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food 3. food qualities 4. nutrient 5. enzyme 6. hormones 7. nutritional status B. History of Nutrition and Laws Related to Nutrition C. Nutrition Programs in the Philippines II. A. Role of Nutrients in the Maintenance of Normal Health
1. Food and its Functions 2. Digestion and absorption 3. Energy and Metabolism B. Different Food Nutrients 1. water 2. protein 3. carbohydrates 4. fats 5. vitamins 6. minerals III. ASSESSING NUTRITIONAL NEEDS A. Physiological Importance of Food 1. Required Nutrition Across the Lifespan a. Pregnancy and lactation b. Infancy c. Toddler d. Pre-school age e. School age f. Adolescence g. Adulthood h. Aging and aged
a. b. c. d. e. f.
Malnutrition and Forms of Malnutrition Marasmus Kwashiorkor Iron deficiency anemia Iodine deficiency Vitamin A deficiency Protein energy malnutrition
B. Eating Disorders 1. Anorexia Nervosa 2. Bulimia Nervosa IV. NUTRITION CONDITIONS 1. diabetes mellitus 2. CVD ( atherosclerosis, congestive heart failure[CHF], HPN ) 3. renal disorder a. UTI b. Acute renal failure c. Chronic renal failure d. Renal calculi 4. gastrointestinal disorder a. nausea and vomiting b. constipation
clear liquid diet 2. high fiber diet 7. full liquid diet 3. AIDS. post-operative diet 6. ROUTINE HOSPITAL DIETS 1. low calcium diet 13. protein restricted diet 11. low protein diet 12. low residue / low fiber diet 6. high calorie diet 9. sodium restricted diet 10. soft diet 5. burns 7. cancer. and other special problems V. diarrhea d. fat controlled diet 8. peptic ulcer 5. bland diet 4. low purine diet 4 . surgery a. acute gastritis e. pre-operative diet b.c.
Lippincott Company Eshleman.. Definition of Terms 5 . Basic Nutrition for Filipinos.. 1991. fluid restriction diet 17. APPLIED NUTRITION COOKING DEMONSTRATION TEXTBOOK AND REFERENCES Claudio. carbohydrate controlled diet VI. Marian. Nutrition Handbook for Nursing Practice. 5th ed. G. MEAL PLANNING AND FOOD PREPARATION VII. Nutrition and Diet Therapy. Philadelphia: J. INTRODUCTION A. Ofelia. 2nd ed.14.. 2002.B. Susan.. Virginia and Dirige. high iron diet 15. Lippincott Company I. 2nd ed. 1993. Philadelphia:J. Manila Philippines: Merriam and Webster Bookstore Dudek.B. diet foe diverticular disease 16.
1. their action. satiety value . Food Quality .Prepared under sanitary conditions. the nutrients and other substances.Any substance. palatability . Food .color. aesthetically and scientifically.What is not seen by naked eyes is the nutrient of food.should be sufficient or enough for consumer 6 . . when ingested or eaten. 3. organic or inorganic. Qualities of Food a. nourishing/ nutritious c.Free from toxic agents b. 2. texture d.Study of food in relation to health . nourishes the body by building and repairing tissues.FNC = science of food. supplying heat and regulating bodily process. Nutrition . aroma flavor. second to oxygen . interaction and balance in relation to health and disease.Sustains life. Safety . .essential identifying nature of nourishment for people which they need for energy and growth 4.
Water b.Important/ essential to human being.Water: most abundant in the body (2/3 of the body weight) . Protein c. Vitamins 7. Mineral d.Minerals: 4% 7 .e. offers variety and planned within the socio-economic context .Protein: 20% . . Nutrients . Biosynthesis: a process wherein the body manufacture nutrients. 6.1. a. 5. Classification of Nutrients a. Essential Nutrients . Carbohydrates e. Fats f.Chemical components needed by the body found chiefly in food. Function a.within budget and suitable to the lifestyle of the person. Body Building -They form tissue or are structural components of the body.
