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Essential Nutrients
  • Water
  • Macronutrients:
    Carbohydrates
    Protein
    Fats
  • Vitamins
    Minerals
Water Soluble
produced by plants
What does the body break carbohydrates into?
glucose to maintain blood levels, provides a source of readily available energy
Where is glycogen stored?
The liver
Where are carbohydrates absorbed?
in the small intestine for healthy people.
Where is protein first broken down?
the mouth by the enzyme pepsin
Where is the biggest chunk of protein digested?
The small intestine
What do proteins break down into?
Amino Acids
where is fat digested?
first the stomach, then small intestine
Fat digestion is done by
bile, pancreatic lipase, and enteric lipase
End products of lipids
glycerol, fatty acids, cholesterol
the value of nutrients or food supply to the body
calorie
Basal Metabolic Rate (BMR)
rate at which the body metabolizes food to maintain the energy requirements
Resting Energy Expenditure (REE)
The amount of energy to maintain basic body functions
Normal range for BMI
18.5-24.9
Obese level for BMI
over 30
Underweight level BMI
under 18.5
Factors influencing nutrition
•Developmental considerations
•Gender
•Ethnicity and culture
•Beliefs about food
•Personal preferences
•Religious practices
•Lifestyle
•Economics
•Medications and therapy
•Health
•Alcohol consumption
•Advertising
•Psychological factors
Nutritional condiserations: Adults
Postmenopausal women need to ingest sufficient calcium and vitamin d
what is helpful to reducing heart disease?
vitamin A,C, and E
Nutritional condiserations: Elderly
  • fewer calories needed by elders because of lower metabolism
  • some may need more charbohydrates for fiber and bulk
  • dental changes may occur
  • impaired sense of taste and smell
  • decreased saliva and gastric juice secretion
  • psychosocial factors may also contribute
Daily vaules of foods
  • 8 or more servings of water
  • 6+ servings of Grains
  • 3+ Vegetables
  • 2+ Fruits
  • 3+ Dairy
  • 2+ Proteins
Nutritional Screening and assessment
Identifies clients for risk of malnutrition
When a resident falls bellow 75% of meal eaten?
A Nutritional assessment by nurse
Malnutrition Risk factors
chewing, inadequte food budget, IV fluids, Living and eating alone, Physical disabilities, Restricted fad diets
Medical history risk factors affecting malnutrition
teen pregnancy, alchohol/substance abuse, catabolic or hypermetabolic conditions, chronic illnesses, dental problems, neurological or cognitive impairments, oral and GI surgeries, Unintentional weight loss or gain
Specialized diets
ADA, Cardiac, Renal
ADA Diet
American diabetic association diet

Based on total calories, balanced meals and charbohydrate counting (45/60g/meal)
Cardiac diet
Limited fat ( less than 30% of diet) saturated fats less than 7% of daily calories, low sodium intake
Renal Diet
Low protein, low sodium, low potasium, controlled fluid intake
Sodium restrictions
improve blood pressure and avoids fluid accumulation
Potassium restrictions
when it is not excreted effectively, too much potasium in the blood is dangerous for heart rythms
Vegetarian Diets
  • Vegan- excludes all meat and animal products
  • Lacto Vegetarian diets-plants and dair products
  • Lacto-ovo vegtarian diet- dairy, plats, and eggs
  • nutrients vegetarians need to focus on protein, iron, calcium, zinc, and B12
Clear liquid diets include
water, tea, coffee, broths, clear sodas, clear juice, plain gelatin
Full liquid diet includes
only liquids, foods that become liquid at room temperature
Famotidine (pepcid)
H2 recepter antagonist
blocks action of histamine at H2 receptor sites of parietal cells

results in decreasing acid secretion and concentration

Used for active ulcers, risk for ulcers, relapsing non-erosive GERD, Initial esophagitis, Upper GI bleeding, OTC formulations
Famotidine (pepcid)
Adverse effects:
Confusion, dizziness, drowsiness.
Restlessness, halucinations, cardiac?heme (rare but life threatening)
Nursing considerations for Famotidine
Therapeutic Effects
Do not take with antacids
Administer before meals or at bedtime
Avoid GI irritants (caffeine beverages, alcohol, spices) & smoking 

Adverse Effects
Older adults may need lower drug doses
Monitor drug levels if renal impairment Monitor elderly closely for confusion
Anti-emetics
Anti-vomiting agent, can be over the counter, used to prevent motion sickness, not reccomended in pregnancy
Zofran (ondansetron)
Anti-emetic,
Routes: PO,PR,IM,IV
Treats motion sickness, nausea, vomiting, chemotherapy
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