Basic Human Needs Nutrition

1. Basic Human Needs Nutrition

2. Nutrients: The Biochemical units of nutrition • Body requires fuel to provide energy for cellular metabolism and repair, organ function, growth & body movement • Food is the fuel that keeps the machine that is our body running

3. Energy requirements based on: • Basal metabolic rate (BMR)-Energy needed to maintain life sustaining ( Breathing, circulation, temperature, heart rate) • Resting Energy Expenditure (REE)-measurement that accounts for BMR plus energy needed to digest food & perform mild activity. Accounts for 60-70% of our daily needs

4. Nutrients • Elements necessary for body processes & function • 6 Categories • Carbohydrates, Proteins, Fats, Water, Vitamins, Minerals

5. Carbohydrates • Main source of energy (55-60% of calories in diet) • Each gram = 4 kcal • Composed of carbon, hydrogen & oxygen • Main source of fuel (glucose) for brain, skeletal muscle during exercise, RBC &WBC production, cell function of renal medulla • Obtained from plant foods, except for lactose (milk, sugar)

6. Simple Carbohydrates • Classified according to saccharides • Monosaccharide- glucose(dextrose), fructose, galactose (building blocks of all other CHO) • Glucose- blood sugar (normal fasting BS=70-100 mg/ml) • Disaccharide- sucrose, lactose, maltose, • Sugar alcohols-sugar replacers • Artificial sweetners

7. Complex Carbohydrates • Polysaccharides are complex carbohydrates • Starches, glycogen, & fiber are polysaccharides • Starches are the major source of CHO in diet (grains, cereals, breads, pasta, starchy vegetables & legumes) • Glycogen- animal starch (found in liver & muscle tissue, provides immediate fuel for muscle action

8. Dietary Fiber • Plant foods that cannot be broken down by body to digest • Fiber eliminated by intestinal waste • Adds volume, no fuel or energy • Fiber in diet helps promote regularity of bowel movements, helps in regulating blood sugar, reducing cholesterol, may promote weight loss, reduce risk of colon cancer & diverticular disease

10. Functions of CHO • Provide fuel (CHO primary source) • Spare body protein (body can convert protein to glucose; body will break down internal protein stores before fat stores in absence of CHO) • Helps prevent ketosis (partially broken down fats accumulate in blood as ketones) • Enhance learning & memory (Glucose)

11. Proteins • Provide a source of energy • 4 kcal per gram • Essential for synthesis of body tissue in growth, maintenance & repair • Collagen, hormones, enzymes, immune cells, DNA, RNA are composed of protein • Blood clotting, fluid regulation, & acid-base balance require protein

12. Protein • Composed of carbon, hydrogen, oxygen,& nitrogen • There are essential and nonessential amino acids • Complete and incomplete proteins • Essential amino acids: isoleucine, leucine, lysine, threonine, tryptophan, methionine, histidine, valine, phenylalanine

13. Protein • Albumin & Insulin are simple proteins • Lipoprotein is a complex protein (Lipid & protein) • Complete & Incomplete proteins

14. Protein • Nitrogen balance- intake & output of nitrogen equal • When intake of nitrogen exceeds output, body is in a positive nitrogen balance (growth, pregnancy, maintenance of lean muscle mass & vital organs, wound healing • The extra nitrogen is used for building, repairing, & replacement of tissues

15. Protein • Negative Nitrogen balance- Body loses nitrogen faster than it gains it • Infection, Sepsis, Fever, starvation, head injury, trauma, burns • Increased nitrogen loss is the result of body tissue destruction or loss of nitrogen containing body fluids

17. How protein functions in the body • Provision of structure • Growth & maintenance of tissue • Regulation of body processes (hormones, enzymes, nucleoproteins) • Development of immunity • Circulation of blood and nutrients • Backup source of energy

18. Fats • Fats(lipids) are the most calorically dense • Composed of carbon, hydrogen, & oxygen (basic structural unit=glycerol) • 9 kcal per gram • Composed of monoglycerides, diglycerides, & triglycerides • Lipogenesis- Synthesis of fatty acids

19. Fats • Fatty acids can be Saturated or Unsaturated, Monounsaturated, or polyunsaturated & Trans-fatty acids • Essential Fatty Acids (Linoleic, Linolenic) must be supplied by diet • Nonessential fatty acids • Necessary for metabolic processes • HDL vs LDL

21. Fats • Animal fats are high in saturated fatty acids • Vegetable fats are high in unsaturated and polyunsaturated fatty acids

22. Functions of Fats • Fuel source • Vehicle for fat soluble vitamins • Satiety value • Sources of essential fatty acids • Organ protection • Lubrication • Insulation • Cell membrane structure

