nutrition and dietetics-lecture

8/18/2019 Nutrition and Dietetics-lecture

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NUTRITION AND

DIETETICS


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NUTRITION

IS THE SUM OF ALL

INTERACTION

BETWEEN AN

ORGANISM AND THE

FOOD IT CONSUMES


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NUTRIENTS

ORGANIC OR INORGANIC

SUBSTANCES FOUND IN

FOODS THAT AREREQUIRED FOR BODY

FUNCTIONING


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ESSENTIAL NUTRIENTS

MACRONUTRIENTS

MICRONUTRIENTS


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DIETARY REFERENCE INTAKE

ESTIMATED ENERGY REQUIREMENT

FAT: 20-35%

CARBS: 45-65%

PROTEIN: 0-35%

FIBER: MEN-3!"# WOMEN 25"#


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FATS $ &CAL'"()#

CARBS*PROTEINS*&ETONES $

4&CAL'"()#

ALCOHOL- +&CAL'"()#


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HOW ENERGY IS USED

60% - RESTING BASAL METABOLIC

RATE

-E,(". /,1( ) ( ,7 )8

-1,1 7, 9"* )" ),1 ",1(


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MACRONUTRIENTS

ENERGY PRO;IDER

MOLECULES ARE LARGER THAN ANY OTHER NUTRIENTS

NEEDED IN LARGE AMOUNTS


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CARBOHYDRATES

TYPES

MONOSACCHARIDES- SINGLE

DISACCHARIDES- DOUBLE

POLYSACCHARIDES- MULTIPLE


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POLYSACCHARIDES

STARCH< INSOLUBLE*NON

SWEET

FIBER< COMPLE= CARB FROM

PLANTS

>SATISFIES APPETITE?


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FUNCTION OF CARB

PREFERRED SOURCE OF

ENERGY

PROMOTE NORMAL FAT

METABOLISM

SPARE PROTEIN

ENHANCE LOWER

GASTROINTESTINAL FUNCTION


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CARBOHYDRATE DIGESTION

PTYALIN- SALI;ARY

AMYLASE

PANCREATIC AMYLASE MALTASE

SUCRASE LACTASE


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LIPIDS

ORGANIC SUBSTANCES

THAT ARE GREASY AND

INSOLUBLE IN WATER BUTSOLUBLE IN ALCOHOL OR

ETHER


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FUNCTION

PRO;IDE CONCENTRATED

SOURCE AND A STORED

FORM OF ENERGY PROTECT INTERNAL ORGANS

MAINTAIN TEMPERATURE

ENHANCE ABSORPTION OFFAT SOLUBLE ;IT@


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TYPES OF LIPIDS

FAT< SOLID AT ROOM

TEMP

OILS< LIQUID AT

ROOM TEMP


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FATTY ACIDS

SATURATED FATTY ACIDS

UNSATURATED FATTY

ACIDS -MONOUNSATURATED

-POLYUNSATURATED


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CHOLESTEROL

HDL- GOOD CHOLESTEROL

LDL- BAD CHOLESTEROL

FUNCTION:

CREATE BILE ACIDS

SYNTHESIE STEROID HORMONESCELL STRUCTURES


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PROTEIN

CLASSIFICATIONS:

ESSENTIAL AMINO ACIDS- CANNOT BE

MANUFACTURED IN THE BODY

NONESSENTIAL- CAN BE

MANUFACTURED IN THE BODY


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FUNCTION OF PROTEIN

DE;ELOPMENT OF BODY

TISSUES

REPAIR TISSUES REGULATE FLUID BALANCE

MAINTAIN ACID BASEBALANCE


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MACRONUTRIENT DEFICIENCY

KWASHIORKOR MARASMUS

AGE OF ONSET YR OLD YR OLD

GROWTH STUNTING STUNTING

E=TREME WASTING

EDEMA PRESENT ABSENT

PLASMA PROTEIN ;ERY LOW NORMAL

OTHERS FATTY LI;ERS&IN LESIONSDEPIGMENTEDHAIR

ANEMIAOLD MANS FACE


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MICRONUTRIENTS

@ ;ITAMINS

2@ MINERALS

-MACRO< O;ER 00#"

-MICRO< LESS 00#"


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VITAMIN

NEEDED IN SMALL

QUANTITIES TO CATALYE

METABOLIC PROCESSES

TYPES

-WATER SOLUBLE

-FAT SOLUBLE


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FAT SOLUBLE VITAMINS

A D E &

;ITAMIN A

3 FORMS

-RETINOL

-RETINAL

-RETINOIC ACID > ACTI;E FORM?


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FUNCTION

GROWTH REGULATORS OF

EPITHELIUM

GAMETOGENESIS

PRESENT IN ROD AND CONE CELLS

FOR ;ISION


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DEFICIENCY TOXICITY

NYCTALOPIA > NIGHT

BLINDNESS?-EARLIESTMANIFESTATION

XEROPHTHALMIA- EYE AND CORNEALDRYNESS

IMPOTENCE ANDGROWTHRETARDATION

HYPERKERATOSIS

PSEUDOTUMOR

CEREBRI > INC ICP?

