Chapter 27 Diet therapy and assisted feeding

  1. Goals of diet therapy
    • treat and manage disease
    • prevent complications
    • restore health
  2. Which patients need feeding assistance
    • patients with paralysis of the arms
    • patients with visual impairment
    • patients with IVs
    • weak/impaired
    • confused
  3. Post op patient
    • NPO 6 - 8 hrs before operation
    • progress from clear to full liquid diet
    • clear liquids started when bowel sounds are heard
    • clear liquids have low residue and are easily digested
    • liquid diets decrease risk of abdominal pain, nausea and vomiting
    • may progress to soft diet before regular diet begins
  4. Obesity
    • 20 - 30% above ideal body weight
    • morbidly obese are 100 lb above ideal body weight
    • 62% of US is obese
  5. Pregnancy
    • Weight gain should be 2 - 4 lb during the first trimester
    • 1 lb/week during the second and third trimester
    • no caloric increase in the first trimester
    • increase of 300 calories/day in the 2nd and 3rd trimesters
  6. Substance abuse
    • may impair absorption of nutrients
    • alcoholics usually have thiamine deficiency
    • if liver function impaired; fats restricted
    • Treatment:
    • vitamin and mineral supplements
    • fluid and electrolyte supplements
    • high calorie, high carb diet
  7. Cardiovascular disease
    • Includes diseases of the blood vessels, hypertension, myocardial infarction, and congestive heart failure
    • Focused on reduction of fat and sodium intake to decrease atherosclerosis
  8. 3 types of cholesterol
    • High-density lipoprotein (HDL) : good cholesterol; cleanse vessels of fatty deposits
    • Low-density lipoprotein (LDL) : increases fatty deposits
    • Very-low-density lipoprotein (VDL) : carries triglycerides; triglycerides contribute to atherosclerosis and coronary artery disease
  9. Diabetes Mellitus
    • Disturbance of the metabolism of carbohydrates and the use of glucose by the body
    • Type 1: juvenile onset (pancreas stops secreting insulin)
    • Type 2: adult onset (cell membrane loses sensitivity to insulin)
    • Meals should contain 45% to 60% carbohydrates, 20% to 25% protein, and 20% to 25% fat
    • Diet therapy to control carbohydrate intake to maintain serum glucose at 75 to 115 mg/dL
    • Carbohydrates should be complex
  10. Risks associated with diabetes mellitus
    • Cardiovascular disease
    • Hypertension
    • Kidney disease
    • Blindness
    • Stroke
  11. HIV/AIDS
    • Associated with:
    • Severe diarrhea
    • Profound weight loss
    • Muscle wasting
    • Therapy includes:
    • Replacement of fluids and electrolytes
    • Weight gain
    • Replacement of lost muscle mass
    • Maintaining the immune system
  12. Nasogastric and Enteral Tubes
    • Usually a temporary measure to provide nutritional support
    • Check tube placement prior to feeding or administering medications
    • Irrigate to ensure it is patent (clear)
  13. Reasons for nasogastric and enteral tubes
    • dysphagia
    • IBS
    • decompress stomach before or after surgery (remove contents)
    • obtain gastric specimens
    • gastric feeding or lavage
    • administer medication
  14. Percutaneous Endoscopic Gastrostomy Tubes
    • Generally used when a patient requires long-term nutritional support
    • Tube placement should be checked every shift and before feeding or administering medication
    • Before feeding or administering medications, amount of residual fluid in the stomach should be assessed
Author
copperkid2
ID
122388
Card Set
Chapter 27 Diet therapy and assisted feeding
Description
Funds chapter 27
Updated