Which class of nutrient supplies the most dense source of energy in our diet?
Fats
How many calories in 1lb of fat?
3500
How many calories per day would need to be cut to lose 1lb/week?
500
How many calories per gram of protein?
4
How many calories per gram of carbohydrate?
4
How many calories per gram of fat?
9
How many calories per gram of alcohol?
1
How do proteins contribute to bodily functions?
Essential component of tissue health (growth and repair)
What are good sources of lean essential amino acids?
Egg whites
Lean chicken
Dried peas and beans
Nuts
Complete vs. Imcomplete Protein Sources
Complete: foods that supply all the essential amino acids in adequate amounts (meat, fish, poultry, eggs, milk, cheese, soy)
Incomplete: foods that supply most but not all essential amino acids (palnts, including legumes, grains and nuts)
What percentage of our diet should be from protein?
10-20% of total daily calories
When would protein requirements increase?
Times of stress
Critical Illness
Wound Healing
Growth
Pregnancy
Nitrogen Balance
The balance between nitrogen intake (protein intake) and nitrogen loss (excretion from urine, urea, feces, hair, nails and skin)
Positive Nitrogen Balance: When nitrogen intake is greater than excretion (something we WANT to happen during preganancy, periods of growth, lactation and recovery from illness).
Negative Nitrogen Balance: When more nitrogen is being excreted than ingested (UNDESIREABLE state in situations such as starvation, illness, trauma or stress).
Nitrogen Balance: When there is a balance between intake and breakdown of proteins (healthy adults).
The school nurse is teaching a high school class about complete and incomplete proteins. What is the best explaination of a complete protein?
D. it contains all of the essential amino acids.
A nurse has been teaching a patient about complimentary proteins. Which of the following statements by the client indicates that the teaching has been effective?
D. "I need to combine specific incomplete proteins each day so that over the course of the day I have adequate protein intake."
Which of the following individuals is likely to have a negative nitrogen balance?
D. an elderly client with an open leg ulcer that is not healing.
Saturated Fat
Usually solid at room temperature
Found primarily in animal foods and palm & coconut oils
Most correlated to coronary artery disease and build up and plaque in arteries
Along with trans-fat, raise LDL levels
Monounsaturated Fat
Usually liquid at room temperature
Found in certain vegetables, nuts and vegetable oils
Lower levels of LDL
Polyunsaturated Fats
Usually liquid at room temperature
Found in certain vegetables, nuts, vegetable oils and in fatty fish
Cholestrerol
Not a fat, but a steriod
Travels through the blood attached to fatty acids
Synthesized/manufactured in the liver
No cholesterol in non-animal products. Only comes from animal products
What food sources provide cholesterol?
Organ meat (specifically liver)
Why do we need to limit cholesterol?
Although saturated fat is a larger contributor, high cholesterol does contribute to coronary artery diease
LDL
Low-density lipoprotein - bad cholesterol
HDL
High-density lipoprotein - good cholesterol
What is the recommended daily intake of fat and cholesterol?
No more than 20-35% of total daily calories
Less than 300mg of cholesterol per day
**Pts with hx or family hx of hyperlipidemia or LDL higher than 130 limited to 7% or 200mg**
What is the recommended daily intake of carbohydrates?
45-65% of total daily calories 1/2 of which should be whole grain
Fat Soluble Vitamins
A - vision
D - absorption of calcium & phosphorus
E - cell reptoduction; source is vegetable oil
K - clotting
More likely to cause toxicity when consumed too much
Water Soluble Vitamins
C
B complex - thiamin B1 (energy & nerve metabolism; source - pork, enriched grains & legumes) Folate (RBC synthesis; source - green leafy vegetables) Cobalamin B12 (role in nerve repair and folate metabolism but needs intrinsic factor for absorption; food of animal origin)
Less likely to be toxic, excess is filtered in the kidneys and eliminated in the urine.
How should the nurse respond to the patient who already limits trans and saturated fats and now wants to reduce cholesterol in the diet?
D. "limit the portion of foods from animal sources."
Vitamins commonly lacking in the American diet
A
C
B
D
Minerals commonly lacking in the American diet
Iron - low intake can cause anemia
Calcium - low intake linked to osteoporosis
Zinc - deficiency linked to poor wound healing
A patient is taking a daily iron suppliment. Which of the following should be taken with the pill to increase absorption of iron?
C. Orange juice
Water
The human body is composed of about 60% water - as age and/or fat increases the amount of % of water decreases.
What should sodium intake be limited to?
2300-3000mg/day
Hospital Diets
General/Regular.
NPO - Nothing by mouth.
Clear Liquid - anything you can see through (GI patient, post-op patient).
Full Liquid - Milk, cream soups, ice cream, yogurt, etc..
Soft and Mechanical - Sores in mouth or cannot chew.