23. Cholesterol • Not a true fat, classified as a sterol • Body manufactures 1000 mg day • Component of bile salts, essential component of cell membrane, necessary for production of several hormones (cortisone, estrogen adrenaline, testosterone) • Elevated blood levels is a major risk factor for CAD ( < 200 mg/dL optimal)

25. Water • Critical component of body • Cell function depends on a fluid environment • 60-70% of body weight • Muscle contains more water than fat • Infants have higher total body water • Fluid needs met by ingesting fluids & solid food high in water content (fruits & veggies)

26. Vitamins • Organic substances present in small amounts in food • Essential for normal metabolism • Body depends on dietary intake • Vitamin content higher in fresh foods • Classification by solubility: water or fat

27. Vitamins • Fat Soluble- Vitamins A, D, E, K • Can be stored in body • Provided through dietary intake except for Vitamin D • Antioxidant role of vitamins • Water Soluble-Vitamin C, B Complex (8 vitamins) • Cannot be stored in body, provided by dietary intake • Vitamins are catalysts in biochemical reactions

28. Functions of Fat-Soluble Vitamins • Vitamin A: vision, healthy epithelial tissue, proper bone growth, energy regulation • Vitamin D: promotes normal bone mineralization, plays a role in calcium and phosphorus absoprtion • Vitamin E: antioxidant role (protects Vitamin A & unsaturated fatty acids from oxidation • Vitamin K: blood clotting, bone metabolism

29. Functions of Water-Soluble Vitamins • Vitamin C: collagen synthesis, powerful antioxidant, adrenal gland function, iron absorption, folic acid conversion • B-Complex: co-enzyme in numerous metabolism mechanisms

30. Minerals • Inorganic elements essential to the body as catalysts in biochemical reactions • Macrominerals-Body requires 100mg or more • Trace elements-Body needs less than 100 mg

31. Minerals • Macrominerals- Calcium, Sodium, Potassium, Phosphorus, Magnesium, Sulfur, and Chloride • Trace Elements- Iodine, Fluoride, Iron, Selenium, Zinc, Copper, Selenium, Manganese, Chromium

32. A & P of Digestion • Mechanical breakdown that results from chewing, churning, mixing with fluid, & chemical reaction till food reaches it’s simplest form • Enzymes speed up chemical reactions

33. A & P of Digestion • Dysphagia- Difficulty swallowing • Absorption occurs in small intestine- primary absorption site for nutrients • Main source of water absorption via intestine, small intestine reabsorbs 9.5 L

36. Metabolism • Catabolism- Breakdown of biochemical substances into simpler substances (starvation) • All body cells except RBC & neurons can oxidize fatty acids into ketones for energy in the absence of dietary CHO

37. Metabolism • Biochemical reaction with cells • Anabolic or Catabolic • Anabolism- Building of more complex substances, occurs when lean muscle is added through diet & exercise • Amino acids are anabolized into tissue, hormones, & enzymes

38. Dietary Guidelines • Recommended dietary allowances • Food Guidelines-Food Pyramid • Daily values on food labels (based on 2000 kcal/day)

41. Nutrition during Growth & Development • Infant • School Age • Adolescents • Young-Middle Adults • Older Adults • Alternative food patterns

42. Nursing Process & Nutrition • Assessment- Anthropometry • Body Mass Index • Ideal Body Weight • Anthropometric measurements • Labs- Albumin, Transferrin, Prealbumin, Protein, Hgb, Total Lymphocyte Count • Nitrogen balance • Dietary & Health history • Clinical Observation

44. Nursing Diagnosis • You tell me!!!!!!

45. Conditions affecting Digestion • CVA • GERD • Hiatal Hernia • Gastric Bypass • H-Pylori • Ulcers • Obstruction • Gallbladder • Malabsorption syndromes • Lactose Intolerance • Celiac disease • IBS • IBD (colitis, Crohns) • Diverticulosis • Diarrhea/Constipation • Hemorrhoids

46. ImplementationAcute Care • Oral delivery of nutrients • Enteral tube feedings • Nasogastric, jejunal, gastric tubes • Less risk for aspiration with jejunal feedings • Indicated in cancer of neck, upper GI tract, GI disorders, CVA, dementia, Inadequate oral intake • Parenteral Nutrition

47. Tube FeedingNsg Responsibilities • Document baseline weight • Check Tube placement • Check residual q 4 hr • Check labs • I & O • Daily weight • Aspiration Precautions • Water Flush • Check for complications

48. Enteral Feeding Complications • Pulmonary aspiration • Diarrhea • Constipation • Tube occlusion • Tube displacement • Delayed gastric emptying (check residual) • Nausea/vomiting/cramping

49. Enteral Feeding Formulas • Osmolite • Perative • Pulmocare • Jevity • Nepro • Hepataid • Glucerna