Chapter 43

Nutrition

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Elements of Energy and Nutrition
Basal metabolic rate (BMR)
Resting energy expenditure
(REE)
Nutrient density
Nutrients: carbohydrates,
proteins, fats, water, vitamins,
minerals

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Carbohydrates

Produce 4 kcal/g
Main source of energy
Saccharides: simple and
complex carbohydrates, fiber

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 Proteins

Produce 4 kcal/g
Essential for growth, maintenance,
and repair of body tissue
Amino acids: essential and
nonessential
Complete and complementary
proteins
Nitrogen balance
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 Fats (Lipids)

Produce 9 kcal/g
Triglycerides and fatty acids
Saturated or unsaturated
Essential or nonessential fatty
acids

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 Water
Comprises 60% to 70% of body weight
Cell function depends on a fluid
environment

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 Vitamins
Essential to normal metabolism
Fat-soluble: A, D, E, K
Water-soluble: C and B complex

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 Minerals

Inorganic elements essential as

catalysts in biochemical
reactions
Macrominerals
Microminerals or trace elements

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Digestive System

Anatomy and physiology

– Digestion
– Absorption
– Metabolism and storage of
nutrients
– Elimination

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Dietary Guidelines

Dietary referenced intakes

(DRIs)
Food guidelines: food guide
pyramid
Daily values
Healthy People 2010

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Nutritional Needs throughout
Growth and Development

Infants through school-age

– Breast-feeding
– Formulas
– Solid foods
– Food habits
Adolescents
– Eating disorders
– Activities
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 Nutritional Needs throughout
Growth and Development (cont'd)

Young and middle adults

– Pregnancy
– Lactation
Older adults

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Alternative Food Patterns
Cultural and religious practices
Vegetarian diets

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Assessment: Diet History

Dietary intake and pattern

Symptoms
Allergies
Taste
Chewing and swallowing
Appetite
Elimination
Medications
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 Assessment
Anthropometry
Body mass index (BMI)
Ideal body weight (IBW)
Laboratory tests
Clinical observations
Client expectations

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Nursing Diagnoses
Risk for aspiration
Constipation
Diarrhea
Imbalanced nutrition: less
than/more than body
requirements
Feeding self-care deficit

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 Planning
Goals and outcomes
– Client’s daily nutritional intake
meets the minimum DRIs
– Client loses ½ pound per week
Setting priorities
Continuity of care

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 Implementation:
Health Promotion

Client education
Meal planning
Food storage and preparation safety

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Implementation: Acute Care

Advancing diets
Promoting appetite
Assisting clients with feeding
Enteral feeding
Parenteral nutrition

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Enteral Feeding
Nasogastric, jejunal, gastric
tubes
Insertion and verification of
placement
Types and preparation of
formulas
Complications

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Parenteral Nutrition
Initiation and management of
insertion site
Types of solutions
Rate of infusion
Prevention of complications

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Implementation: Restorative Care

Medical nutrition therapy for

specific illnesses, conditions,
or injuries
– GI diseases
– Diabetes
– Cardiovascular diseases
– Cancer
– HIV
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 Evaluation
Client care
Client expectations

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