Either organic/inorganic: Organic: carbon-containing compounds and the exemption of carbonate and cyanide.Fats a. Inorganic: minerals and water c. b. Regulating .macro / micronutrients 8 .includes all the 6 groups of nutrients. Chemical nature . do not yield energy.2.Carbohydrates: 1% (about 1/3 by) . Concentration .3 Furnish energy .all are physiologically essential to the body. minerals and vitamins * Non-caloric nutrients thus. d.. a.Maintain normal physiologic process .Carbohydrates. Essentiability .Fuel nutrient . fat and protein * H2O.maintain homeostasis of body fluids and expedite metabolic .
. 9.Organic substance produced by special cells of the body which are circulated in blood to specific organs/tissues. d. . .Regulate vital processes which are highly specific.1 Macronutrients: present in relatively large amounts in the body.Insulin.2 Micronutrients: all vitamins and trace minerals (measured in milligrams) 8. Targets: 9 . Fat . Hormones . Nutrition Programs in the Philippines ( to be given as assignment ) Goal: To improve nutritional status of the Filipinos.Ongoing chemical process within the body that converts digested nutrients into energy for the functioning of the body cells B. Metabolism . Enzymes . CHO. .Produced by endocrine and ductless glands. CHON.005 7-of body weight.organic catalysts that are protein in nature and are produced by living cells. thyroxin. History of Nutrition and Laws Related to Nutrition ( to be given as assignment ) C.H2O.Major minerals – above . progesterone 10.d. adrenaline.
1. Organization programs in poorest areas. Malnutrition (PEM) – Pre. Intensive alliance among stakeholders towards increased investment in nutrition. 3. Integration of nutrition considerations in development policies and programs. Agenda: N U T R I T I O N B R E A S Nationwide Salt Iodization Unified efforts for micronutrient food supplementation and food fortification Targeted assistance to ensure household food and nutrition security Reinforced capacities in policy and plan formulation. surveillance. school children. 5. 4. 6. Breast milk Reduced allergy Establish bonding Antibodies Safe and sterile 10 .school and school children – 20% Reduce prevalence of chronic energy deficiency (CED) – adults – 20% Reduce prevalence of iron deficiency anemia – 20% IDA Reduce prevalence of low deficient serum retinal level – 6 months to 6 years old children. 2. Reduce iodine deficiency indicated by median urinary iodine excretion (UIE) level-school children Reduce prevalence of overweight-pre-school. Non-wage benefits packages in labor and industry. Reduce prevalence of protein energy. Tri-media approach for effective nutrition information and education campaign. research and its utilization. adult male and female – 20%. advocacy.
A. Supplying heat and energy Regulating bodily processes 11 . carbohydrate and mineral and vitamins. Milk is a food comprise of water. Water is a beverage which is considered food as well as nutrient. mineral and vitamins.T F E E D I N G Temperature is constant Fresh Economical Easy to give Digestible Infection free Nutritious Gastroentiritis is reduced II. Nutrients are not seen by the naked eye. fat. Milk. Food and its function Food includes articles used as drink or food and the articles used for the component of such. protein. Kalamansi juice is food that contains water. carbohydrate. fish. fruit and vegetable are tangible food. Denotes that food can be simple or complex in its chemistry and contains nutritional and or non nutritional and or nor nutritional components (Food coloring. egg. Role of Nutrients in the Maintenance of Normal Growth 1. spices and preservatives) Functions of food: Nourishes the body by building and repairing tissues.
