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According to the Food Pyramid you need:
Grains (eat ___ every day)
Fruit ( __ cups every day)
Vegetables ( __ cups every day)
Meat and beans (eat ___ oz. every day)
Milk ( __ cups daily) ( for children 2 to 8 its __ cups)
Fats, Oils, & Sweets (use sparingly)
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Grains (eat 6 oz. every day)
- Fruit (2 cups every day)
- Vegetables (2 ½ cups every day)
- Meat and beans (eat 5 ½ oz. every day)
- Milk (3 cups daily) ( for children 2 to 8 its 2 cups)
- Fats, Oils, & Sweets (use sparingly)
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Physiological RISK factors for Nutrition include:
- Developmental considerations
- State of health
- Alcohol abuse
- Medication
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Socioculture/ Psychosocial RISK factors for Nutrition include:
- Religion / culture
- Economics
- Meaning of food
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Dietary Risk Factors for Malnutrition include:
- disease
- eating poorly
- tooth/mouth pain
- economic hardship
- reduced social contact
- multiple medicines
- involuntary wieght loss/gain
- needs assistance in self care
- elder years above age 80
DETERMINE
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What things do you need to know for a nutritional assess?
- History - Dietary, Socioeconomic
- Physical - Anthropometrics, BMI, Clinical findings
- Laboratory data
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What are Anthropometric measurements?
- Height and weight (most common obtained)
- Triceps skin fold measurement
- Midarm circumference
- BMI
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Clinical Signs of Nutritional Status
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•Signs do not appear until late
- •General Appearance
- •Mouth
- •Gums
- •Skin
- •Hair
- •Musculoskeletal
- •Circulation
- •Mental Status
- •Weight
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What lab data do you need for a nutritional assessment?
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Hemoglobin (O2 carrying protein of the red blood cells)
- Hematocrit (volume of red blood cells packed)
- Albumin
- Prealbumin
- Transferrin
- 24 hour urine
- Urine creatinine Nitrogen Balance
- (UUN)-Urine urea nitrogen
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A clear liquid diet includes:
-
•Gelatin
- •Fat free broth
- •Bouillon
- •Ice pops
- •Clear juices
- •Carbonated beverages
- •Regular and decaf beverages
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A Full Liquid Diet includes:
- •Milk
- •Plain frozen desserts
- •Cream of tomato soup
- •Vanilla milk shake
- •Ice cream
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What does the BRAT diet include?
- Bananas
- Rice
- Applesauce
- Toast
(recomended for children experiencing N/D)
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Short term Feeding Tudes include:
- Nasogastric
- Nasointestinal (small intestine)
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Long term feeding tubes include:
- Gastrostomy (stomach)
- PEG (percutaneous endoscopic gastrostomy)
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What are some Indications for usage of Feeding Tubes?
- Inadequate oral intake/ NPO
- Difficulty swallowing/ chewing
- Anorexia nervosa
- Prolonged lack of appetite
- Cancer
- Severe depression
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Contraindications for Feeding Tubes include:
- Intestinal obstruction
- Paralytic ileus
- Intractable vomiting
- Severe diarrhea
- High risk for aspiration
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What does PEG stand for?
Percutaneous Endoscopic Gastrostomy
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What type of feeding formula are these:
Ensure, Sustacal, Resource, Meritene
- Polymetric
- (GI tract must be able to absorb whole nutrients)
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What type of feeding formula are these:
Single macronutients
- Modular(Used in conjunction with other food therapy)
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What type of feeding formula are these:
Pre-digested formulas
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What type of feeding formula:
Utilized with certain disease processes
Liver failure, Kidney failure, Diabetes, Lung disease
Specialty
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What are the Delivery Methods for Enteric Feedings?
- Intermittent
- Bolus
- Continuous
- Cyclic
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Measure Residual At least every ____ hours for continuous feeding
4
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When do you Periodic flush the tube with H2O?
- Before and after meds
- Every 4 hours for cont. feedings
- After each intermittent feeding
- Anytime feeding interrupted
- *Crush meds thoroughly
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What are the S/S for Hypoglycemia (less than 60 mg/dl)
- –Hunger
- –Shakiness
- –Loss of concentration
- –Pulse rapid
- –Hypotension
- –Cool, clammy skin
- –Nausea
- –Seizures
- –Coma
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What are the S/S of Hyperglycemia (greater than 120 mg/dl)
- –Weakness
- –Thirst
- –Flushed cheeks
- –Dry skin and mouth
- –Nausea and vomiting
- –Glucosuria
- –Fruity odor to breath (late sign)
- –Coma
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