• Are nutrients that contain molecules of carbon
hydrogen and oxygen , found in plant
• Classification according to the number of
SUGAR or Saccharide so carbohydrate sub-
divide into:
• Monosaccharide
• Disarrcharides
• Polysaccharides (Starches)
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• Carbohydrate , the chief component of most
diets , are the body’s primary source for quick
energy
• In addition to calorie may contain FIBER which
is complex polysaccharides that humans are
unable to digest
• Cellulose is a type of fiber in the stems , skins
and leaves of the fruits and vegetable
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• Which forms intestinal bulk to promote bowel
elimination
• Other type of fiber lower serum cholesterol
level
• Source include : cereals , grains , rice , wheat ,
oats , corn , milk is the only significant animal
source of carbohydrate
 Fats
• Nutrients that contain molecules composed of
glycerol and fatty acids called glycerides , this
known as LIPIDS
• Fats referred to as
• Monoglycerides
• Diglycerides
• Or Triglycerides
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fats are more concentrated in energy than
carbohydrate and fats
In spite that fats has a high calories , they
should not be eliminated from diet
Fats provide energy , necessary for chemical
reactions in the body , absorption of some
vitamins
Provide favor or taste to the food and we feel
satisfied
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• The following sources contain fat : meat , fish ,

and poultry , margarine and vegetable oil , egg
, yolks , whole milk and cheese butter ,
peanut butter , salad dressings , avocados ,
chocolate , nuts , salty snacks and most
desserts
 Role of Cholesterol
• Cholesterol is transported through the blood
in molecules of LIPOPROTEINS which is
combination of fat and protein
• Lipoproteins vary in their proportions of
protein to cholesterol , the more protein a
molecule contains the higher is its density
• High-density lipoprotein(HDL) is referred as
Good Cholesterol because cholesterol is
delivered to the liver for removal
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• Low-density lipoprotein is called Bad
Cholesterol because cholesterol is deposited
within arteries wall which is the result of
cardiovascular disease (LDL)
• So big risk for cardiac disease and vascular
diseases
 Types of Fats
• Saturated fats ; are lipids , it is solid found in
red meats , cholesterol only present in foods
of animal origin but the body also synthesize
cholesterol
• Unsaturated fats ; missing hydrogen healthier
found in fish , poultry , corn , olive…
 Minerals
Noncalorie substance in food that are essential
to all cells , help to regulate many of the
body’s chemical processes such as blood
clotting and the conduction of nerve impulse
See table 15-2 page 282 , common dietary
minerals , the chief function and sources :
required in exams
 Vitamins
• Are chemical substance necessary in minute
amounts for normal growth , health
maintenance and body functioning
• Water-soluble vitamins such as B complex and
C require for daily replacement of fluid
• Fat-soluble vitamins A, D , E , K vitamins stored
in the body as reserves for future needs
• Table 15-3 page 283 self study : functions and
sources
 Nutritional Strategies
• Nutrition and weight status objectives for
healthy people 2030 see box 15-2 page 284
• Department of Agriculture's Myplate referring
to labels about nutrition on processed and
packaged foods and understanding standard
definitions for terms used on food labels
 Myplate
• Introduce in 2011 by US department of
Agriculture replaces the previous used Food
Pyramid and Mypyramind
• Myplate is an improved simplified tool for
promoting a healthful daily intake of food
• fig 15-2 page 284
• Advantage is that the recommended percentage
of consumed food from among five food group
categories promote healthy nutrition
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• Children , adolescents , pregnant women and

