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Unit 26

Unit 26. Nutritional Needs and Diet Modifications. Objectives. Spell and define terms. Define normal nutrition. List the essential nutrients. Name food groups and list foods included in each group. State liquids/foods allowed on basic facility diets. Objectives.

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Unit 26

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  1. Unit 26 Nutritional Needs and Diet Modifications

  2. Objectives Spell and define terms. Define normal nutrition. List the essential nutrients. Name food groups and list foods included in each group. State liquids/foods allowed on basic facility diets.

  3. Objectives • Describe purposes of the following diets: • Clear liquid • Full liquid • Soft

  4. Objectives • State the purpose of calorie counts and food intake studies. • Define dysphagia and explain risks of this condition.

  5. Objectives Describe general care for the patient with dysphagia and swallowing problems. State purposes of therapeutic diets. List types of alternative nutrition.

  6. Objectives Describe the nursing assistant actions when patients are unable to drink fluids independently.

  7. Introduction • Nutrition • Entire process by which the body takes in food for growth and repair and uses it to maintain health

  8. Normal Nutrition • Food is normally taken into the body through the mouth • The beginning of the digestive tract • Digestion • Breaking down foods into substances used by body cells for nourishment • These substances are called…essential nutrients

  9. Essential Nutrients • To be well nourished, we must eat foods that: • Supply heat and energy • Regulate body functions • Build and repair body tissue

  10. Essential Nutrients • Six essential nutrients: • Proteins • Carbohydrates • Fats • Minerals • Vitamins • Water

  11. The Food Guide Pyramid • USDA Food Guide Pyramid • Designed to be individualized to each person to maintain a healthy weight • Refer to Figure 26–1 to review the six food groups and the familiar USDA Food Guide Pyramid

  12. The Food Guide Pyramid

  13. Water Water is an essential nutrient that is necessary to life A person can live only a few days without water

  14. Water Water is necessary for all cellular functions in the body An adequate intake of fluids is required to replace fluids lost through urine, stool, sweat, and evaporation through skin

  15. Water • The normal adult intake of fluids • Should be two to three quarts a day

  16. Water • Offering liquids to patients frequently is important because: • Some patients cannot drink liquids without your help • Elderly patients have a decreased sense of thirst • Adequate fluid intake is necessary to prevent urinary problems and constipation

  17. Dysphagia • Dysphagia is when a patient has difficulty swallowing • Dysphagia may be a result of: • Stroke • Cancer of head, neck, esophagus • Neurological diseases • Dementia

  18. Dysphagia • Signs and symptoms of dysphagia: • Taking a long time to swallow • Frequent clearing or coughing of throat • Swallowing three of four times with each bite • Lack of a gag reflex or weak cough • Difficulty controlling liquids or secretions in mouth • Inform nurse if you see any of these

  19. Basic Facility Diets • Food served to patients in the health care facility is prepared by the dietary department • It includes the essential nutrients

  20. Basic Facility Diets • The way in which it is prepared and its consistency • Will depend on each individual patient’s condition and needs • Sometimes very strict dietary control is needed

  21. Basic Facility Diets • Types of common Facility Diets: • Regular (also called general or house) • Full liquid • Clear liquid • Soft • Specialized diets: • 1800, 1500 or 1200 ADA diets • NAS diet (no added salt)

  22. Regular Diet • The regular-select or house diet is a normal or regular (unrestricted) diet • Includes all food groups • Offers great variety • Excludes only very rich foods, fried foods, or heavily seasoned foods which might be difficult for inactive people to digest

  23. Clear Liquid Diet • Temporary diet because it is an inadequate diet • Made up primarily of water and carbohydrates for energy • It may be used postoperatively • Or when the patient has a condition such as nausea and vomiting • Consists of liquids that do not irritate, cause gas, or encourage bowel movements

  24. Clear Liquid Diet Examples of Clear Liquids are: Tea Coffee no cream Soup broths Jello 7-Up, Sprite, GingerAle Apple juice Popsicles

  25. Full Liquid Diet • Does supply nourishment • May be used for longer periods of time than the clear liquid diets • Used for patients: • With acute infections • Have difficulty chewing • Have digestive tract conditions • Examples: • Sherbert • Soups • Milk and ice cream