INCREASED RIS& OFFRACTURE

TERATOGENIC


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VITAMIN D

ORGANS ESSENTIAL

@ S&IN

2@ LI;ER3@ &IDNEY

RESPONDS TO HYPOCALCEMIA

AND PTHINCREASE CALCIUM AND

PHOSPHATE


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DEFICIENCY TOXICITY

RICKETS: INCHIDRENBEFORE EPIPLATES CLOSES

OSTEOMALACIA:IN ADULTS*

AFTER EPIPLATES CLOSES

MOST TO=IC;ITAMIN

HYPERCALCEMIA-ANORE=IA ANDNAUSEA-THIRST

-STUPOR


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VITAMIN E

FUNCTION

-ANTI O=IDANT

-PRE;ENT O=IDATION OF LDL

DECREASE ATHEROSCLEROSIS


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DEFICIENCY TOXICITY

RBC FRAGILITY

NEUROLOGICDYSFUNCTION

LEASTTO=IC;ITAMIN


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VITAMIN K

BLOOD COAGULATION

CLOTTING FACTORS

0

+

2

1972


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DEFICIENCY TOXICITY

HEMMORHAGIC DSE OFNB

AUNDICE ANDHEMOLYTIC ANEMIA


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WATER SOLUBLE VITAMINS

;ITAMIN B AND ;ITAMIN C

ARE NOT STORED IN THE BODY AND

CAN BE E=CRETED IN THE URINE


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B1

THIAMINE

DEFICIENCY:

BERI BERI

WERNIC&E-&ORSA&OFF


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B2

RIBOFLA;IN

DEFICIENCY:

STOMATITIS

CHEILOSIS

DERMATITIS


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B3

NIACIN

DEFICIENCY:

@ PELLAGRA

2@ HARTNUP DISEASE

3@ CARCINOID SYNDROME


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B5

PANTOTHENATE

DEFICIENCY

@DERMATITIS

2@ ENTERITIS

3@ ALOPECIA

4@ ADRENAL INSUFFICIENCY


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B6

PYRIDO=INE

DEFICIENCY CAN BE SEEN IN

ISONIAID USE


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B12

COBALAMIN

DEFICIENCY:

PERNICIOUS ANEMIA

>MEGALOBLASTIC ANEMIA?

DIAGNOSTICS: SCHILLING TEST


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VITAMIN C

DEFICIENCY:

SCUR;Y


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ESSENTIAL MINERALS

CALCIUM

000-500MG DIETARY C) PER DAY

SOURCES:

BROCCOLI

CARROTS

CHEESE

SPINACH* GREEN BEANS


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PHOSPHORUS

SOURCES

FISH

NUTS

ORGAN MEATS

POR& BEEF CHIC&EN

WHOLE GRAIN BREADS AND CEREALS


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POTASSIUM

A;OCADO

BANANAS

CANTALOUPE

CARROTS


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SODIUM

CHEESE

BACON

BUTTER

CANNED FOOD


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ZINC

EGGS

LEAFY ;EGETABLES

MEATS

PROTEIN RICH FOODS

DEFICIENCY- ACRODERMATITIS

ENTEROHEPATICA


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IRON

BREADS AND CEREALS

DAR& GREEN LEAFY ;EGETABLES

EGG YOL&

LI;ER

MEATS


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TYPES OF DIETS

CLEAR LIQUID DIET

P(71 81 ),1 7# 8(78.

I,)8 1," )( 7#8 798 (*

#)8,7(1 (7,* 7( ,7 7()8 ,) 7(

) 87," #


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P()()7, 7( ("(. 7(

P7 7 8, F7( ")(7,( 7(

),()


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Nur!"# $%"!&'r()!%"

D, , )87(

E)8. 1"1 ),1

)7(1 M,#)8 (1 8

T(),)(, 7 8" ),18J1 K (77# #@


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Fu** *!+u!& &!')

I ,(7,)88. 1, ,

)87( ),1 ,(,

F7( 8, ) )( ),"

18. , 9)8879," 7(

78()," 781 771


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M'$,("!$(**- (*)'r'& &!')

M,#)8 9,"

D8. 9," ), 78()

/(

F7( 8, 9 1,)8 (78#*

)1 7( , ("(.* 1.)")


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Nur!"# $%"!&'r()!%"

A71 ,* 1(1 (* (1 771*

#7 7( )81 #)

F771 )( (1* #)1 * "(7,1*

71


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S%.) &!')

F7( 8, 97 ) 18. 9,"

7( 9)8879,"

C8, 9 8( 7, #7 7("#* 7()8 ("(.* (7, )9*

1.)")* (7


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Nur!"# $%"!&'r()!%"

C8, 9 #7 7( $ (1 771

K 778( #

D(. #7 $ 7, 7( ),1.

D(,," (7" ) ()9


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L%/ r'!&u' &!')