mixing and controlled emptying occurs in the stomach and intestines. substances that initiated and accelerate chemical reactions without undergoing change. Digestion in the stomach Stomach receives the food and acts a reservoir for a short time. It also provides favorable medium for absorption of Calcium and other minerals. The storage. When masticated food mass (called bolus) is swallowed. Digestion chemically happens by the actions of enzymes resulting the eventual splitting up of food stuff into simple components. 12 . Enzymes are protein in nature. The acid medium is also responsible for the reduced activity of harmful bacterial that may have been taken in with the food. Thick slimy mucus called mucin is secreted from the stomach wall to protect the cells from being digested by the enzymes. All foods are liquefied and mixed with the HCL acid. Digestion Digestion is accomplished mechanically by chewing and swallowing in the mouth. it passes downward to the esophagus by means of muscular contraction. The food leaves the stomach in the form of chime.Sustains life second to oxygen 2. Digestion in the mouth With the entrance of food in the mouth. Food reduced to semi fluid (called chime) The acidity of the stomach (caused by HCL) stops the digestive action ptyalin in the food mass. Digestion and absorption Review Anatomy of Digestive Tract a. digestion started by means of mastication.
Any bulky and unused parts of the diet are passed on to it. Energy dependent active transport – the nutrient molecules must pass through the intestinal membrane to supply the materials needed by the body even against a pressure gradient and this mechanism requires extra work and energy. water is reabsorbed causing the formation of a fairly solid mass. Passive diffusion and osmosis – small molecules passed through the capillary membranes and diffuse easily into capillaries of the villi depending on the pressure. In the colon. 13 .Stomach is normally emptied in 1-4 hours with carbohydrate leaving the stomach rapidly followed by fats. b. The villi are fingerlike projections lined in the intestinal wall which increase the surface area for absorption. When the rectum is reached. cell cast off from the intestines and some mucus and some salts. Absorption When the products of digestion pass through the lining of digestive tract into the blood stream and lymph. This consists of undigested food fibers. The absorption of digested food takes place largely in the small intestine through villi. it is termed as absorption. Digestion in the Large Intestine The large intestine does not take part in the digestion of food. The absorption in the small intestine may be accomplished by a number of processes depending on the nature of the nutrient and the prevailing pressure gradient. the mass is evacuated in the form of feces. Facilitative absorption or carrier-mediated diffusion – molecules which are large enough to traverse the membrane pores are helped by the specialized transport systems which carried the large molecule through the barrier. bacteria.
f. Protein Contains several millions of protein molecules. lipoproteins.Engulfing (pinocytosis) – when very large molecules are involved. it carries simple sugar. Water acts as lubricant of the joints and the viscera in the abdominal cavity thus can protect a sensitive tissue. Hydrates skin. Protein is needed for building and repairing cells and specialized role in metabolism. building blocks of protein are amino acids. water is essential to stay alive. Moisten the eyes. e. g. Functions of Water a. If about 20% of body water is lost. Water accounts for about 60-65% of body weight for normal adult. d. Regulator of the body temperature through its ability to conduct heat. b. Used to excrete waste products from lungs. B. Acts as a shock absorber inside the spinal cord and amniotic sac surrounding the fetus. organ and tissue in the body. the intestinal villi act like amoeba or leukocytes by ingesting foreign particles into the interior of the cell. Vital component of every cell. vitamins and minerals for transportation to the different tissues for proper functioning and nourishment. c. Various Nutrients of Food Water Next to oxygen. Serves as transport medium for many biological reactions especially in digestion and absorption and circulation. Universal solvent. 14 . skin and kidneys. nose and mouth. This method is used for fat metabolism. amino acid. death results. Participates in maintaining electrolyte balance.
ripe fruits and some vegetables. Mannitol – poorly absorbed in the intestines and used a food ingredient and as drying agent. b. Classification: a. Referred to as dietary essentials. Known as “Physiologic sugar. Carbohydrates Originally called “Saccharides” sugar Organic compound abundant in plants and wide spread in nature. • Galactose – not found in nature but is hydrolyzed from fructose or “milk sugar. 15 .” It is also the circulating carbohydrate. c. • Fructose – sweetest of all sugar and found preformed in honey.Classification of Amino Acid a. b. • Sugar alcohols – have sweetening power as glucose. a.” Glucose is converted to galactose to form sugar or lactose in breast milk. Sorbitol – absorbed slowly than other monosaccharide and it has been used to delay the onset of hunger. Monosaccharides – simplest form of sugar • Glucose – dextrose or grape sugar . Semi-essential (semi indispensable) amino acid reduces the need for particular essential amino acid (EAA). It can be essential by the body as long as the materials for synthesis are adequate. Non-essential amino acid (NEAA) – “dispensable amino acid” – not a dietary essential. Amino acid that can maintain life processes for an adult but not enough for normal growth in children.Most important sugar in human metabolism. Essential – cannot be synthesized by the body from materials readily available at a speed to keep up normal growth rate.
