NURSING 001 Chapter 19 Nutritional Concepts and Related Therapies.

Ch 19 Nutritional Concepts and Related Therapies Wednesday pg 485-508 ch 6 box 6-4 pg 101-105/ Thursday test 508-532 and CH 22 p 676-684 Nutrition: sum of all processes involved in taking in nutrients and using them to ...

Ch 19 Nutritional Concepts and Related Therapies Wednesday pg 485-508 ch 6 box 6-4 pg 101-105/ Thursday test 508-532 and CH 22 p 676-684 Nutrition: sum of all processes involved in taking in nutrients and using them to maintain body tissue and provide energy (one of the foundation of life); Good nutrition is essential for optimal health throughout all stages of life Role of the nurse in promoting nutrition: ​Pt look at nurse for more information ● responsible for assisting pt to eat, record intake, observe signs of poor nutrition and communicating about dietary concerns to hcp ● Nurse needs knowledge of nutrition to help pt Basic nutrition: Diet planning guides Guidelines started as farmers bulletin more than 100 yrs ago and then evolved into basic 7, basic four, the food guide pyramid,Mypyramid, and currently MyPlate MyPlate: ​Developed by USDA in 2011 ● Image of round plates divided into 4 different color selection ○ Vegetables, fruit, grain, protein and a seperate group dairy ● USDA suggest ppl balance calories by reducing portions; increase intake of fruit and vegetables ● Reduce amount of sodium and sugary foods in the diet Dietary guidelines for americans: ​the latest of these guidelines and include recommendation for the general population ● Help choose overall healthy diet ● This guide balances calories: consuming more fruits, vegetables, whole grains, increasing fat-free or low-fat dairy and seafood; consuming low sodium, saturated fat, trans fat, cholesterol, added sugars, and refined grains ● Dietary guidelines for americans affects: food stamps, WIC, school breakfast and lunch programs ○ The government developed these guidelines to address adequate nutrition, avoid overnutrition and chronic disease Dietary Reference intakes (DRI):​ refers to a set of nutrients based values that serve for both assessing and planning diet ● DRI replace and expand on recommended dietary allowance (RDA) have been around for more than 50 years ● Purpose of the DRI is to help provide individuals optimize their health, prevent disease, and avoid consuming too much of a nutrient Essential nutrients: Basic functions A nutrient: a chemical compound or element in food that is necessary for good health Essential nutrient: nutrients that the body cannot make in the amounts essential for good health; therefore, it is necessary to obtain these nutrients through a diet ○ 6 classes of essential nutrients: carbohydrates, fats, proteins, vitamins, minerals, and water ○ Each necessary for life ○ 3 major functions of nutrients: 1) providing energy 2) building and repairing tissue 3) regulating body processes Providing energy ● Kilocalorie(kcal): is a measurement of energy, much as a pound is measured in weight ○ The more kcal a food has the more energy it will provide ● Of the 6 essential nutrients only 3 provide energy: carbohydrate, fats, and proteins ○ Carbs and proteins provide approximately 4 kcal/g, Fats provide 9 kcal/g, Alcohol supplies 7 kcal/g ● Caloric distribution: Obtain 45-65% of daily kcal from carbs, 20-35% from fats, 10-35% from protein Building and repairing tissue ● Protein is the nutrient that places the most important role in building and repairing ○ It contains amino acids ● Calcium and phosphorus are minerals that are necessary nutrients in bone structure, iron, another mineral makes up a large part of hemoglobin in RBC Regulating body processes ● Metabolism: combination of all chemical processes that take place in living organisms ○ Processes of building up and breaking down tissue ○ Nutrients play a role in metabolism and help regulate certain body processes ■ The presence of carbs is required for fat to be used correctly ■ Vitamin B are necessary for the body to derive energy from food ■ Water is an integral part of almost all chemical reactions in the body ● By studying how the body uses nutrients scientist have found 2 important facts ○ Individual nutrients have many functions in the body ○ No nutrient works alone Carbohydrate:​ organic compounds containing carbon, hydrogen, and oxygen ● Main function to provide energy ● Also needed in adequate amounts to keep protein from being used as energy ● Made up of saccharides (sugar units) ● Classified as simple or complex carbohydrates ○ Simple carbohydrates: include monosaccharides and disaccharides ■ Monosaccharides have one unit of sugar require no digestion ■ Fructose (monosaccharide) found in fruits and glucose (blood sugar) ■ Disaccharides are made up of two sugar units bonded together ● Once they go into the body hydrolysis breaks them down into monosaccharides ● Ex. table sugar (sucrose) and milk (lactose) ● DRIs relating to carbohydrates indicates that 45%-65% of adult calories should be a form of carbohydrates ○ Added sugar should be no more than 8% (40g) ○ Simple sugars are found in milk and fruits ● Complex carbohydrates: polysaccharides made of long chains of glucose units ○ All break down into simple sugars when digested ○ 3 types of complex carbohydrate are ■ Starch- found in plant foods such as grains, legumes, and vegetables (breaks down more slowly b/c its larger ■ Glycogen: (animal starch) made of simple sugars, stored in liver used when body glucose is low ■ Dietary fiber: humans cannot digest, fiber consumed secreted in feces has no nutritional value ● It can lower cholesterol and blood glucose level and assist in weight loss ● Insoluble fiber: found in wheat bran, vegetables, whole grains and some fibrous fruit ● Water-soluble fiber: fruits, oats, barley, and legumes Daily requirements of Carbohydrates ● Fiber intake 21 and 38g/day ● MyPlate recommends increasing fruits and vegetables, and consuming at least half of grains as whole grains NOT refined ● Increase in fiber can cause gas, bloating and constipation, too much can lead to osteoporosis and anemia ● 8 glasses of water per day Digestion and metabolism of carbohydrates All carbohydrates broken down in digestive tract into monosaccharides before absorbed and converted to glucose except fibers ● Extra carbohydrates are stored as glycogen Fats (lipids): ​organic substances of a fatty nature that are insoluble in water and necessary for good health ○ Both fats and cholesterol are lipids ● They provide the most concentrated source of energy of all nutrients; need 9 kcal/g ● Dietary fats provide Satiety (a feeling of fullness and satisfaction from food) ○ Adds aroma to foods and provides the body with essential fatty linoleic acids and linolenic acid ○ Dietary fats also carry fat soluble vitamins: A,D,E, and K ● Composed of carbon, hydrogen and oxygen just like carbohydrates ● Lipids also contain fatty acid and glycerol; b/c of this they may be called glycerides or triglyceride ○ Fatty acids are the building blocks of fat ● Classified as either saturated or unsaturated ○ Saturated fatty acid:​ ​chemical bonds are completely filled or saturated with hydrogen ■ Are generally of animal origin and solid at room temp ■ Have a long shelf life because the fat is strong so it takes long to spoil ■ Tend to increase blood cholesterol, increasing the risk of atherosclerosis ■ 7% of total daily calories