-
Goals of diet therapy
- treat and manage disease
- prevent complications
- restore health
-
Which patients need feeding assistance
- patients with paralysis of the arms
- patients with visual impairment
- patients with IVs
- weak/impaired
- confused
-
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
-
Obesity
- 20 - 30% above ideal body weight
- morbidly obese are 100 lb above ideal body weight
- 62% of US is obese
-
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
-
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
-
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
-
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
-
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
-
Risks associated with diabetes mellitus
- Cardiovascular disease
- Hypertension
- Kidney disease
- Blindness
- Stroke
-
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
-
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)
-
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
-
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
|
|