ATI Nutrition Proctor GUIDE

PART 1: GENERAL NOTES (Important Facts) • Be wary of questions regarding children drinking too much milk i.e. more than 3-4 cups of milk each day. Too much milk intake reduces intake of other essential nutrients, espec ...

PART 1: GENERAL NOTES (Important Facts) • Be wary of questions regarding children drinking too much milk i.e. more than 3-4 cups of milk each day. Too much milk intake reduces intake of other essential nutrients, especially iron. Watch for anemia with milk-aholics. • Vitamin D’s presence is required by the parathyroid gland, in order for it to function. • If the patient is taking digoxin or K-supplements, avoid salt substitutes because many are potassium based • Potassium Sources: bananas, potatoes, citrus fruits • No milk (as well as fresh fruit or veggies) on neutropenic precautions. • Nondairy sources of calcium include RHUBARB, SARDINES, COLLARD GREENS 24 • Nonfat milk reduces reflux by increasing lower esophageal sphincter pressure • Yogurt has live cultures, so do not give to immunosuppressed patients • No phenylalanine with a kid positive for PKU (no meat, no dairy, no aspartame). • Acid Ash diet: cheese, corn, cranberries, plums, prunes, meat, poultry, pastry, bread • Alk Ash diet: milk, veggies, rhubarb, salmon PART 2: Focused Review Notes Manifestations of Vitamin A Toxicity  Can cause teratogenic effects on fetuses  Blurred vision  Bone pain or swelling  Hypercalcemia  ICP  Liver damage  Skin peeling, itching  Nausea and vomiting  Abnormal softening of the skull bone (children) and bulging fontanels Planning Care for a Client Who Follows Seventh-Day Adventist Dietary Laws  Vegetarianism o Do not consume animal products of any type INCLUDING eggs and milk products. o Vitamin B12 and Vitamin D supplements may be needed with a pure vegan diet.  Vegan diets are adequate in protein due to intake of nuts and legumes (dried peas and cooked beans). Initiating Continuous Enteral Feeding  This is recommended for critically ill patients because it is associated with small residual volumes, and a lower risk of aspiration and diarrhea.  Residual volumes should be measures q4-6hrs.  Feeding tubes should be flushed with water q4hr to maintain patency and hydration.  If patient’s gastric volume exceeds 500ml, the continuous feeding should be HELD and tolerance reassessed. ATI Nutrition Proctor o In children, residual volumes should be measured and held if the amount is equal to or greater than ¼ the prescribed feeding amount.  Residual should be returned and the amount rechecked in 30min to 1hr. Recommendations for Nutritional Supplement  Add skim milk to powder milk (double strength milk)  Use whole milk instead of water recipes  Add cheese, peanut butter, chopped hard-boiled eggs, yogurt.  Dip meats in eggs or milk and coat with bread crumbs before cooking.  Nuts and dried beans are significant sources of protein  great alternatives to dairy allergy or lactose intolerance! Assessing Caloric Intake  Toddlers: 1 to 3 years old o Limit 100% juice 4 to 6oz a day o The 1 to 2-year-old requires whole cow’s milk to provide adequate fat. o Food serving size is 1 tablespoon for each year of age.  Preschoolers: 3 to 6 years old o Preschoolers need 13 to 19 g/day of complete protein. o 1 tablespoon per year of age for size of foods. o May switch to skin or 1% low-fat milk after 2 years.  School-Age Children: 6 to 12 years old o Weight loss program is directed for children 40% overweight.  Adolescence o Energy requirements average 2,000 calorie/day for a 12 to 18-year-old female. o Energy requirements average 2,200 to 2,800 calorie/day for a 12 to 18-yearold male. o Average U.S. adolescent consumes a diet deficient in folate, vitamin A and E, iron, zinc, mag, calcium, and fiber.  Adulthood and older adulthood o Need a balanced diet