Basic Nursing: Foundations of Skills & Concepts Chapter 18

Basic Nursing: Foundations of Skills & Concepts Chapter 18 BASIC NUTRITION

Nutrition • All of the processes involved in consuming and utilizing food for energy, maintenance, and growth.

Physiology of Nutrition Five processes are involved in the body’s use of nutrients: • Ingestion. • Digestion. • Absorption. • Metabolism. • Excretion.

Ingestion • The taking of food into the digestive tract, generally through the mouth.

Digestion • The mechanical and chemical processes that convert nutrients into a physically absorbable state. Digestion includes: • Mastication (chewing). • Deglutition (swallowing). • Peristalsis (coordinated, rhythmic, serial contractions of the smooth muscles of the GI tract).

Absorption • The process by which the end products of digestion pass through the small and large intestines into the blood or lymph systems.

Metabolism • The body’s conversion of nutrients into energy. • Basal metabolism is the amount of energy needed to maintain essential physiologic functions when a person is at complete rest, both physically and mentally.

Excretion • The process of eliminating or removing waste products from the body.

Water Carbohydrates Fats Proteins Vitamins Minerals The Six Essential Nutrients

Water • The Most Important Nutrient. • Daily requirements: 1,000mL of water to process 1,000kcal eaten.

Solvent (dissolves substances to form solutions). Transporter (carries nutrients, wastes, etc. throughout the body). Regulator of body temperature. Lubricant (aids in providing smooth movement for joints). Component of all cells. Hydrolysis (breaks apart substances, especially in metabolism). Functions of Water

Classification & Sources of Water • Liquids consumed (water, coffee, juice, tea, milk, soft drinks). • Foods consumed (especially fruits and vegetables). • Metabolism (produces water when oxidization occurs).

Water: Digestion, Absorption and Storage • Water is not digested. It is absorbed and used by the body as we drink it. It cannot be stored by the body. The body loses water in four ways: • Urine. • Feces. • Perspiration. • Respiration.

Water: Signs of Deficiency • Abnormal water losses include profuse sweating, vomiting, diarrhea, hemorrhage, wound drainage (burns), fever, and edema. • A deficiency of water is called dehydration. Prolonged dehydration results in death.

Carbohydrates • The chief source of energy for the body. Made up of carbon, hydrogen, and oxygen. They are the major source of food for all people. • Daily requirements: 50% to 60 of an individual’s kcal intake per day.

Functions of Carbohydrates Carbohydrates are... • The primary source of energy for the body. • Spares proteins from being used for energy, thus allowing them to perform their primary function of building and repairing body tissues. • Needed to oxidize fats completely and for synthesis of fatty acids and amino acids.

Carbohydrates: Classification and Sources • Carbohydrates may be simple or complex. • Simple are single or double sugars. • Complex are composed of many single sugars joined together (starch, dietary fiber, glycogen).

Carbohydrates: Digestion, Absorption and Storage • Digestion of cooked starches begins in the mouth. • Little digestion occurs in the stomach. • Carbohydrate digestion completed in the small intestine. • Carbohydrates are used completely, leaving no waste for the kidneys to excrete.

Carbohydrates: Signs of Deficiency • Mild deficiency can result in weight loss and fatigue. • Serious deficiency can result in ketosis.

Fats • The most concentrated source of energy in the diet. An essential nutrient, but too much can be a health hazard. • Daily requirements: should not exceed 25% to 30% of an individual’s caloric intake per day.

Functions of Fats • Provides concentrated source of energy. • Assists in absorption of fat-soluble vitamins. • Is a major component of cell membranes and myellin sheaths. • Improves flavor of foods and delay’s stomach’s emptying time. • Protects and hold organs in place. • Insulates body, thus assisting in temperature maintenance.

Classification of Fats • Triglycerides (true fats). • Phospholipids (lipoids, composed of glycerol, fatty acids, and phosphorus). • Cholesterol.

Sources of Fats • Animal (lard, butter, milk, cream, egg yolks, and fat in meat, poultry, and fish). • Plant (oils from corn, safflower, peanut, palm, etc., as well as nuts and avocado).

Digestion, Absorption and Storage of Fats • No chemical breakdown of fats occurs in the mouth and very little in the stomach. • Digestion occurs in small intestine. • Fats not immediately needed by the body are stored as adipose tissue.

Fats: Signs of Deficiency and Excess • Deficiency occurs when fats provide less than 10% of daily kcal requirement. • Gross deficiency may result in eczema, retarded growth, and weight loss. • Excessfat consumption can lead to overweight and heart disease.

Proteins • The only nutrient that can build, repair, and maintain body tissues. • Daily requirements: determined by size, age, gender, and physical and emotional conditions. • Daily protein requirement for average adults is 0.8g for each kilogram of weight.