• Glycogen . Least sweet among sugars only 1/16 as sweet as sucrose or table sugar. maple syrup. grains. sorghum. • Dextrin – intermediate product digestion or formed from partial hydrolysis of starch. The action of dry heat o starch (as in toasting bread or browning of cake crust in the oven) produce dextrin. Important component of nucleic acid and some co-enzymes. Liver glycogen – changed into glucose and circulate as such by the blood to other parts of the body. chiefly in the liver and muscles. 16 . Polysaccharides – not water soluble sugar • Starch. b. c. • Lactose – “milk sugar” found in milk and milk products. Also abundant in molasses.“animal starch” because its storage form of carbohydrate in the body. b. a. Also known as table sugar.• Pentoses – found in meat and sea foods in bound form.most abundant and cheap form of carbohydrate. Muscle glycogen – used directly to supply energy for the surrounding tissues as during exercise and work. Storage formation in plants. Dissacharides – “oligosaccharides” two sugar unit base • Sucrose – “ cane sugar to beet sugar” since it is commercially prepared from sugar cane and sugar beets. • Maltose – “malt sugar” because it is derived from the digestion of starch with the aid of the enzyme. diastase found in sprouting grains. It is usually combined with dextrin for infant milk formula.
protein 18%. iodine in thyroxine. 5.chlorine. . Traces can be found in water.Calcium. During a prolonged period of food deprivation fat stores may make even greater contribution to energy needs.Maintenance of acid base balance a. Fats Called lipids are actually family of compounds that include both fats and oils. 17 . Acid forming. phosphorus and magnesium in the bones and teeth. Base – calcium. K.Protects organs from temperature extremes and mechanical shock. potassium and magnesium. .Provides a continuous fuel supply. E.4. Minerals Found in unrefined food mostly combination with each other and other organic constituents. The body’s fat mass has virtually unlimited storage capacity and fat supplies 2/3 of body’s ongoing energy need. In the body minerals compromise about 4-6% of total body weight. iron in rbc. • Regulatory – these includes physiological processes for normal functioning of tissues. . carbohydrate 1%. . helping to keep the body’s lean tissue form being depleted. fat 13%. D. The rest of the body weight consists of water 63%. sulfur and phosphorus b.Helps maintain the health of the skin and hair. chlorine in gastric secretion. sodium. Functions • Structural – refers to the presence of the mineral in significant amounts to be part of the cells or body fluids of as an important component of a molecule. .Carrier of fat soluble vitamins A. .
It helps to initiate a wide variety of body responses including energy production use of minerals and growth of healthy tissue. Copper (Cu). Vitamins . Regulator of muscle contractility-minerals maintain normal contraction and relaxation of muscles including magnesium.• • • Catalysts for metabolic reactions – potassium.Organic compounds that are required in small amounts for normal growth.Vitamins are co. Vitamins do not provide energy. Potassium (K). Characteristis a. Organic compounds – all vitamins have carbon. Sodium (Na). Magnesium (Mg). Chlorine (CI). calcium. potassium. Potent minute quantities – very small concentrations of vitamins needed to maintain life and normal growth. Dietary essentials – vitamins are ingested from diet. magnesium and phosphorus hasten the anabolism of glucose to form glycogen. zinc (Zn). hydrogen and oxygen in their chemistry component. 18 . Classification • Macrominerals – calcium (Ca). selenium (Se). b. • Microminerals – Iron (Fe). Sulfur (S). Iodine (I). . sodium. calcium Transmitter of nerve impulses – during stimulation of a nerve fiber. reproduction and maintenance of health. Phosphorus (P). Measurements range from micrograms. (mcg or ug) c. Flourine (F) 6. Manganese (Mn).enzymes. Na and K exchange with each other across the cell membrane to facilitate the transmission of a nerve impulse.