F7( 8, 9 ,8)##)7,

, ,,)8 ()* 879 GI

#78. I,8)##)7(. B798 D*

")(7,(* 1)(()* GI

17(1(


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H!#, r'!&u' &!')

F7( 7,)7,* (()8

798 .,1(7#*

).#7#)1(8)( 1


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Nur!"# $%"!&'r()!%"

P(71 25-30" 7 1)(.

( 1)8.

I,() ( "()1)88. G) 7(#," 771 781

8#1


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C(r&!($ &!')

F7( )(78(7*

1) #88*

.(81#)*H.(,7,* MI* ,(7

.,1(7#


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Nur!"# $%"!&'r()!%"

R( 7)8 )#7,

7 ) ),1 71# ,

1


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F() r')r!$)'& &!')

U1 7 (1 .#7# 7

)17#,)8 ),* )7(()

8)8,

M)8)7(7, 17(1(*

),()* ")888)11( 1

),1 GERD

H!#, $(*%r!' ,!#,


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H!#, $(*%r!'0 ,!#,r%)'!"

S( (* (,*

97,1 )8,"*

),(* HI;* AIDS*

COPD*


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S%&!u r')r!$)'& &!')

H.(,7,* )( )8(*

(,)8 1)* )(1)

1)* ),1 8( 1)@


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Nur!"# $%"!&'r()!%"

I,11)81 $ 4" 7 N) 1)8.

M71() ((7, $ 2-3 " 7 N)

S( ((7, $ " 7 71#

E,7()" ( 771 ()( ),

(71 771


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Pr%)'!" r')r!$)'& &!')

U1 7( (,)8 ),1 8(

1)


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Nur!"# $%"!&'r()!%"

P(71 ,7" (7, 7

#),), ,(7,)8 ) 988

,7 )8879 81 7 (7,

9) (71@

H" 787")8 )8


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R'"(* &!')

U1 7( 8, 9 ) 7(

(7, (,)8 )8( ),1 7

(J(," 1)8. 7( (7,)8

1)8.@

M7 8, (," 1)8.,1 7 (( 81@


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Nur!"# $%"!&'r()!%"

C7,(7881 )#7, 7

(7,* 71#

77(


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L%/ ur!"' &!')

U1 7( "7* 1,.

7,


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Nur!"# $%"!&'r()!%"

P((7( 7( ( )1* 9 7(#

7, ),1 (.)8

F771 7 (( ,81 ),7*

((,"* #)(8* )(1,* )887*

"8),18)( #)* "()* #) /()*

981 ")#* ")# "77* ),1 9()1@


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VEGETARIAN DIETS

LACTO OVO $ CONSUMES EGGS

AND DAIRY

LACTO VEGETARIAN- CONSUMESDAIRY PRODUCTS BUT E=CLUDES

EGGS

VEGAN $ E=CLUDES ANIMAL

PRODUCTS


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PESCO VEGETARIAN $ CONSUMES

SEAFOOD E=CEPT MEAT* POULTRY*

EGGS AND DAIRY PRODUCTS@


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TUBE FEEDING

POINTS TO REMEMBER

FOWLERS POSITION

ASSESS TUBE PLACEMENT

ASSESS RESIDUAL FEEDING

CONTENTS


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FEEDING BAG OPEN SYSTEM 4

NURSING CONSIDERATIONS:

HANG BAG 2 IN@ ABO;E THE

INSERTION POINT

CLAMP TUBING THEN ADD FORMULA OPEN CLAMP THEN RUN FORMULA

ATTACH THE FEEDING BAG TO THE

TUBE


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SYRINGE


PRE;ENT E=CESS AIR IN ENTERING

STOMACH

ADMINISTER SLOWLY

PREFILLED BOTTLE WITH DRIP


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PREFILLED BOTTLE WITH DRIPCHAMBER CLOSED SYSTEM 4


HANG ABOUT 2 IN ABO;E

INSERTION POINT

PRE;ENT INSTILLATION OF E=CESS AIR

ENSURE CLIENT COMFORT


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AFTER FEEDING

FOWLERS POSITION OR SLIGHTLYELE;ATED RIGHT LATERAL

POSITION K LEAST 30 MIN

GASTROSTOMY OR


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GASTROSTOMY OR EUNOSTOMY FEEDING

INSERTION

LUBRICATE AND INSERT END OF

TUBE 4-6 IN@

CHEC& PATENCY > 7( 5-30 #89)(* 879 (8.* ),?

( (1)8 1," (. 4-6 7(


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FEEDING

CHEC& RESIDUAL FORMULA > 50#8

7( #7( (. 1," 988

)1#,(1@? HOLD 3-6 INCHES ABO;E OSTOMY

SLOWLY INSTILL THE FORMULA

BEFORE FORMULA RUNS OUT*FLUSH WITH 30 CC WATER

AFTER FEEDING


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AFTER FEEDING

REMAIN IN SITTING OR SLIGHTLELE;ATED RIGHT LATER POSITION

FOR 30 MIN

ASSES PERIOSTOMAL S&IN


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TOTAL PARENTERAL NUTRITION

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