Functions of Proteins • To provide amino acids necessary for synthesis of body proteins, used to build, repair, and maintain body tissues. • To assist in regulating fluid balance. • Used to build antibodies. • Plasma proteins help control water balance between the circulatory system and surrounding tissues. • In event of insufficient stores of carbohydrates and fats, protein can be converted into glucose and used for energy.

Classification & Sources of Proteins • Complete proteins contain all 9 essential amino acids. (All animal fats, except for gelatin, are complete. Only plant fat that is complete is soybeans). • Incomplete proteins have one or more essential amino acids missing (plant proteins).

Digestion, Absorption and Storage of Protein • Digestion begins in the stomach. • Most digestion takes place in the small intestine. • Amino acids not used to build proteins are converted to glucose, glycogen, or fat and are stored.

Signs of Deficiency and Excess of Protein • Muscle wasting. • Edema (swelling). • Lethargy and depression. • Excess can result in heart disease, colon cancer, osteoporosis.

Vitamins • Essential organic compounds that regulate body processes and are required for metabolism of fats, proteins, and carbohydrates. • Needed in very small amounts.

Foundations of Vitamins • Unique to each individual vitamin.

Classification and Sources of Vitamins • Grouped according to solubility (fat-soluble or water-soluble). • Sources are foods and vitamin supplements.

Digestion, Absorption and Storage of Vitamins • Do not require digestion. • Fat-soluble vitamins absorbed into lymphatic system; water-soluble vitamins absorbed into circulatory system. • Excess fat-soluble vitamins stored in the liver and adipose tissue. • Excess water-soluble vitamins are excreted through urine.

Signs of Deficiency and Excess of Vitamins • Vitamin deficiencies commonly afflict alcoholics, the poor, incapacitated elders, clients with serious disease that affect appetite, mentally retarded persons, and neglected children. • Vitamins consumed in excess can be toxic.

Minerals • Inorganic compounds that help regulate Body processes and/or serve as structural components of the body. • Daily requirements: Amounts greater than 100 mg/day. Trace minerals less than 100 mg/day.

Functions of Minerals • Unique to each individual mineral.

Classification & Sources of Minerals • Classified as major minerals or trace minerals. • Found in water and in natural foods, as well as supplemental minerals.

Digestion, Absorption & Storage of Minerals Influenced by Three Factors: • Type of food (minerals from animal foods more readily absorbed than those from plant foods). • Need of body (a deficiency will result in more absorption). • Health of absorbing tissue.

Signs of Deficiency and Excess of Minerals • Too much mineral intake can be toxic. • Excessive amounts of minerals can result in hair loss and changes in the blood, muscles, bones, hormones, blood vessels, and nearly all tissues.

Four Food Groups (Historical) • For many years, a plan to help people construct a well-balanced diet, with food choices from milk, meat, fruit/vegetable, and bread/cereal groups.

Food Guide Pyramid Fats, oils & sweets Use sparingly Milk, Yogurt & Cheese Meat, poultry, fish, dry beans, eggs & nuts 2-3 servings Vegetables & Fruits (2-5 servings) Bread, cereal, rice & pasta (6-11 servings)

Dietary Guidelines for Americans • Eat a variety of foods. • Maintain healthy weight. • Choose a diet low in fat, saturated fat, and cholesterol. • Choose a diet with plenty of vegetables, fruits, and grain products. • Use sugars, salts, and sodium only in moderation. • Drink alcoholic beverages only in moderation.

Factors Influencing Nutrition • Culture. • Religion. • Socioeconomics. • Fads. • Superstitions.

Nutritional Needs During the Life Cycle Affected by: • Nutritional status • Height and weight • Meal and snack pattern • Adequacy of intake based on food guide pyramid • Food allergies • Physical activity • Cultural, ethnic, and family influences • Use of vitamin/mineral supplements

Nutritional Diseases • Primary Nutritional Disease: occurs when nutrition is cause of the disease (scurvy, rickets, beri-beri, anemia). • Secondary Nutritional Disease: complication of another disease or condition.

Weight Management Maintaining weight at a desired level can be very difficult for some people. • Overweight: 11% to 19% above desired weight. Obesity is 20% or more. • Underweight: 10% to 15% below desired weight.

Safety of Food Depends upon: • Proper Storage. • Proper Sanitation. • Proper Cooking.

Food Allergies • Occurs when the immune system reacts to a food substance, usually a protein. • When such a reaction occurs, antibodies form and cause allergic symptoms.

The Nursing Process: Assessment Two types of data: • Subjective. • Objective.

Basic Nursing: Foundations of Skills & Concepts Chapter 18