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CH 40

Nutritional needs

QuestionAnswer
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