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SCI Nutrition

Angela DiTucci, R.D. SCI Nutrition. Gastrointestinal Genitourinary Respiratory Neuromuscular NUTRITION Skeletal Cardiovascular Integumentary Metabolic. Physical Ability . Functional Ability / Capacity Mastication Ability Swallowing Issues. Medications.

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SCI Nutrition

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  1. Angela DiTucci, R.D. SCI Nutrition

  2. Gastrointestinal Genitourinary Respiratory Neuromuscular NUTRITION Skeletal Cardiovascular Integumentary Metabolic

  3. Physical Ability • Functional Ability / Capacity • Mastication Ability • Swallowing Issues

  4. Medications • High dose steroids • Anabolic therapy • Bowel • Bladder • Gastrointestinal • Pain • Cardiovascular

  5. Use of Herb / Botanicals • Saint John’s Wort -”Makes you feel good.” -”It’s natural.” • Echinacea -”Boosts the immune system.” -”Protects against the common cold and flu.” • Garlic -”Lowers cholesterol.”

  6. Psycho / Social Issues • Depression • Self image • Food = source of gratification • Feeding = important issue in independence and socialization • Ability to purchase food and prepare meals • Living arrangements / meal arrangements • Availability of community resources • Alcohol intake

  7. Weight Change • Acute Phase = Weight loss -Increases risk of pressure ulcer development. -Increases susceptibility to fatigue -Decreased resistance to infection • Long-term Phase = Weight gain -Difficulty with lifts, transfers, ADL’s -Increases risk for Diabetes, CHD, HTN -Increases risk of pressure ulcer

  8. Bowel Management • Fiber • Gas • Diarrhea • Fluid

  9. Fluids • Digestion and absorption of food • Elimination of body waste • Regulation of body temperature • Distribution of nutrients to body cells • Prevention or urinary tract infections 2000 cc – 3000 cc fluid daily

  10. Suggestions for Teaching to Increase Fluid Intake • Keep a water bottle. • If with impaired hand function, work with OT-adaptive straws / cups. • Drink 1-2 glasses of water every time the leg bag is emptied. • Drink before meals rather than afterwards when full. • Do most of the drinking before early evening measurements. • Caffeine, alcohol, juices

  11. Skin Integrity • Risk Factors -Hypoalbuminemia -Weight -Anemia • Diet -High quality diets -Protein -Calories -Fluids -Zinc -Vitamin C -Vitamin A -Iron, Folate, B12

  12. Impaired Glucose Tolerance • Risk Factors • Altered body metabolism • Decrease in muscle mass and increase in fat • Inactivity • Aging process

  13. Lipid Abnormalities • Increased prevalence of Heart Disease • Lipid abnormalities • Glucose intolerance • Increased weight • Limited Activity • Risk Factors for Lipid Abnormalities • Impaired carbohydrate metabolism • Reduced activity • Increased adiposity • Changes in metabolism • HDL

  14. Osteoporosis • Risk Factors • Diabetes • Steroid Use • Smoking • Vitamin D Deficiency • Excessive Alcohol and/or caffeine use • Additional Risk Factors 2° SCI • Inactivity • Changes in Autonomic and nervous systems

  15. Osteoporosis • Intervention • Physical activity- weight bearing or resistance • Calcium • Vitamin D • Smoking cessation (smoking speeds up bone loss) • Limit ETOH/Caffeine (also speeds up bone loss)

  16. Role of nutrition for the SCI person across the continuum of care.Team approach to the nutritional care of the SCI person.

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