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CH 40
Nutritional needs
| Question | Answer |
|---|---|
| total energy expenditure | sum of all calories used. |
| 6 classifications of nutrients | Carbohydrates, proteins, fats, Water, vitamins and minerals |
| Carbs | 1g=4cal. All carbs convert to glucose.Excess glucose also converted to fat and is stored as triglycerides when glycogen stores are adequate |
| proteins | Vital “building blocks”. Animal (complete), plant (incomplete). 1g = 4 calories; RDA: 0.8 g/kg. Broken down and absorbed in the small intestine ⇨ liver Serum Albumin (total protein). Nitrogen balance |
| Fats (lipids) | Provides energy; aids in absorption of fat-soluble vitamins. 1g = 9 calories. Saturated(bad) vs. Unsaturated(good) |
| vitamins are essential | Needed for metabolism of carbohydrates, proteins and fats. Only small amounts required. Not made in the body; we get them from food/supplementation |
| water soluble vitamins | C and B complex vitamins |
| fat-soluble | Vitamins: A, D, E and K. Excess fat-soluble vitamins → stored in liver and adipose tissues; can be toxic |
| minerals | Provide structure within the body & regulate body processes; need very small amts. |
| Macrominerals (bulk) | Calcium, phosphorus, magnesium, sodium, potassium, chloride and sulphur |
| Microminerals (trace) | Iron, zinc, iodine, etc. |
| Maintaining Fluid Balance | Balance regulation, Average intake/output, Normal fluid losses, Measuring fluid balances, intake, Output, Weight |
| Factors Influencing Nutritional Needs | Developmental Age, Gender, Health Status, Economics, Religion/Culture |
| assessing nutritional risks | Monitoring food intake & labs, Measurement, Physical barriers |
| NPO | Before or after surgery, Medical/lab testing requirement, Severe N/V; Acute GI issue (ex. bowel obstruction), Comatose, Inability to chew or swallow safely |
| nutritional support | Enteral Nutrition -Entering stomach or small intestines Parenteral Nutrition-Intravenous |
| nasogastric tube (NG) | Small-bore tubing Short-term use-Decompression, Nutritional support. Risks: Aspiration |
| nasontestinal tube (NI) | Uses: Risk of aspiration, Bypass stomach, Delayed gastric emptying Risk: dumping syndrome |
| Percutaneous Endoscopic Gastrostomy Tube (PEG) | Long-term support. |
| enteral nutrition nursing care | Check orders, Abdominal assessment, Confirm tube placement, Assess residual (as ordered), Patient positioning |
| checking for residual | Follow physician/dietitian order or facility policy, Prior to every feeding; if continuous then q 4-6 hrs, 200-250ml or >; ⇧ aspiration risk, Call physician if > 250ml residual, Flush after checking residual 30-60ml |
| monitor for complications | Aspiration, GI upset, diarrhea, Nasal erosion, Stoma infection, Extubation, Clogged tubing-MOST common |
| clogged tubing | lways flush w/30-60 ml H2O 1. After aspirating for pH (checking placement) 2. After checking residual 3. Before/after feeding or medication 4. At least q 4 hrs, if continuous feeding |
Created by:
mtbreiby2
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