  26. Soft Diet • Usually follows the full liquid diet • Although this diet nourishes the body, between-meal feedings are sometimes given to increase the calorie count. • Mildly flavored, lightly seasoned foods • Examples: • Oatmeal, cheese, pudding, sponge cake, cooked vegetables, pasta

  27. Special Diets Planned to meet specific patient needs Patients may need special diets because of religious preferences or health needs

  28. Religious Restrictions Religious practice requires changes in diet for some patients.

  29. Therapeutic Diets • Standard diets can be changed to conform to special dietary requirements • For example • An order might be written for a low-sodium soft diet when a patient has ill-fitting dentures and heart disease

  30. The Diabetic Diet Diet is an integral part of the therapy of the patient with diabetes mellitus The diet is nutritionally adequate Sometimes a proper diet is all that is needed to control the disease

  31. Sodium-Restricted Diet Sodium-restricted diets may be ordered for patients with chronic renal failure and cardiovascular disease These diets are some of the most difficult diets to follow

  32. Calorie-Restricted Diet As long as activity remains constant A person must take in approximately 500 calories a day less than usual to lose one pound

  33. Low-Fat/Low-Cholesterol Diet • Prescribed for patients who suffer from: • Vascular disease • Heart disease • Liver disease • Gallbladder disease • Those who have difficulty with fat metabolism

  34. Mechanically Altered Diets • Any diet may be mechanically altered • This means that the consistency and texture of foods are modified • Making foods easier to chew and swallow

  35. Mechanically Altered Diets • Usually chopped to the texture of hamburger • Making it easier to swallow • Soft items, such as bread, are not modified • Usually served to patients with dental or chewing problems, and those with missing teeth

  36. Pureed Diet • Blenderized until it is the consistency of pudding or baby food • Given to patients who have dysphagia • At risk ofaspiration

  37. Pureed Diet • The pureed food should not be watery • If it is the proper consistency, a plastic spoon will stand upright without falling • Make the meal as visually appealing as possible • Avoid referring to the pureed food items as baby food

  38. Supplements and Nourishments Many patients receive a nutritional supplementor between-meal nourishments Supplements are ordered by the physician and have a definite therapeutic value

  39. Supplements and Nourishments • Nourishments are substantial food items given to patients to increase nutrient intake • Often planned and ordered by the facility dietitian • Sandwiches or pudding • Nutritious liquids, such as milkshakes

  40. Snacks Planned and regularly given, or unplanned upon patient request Given to patients to prevent or eliminate hunger between meals

  41. Calorie Counts and Food Intake Studies The physician or dietitian may order special food intake studies for a patient with special nutritional needs

  42. Calorie Counts and Food Intake Studies The patient’s food intake is carefully recorded for a period of time, usually three days The food intake is analyzed for nutritional adequacy and number of calories consumed

  43. Calorie Counts and Food Intake Studies • The dietitian uses this information • To plan a diet to meet the patient’s special medical needs

  44. Fluid Balance • Balance between liquid intake and liquid output • We take in approximately 2 ½ quarts of fluid daily • Typical output equals about 2 ½ quarts daily

  45. Recording Intake and Output • An accurate recording of intake and output(I&O), or fluid taken in and given off by the body • Basic to the care of many patients • Some patients have an order to force (encourage) fluids • While others have a fluid restriction

  46. Recording Intake and Output A fluid restriction requires a physician order You will find information regarding whether to push or restrict fluids on the care plan

  47. Changing Water • It is important to provide fresh water for patients • Water is essential to life • In all cases, you should know whether a patient is allowed ice or tap water and if water is to be especially encouraged

  48. Sensory Problems • Some patients have sensory problems affecting their appetites, such as problems with food: • Temperature • Smell • Taste • Hearing and vision

  49. Sensory Problems • Some patients have sensory problems affecting their appetites, such as problems with food: • Touch • Texture

  50. Sensory Problems • Presentation and attractiveness of food are especially important for patients • Whose smell, taste, and texture sensations are impaired

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