breastfeeding mothers require more servings
per day of certain food groups particularly the
milk group
 Nutritional Labeling
• Nutritional information has appeared on food
labels since 1974
• Now a day all meat and poultry are labeling
with disease prevention guidelines , provide
90% of process packaging information see
figure 15-3 page 285
• Labels identifies household measurement
serving
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• Consumer must become familiar with a variety
of terms such as daily value DV which are
calculated in percentage based on standards
set for total fat , saturated fat , cholesterol ,
sodium , carbohydrate and fiber in a 2000 cal
diet
• The standards are follows : points page 285
• Regulation and calculation will be taken in
Nutrition course
 Nutritional Patterns & Practices
• Most people learn their eating habits early in
life
• Economic , emotional , and social variables
influence the kinds of food a person consumes
and his/her eating habits
• Some influential factors include the following :
points page 286
 Vegetarianism
• Are people who restricted their consumption of
animal food sources , modifying their diets for
religious or personal reasons
• Vegans : rely exclusively on plant sources for
protein
• Semi- vegetarians exclude only red meat
• Vegetarians have a lower incidence of colorectal
cancer and fewer problem of obesity
• Client & family teaching 15-1 page 286 self-study
 Nutritional Status Assessment
• Nurses asked subjective questions about diet
history
• Nurses gather objective data using physical
assessment techniques
• Subjective data : diet history finding add a
data base about nutritional information
• Common components in a diet history include
the following : points page 286
 Objective Data
•
• the body is composed of water , fat , bone and
muscle
• The nurse uses physical assessment and
laboratory data , anthropometric data , and a
person’s body measurement , help to
determine a client’s nutritional status
 Anthropometric Data
• Is a measurement to the body size and
composition
• The nurse obtains them by measuring height
and weight , calculating body mass index BMI
measuring midarm conference , triceps skin
fold thickness and abdominal conference
• Electrical figure 15-5 page 287 calculate body
mass , body fat and total body water
 Body Mass Index
• Body mass index
• Midarm
• Triceps
• Abdominal circumference
• Will be presented by a student , questions in
exam
 Physical Assessment
• In addition to the objective data of BMI , Body
mass index , the nurse assess the following in
the client:
• Points page 288
• Laboratory Data : include HB , hematocrit ,
glucose , serum albumin , cholesterol ,
triglyceride and lipoprotein level
Management of problems Interfering with
Nutrition
• After assessment we formulate nursing
diagnosis concerning the nutrition according
to the NANADA see page 289
• Some problems or disorders concerning the
nutrition :
• 1-Obesity in which BMI exceeds more and
person need for healthy weight-reduction
measures
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• 2-Emaciation: progressive or prolonged weight
loss may be due to malnutrition , need
adjustment to gain weight
• 3-Anorexia: loss of appetite may be due to
illness , altered taste and smell oral problems
tension or depression
• Explain about anorexia nervosa
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• 4-Nausea : usually precede vomiting
• Nausea may associated with feeling faint or
weak , dizzy , perspiration , skin pallor , rapid
pulse , headache
• 5-Vomiting: loss of stomach contents through
the mouth ,
• Types of Vomiting:
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• 1-Emesis or vomitus the substance that is
vomited is readily visible
• 2-Retching is the act of vomiting without
producing vomitus
• 3-Regurgitation bringing stomach contents to
the throat and mouth without effort of vomiting
• 4-Projectile vomiting that occurs with great
force associated with disease condition such as
increase pressure in the brain or GI problem
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• 6-Stomach Gas , result from swallowing air

• Eructation ; or belching is a discharge of gas
from the stomach through the mouth
• Flatus : gas formed in the intestine and
released from the rectum
 Management of client Nutrition
• Common Hospital Diets :
• Regular or general or normal diet
• Light or convalescent omit fatty or fried ..
• Soft , sometimes we mix light with soft
• Full liquid
• Clear liquid
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• Assist in providing Meal trays special to those
client how have Dysphasia difficulty in
swallowing , impaired vision , dementia or
other health problem that inhibit the client to
eat only may be he/she needs assistance or
complete depend on the nurse
• See book page 394
 Gastrointestinal Intubation

Intubation
Page 643
 Intubation
• Generally means the placement of the tube or
insertion into the stomach or intestine by the
way of the mouth or nose
• Orogastric intubation : the insertion of the
tube through mouth into the stomach
• Nasogastric tube : insertion through the nose
to the stomach
• Nasointestinal : insertion of the tube through
the nose to the intestine
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• Ostomy : surgically created opening –
gastrostomy
• Gastric or intestinal tubes are used for a
variety of reasons including the following
• Points are important page 644
• Showing NGT insertion for feeding , irrigation
, removing…