Nutritional needs
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| total energy expenditure | sum of all calories used.
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| 6 classifications of nutrients | Carbohydrates, proteins, fats, Water, vitamins and minerals
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| Carbs | 1g=4cal. All carbs convert to glucose.Excess glucose also converted to fat and is stored as triglycerides when glycogen stores are adequate
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| 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
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| Fats (lipids) | Provides energy; aids in absorption of fat-soluble vitamins. 1g = 9 calories. Saturated(bad) vs. Unsaturated(good)
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| 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
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| water soluble vitamins | C and B complex vitamins
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| fat-soluble | Vitamins: A, D, E and K. Excess fat-soluble vitamins → stored in liver and adipose tissues; can be toxic
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| minerals | Provide structure within the body & regulate body processes; need very small amts.
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| Macrominerals (bulk) | Calcium, phosphorus, magnesium, sodium, potassium, chloride and sulphur
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| Microminerals (trace) | Iron, zinc, iodine, etc.
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| Maintaining Fluid Balance | Balance regulation, Average intake/output, Normal fluid losses, Measuring fluid balances, intake, Output, Weight
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| Factors Influencing Nutritional Needs | Developmental Age, Gender, Health Status, Economics, Religion/Culture
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| assessing nutritional risks | Monitoring food intake & labs, Measurement, Physical barriers
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| 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
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| nutritional support | Enteral Nutrition -Entering stomach or small intestines
Parenteral Nutrition-Intravenous
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| nasogastric tube (NG) | Small-bore tubing
Short-term use-Decompression, Nutritional support. Risks: Aspiration
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| nasontestinal tube (NI) | Uses: Risk of aspiration, Bypass stomach, Delayed gastric emptying
Risk: dumping syndrome
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| Percutaneous Endoscopic Gastrostomy Tube (PEG) | Long-term support.
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| enteral nutrition nursing care | Check orders, Abdominal assessment, Confirm tube placement, Assess residual (as ordered), Patient positioning
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| 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
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| monitor for complications | Aspiration, GI upset, diarrhea, Nasal erosion, Stoma infection, Extubation, Clogged tubing-MOST common
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| 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
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