.For normal bone and skeletal growth.Maintenance of prothrombin level in blood plasma. milk and cheese. • Vitamin D . liver. margarine. vegetable oils. Vitamin E .Promote normal bone and teeth development because it facilitates absorption of calcium and phosphorus. soybean oil and wheat germ. Vitamin K . cottonseed. egg yolk • • 19 .Prevention of hemolysis of rbc( separation of Hgb from rbc) .Maintains the integrity of epithelial tissues. clams. legumes. mayonnaise. cheese. Sources – liver.Anti oxidant in both animal and plant tissues. Sources . corn. Sources – wheat. Excessive use causes complete disintegration of bone matrix. sardines. “dilis”. It is needed for normal night vision. liver.Animal sources.fortified margarine. other organ meat.For nervous and reproductive system need vit. Excessive amounts of retinol make the membrane abnormally susceptible to rupture as observe in hypervitaminosis A. tahong and shell fish. nuts and legumes. salmon and egg yolk. milk. cream. dark green leafy vegetables. tomatoes. Fishes. . .Lack of vit D results in reduced intestinal absorption of Calcium and phosphorus Sources . eggyolk. A for stability of cell membrane. butter. bran. wheat. soybean. Fish liver oil are richest natural source. butter. especially mucus linings.Fat Soluble Vitamins • Vitamin A (Retinol) . salad dressing.
lean meat. Sources . . shellfish.Involves in brain metabolism.For normal function of the nerves Sources – lean pork.Maintain healthy skin.cheese.proper growth and development Sources .Helps maintain good appetite. liver.Building body resistance against infection. B1 . melons. green leafy vegetables • 20 .Prevents scurvy .Needed in formation and maintenance of intracellular cementing substance .Prevention of megaloblastic anemia and pinpoint hemorrhages. . Eaten raw leafy greens. and berries.Helps prevent cataract. eggs. good muscle tone especially GIT. oranges. C . pork liver. . normal vision .Water Soluble Vitamin • Ascorbic Acid . Riboflavin . meat. whole grains. . dayap. • Thiamin – Vit.Iron utilization is improved by vit. .Helps in healing wounds and bone fractures. kalamansi.Anti oxidant vitamin protects normal cells from damage of free radicals and other substances by oxidation. egg yolk. peppers and tomatoes. papaya. organ. legumes.guava. tongue and mouth. milk. . legumes and nuts.
fish. eggs. lean meat. diarrhea. . B6 . pork. Sources – liver and organ meat. and integrity of the CNS Sources . egg and legumes Pyridoxine – Vit. whole grains.Important in energy metabolism. milk and cheese. organ.liver. .• Niacin . Folic acid and PGA (Pteroylglutamis Acid) .Aids in acid metabolism Sources .Macrocytic anemia is pregnancy • • • • 21 .Essential of the normal forming of nerves. bran. cheese and legumes. poultry. vomiting. legumes. s/s – anorexia. and GIT. fish and poultry. Pantothenic acid .Prevents permicine anemia – incurable blood disorders. Cobalamin . meat. achlorhydria. Promotes normal G in P.Maintenance of normal growth. protein and fat metabolism . abdominal pain.liver and organ meat.Essential for carbohydrate.Helps in synthesis of heme – Fe containing CHON of Hg. cereals. healthy skin. bone marrow.
. The functions of nutrients. how they interact. and the processes by which the body digest.Sexual maturity appears later in populations that are malnourished than in developed countries and occurs at an earlier age in each succeeding generation.III.Retarded growth and delayed sexual developments results from deficiencies of certain nutrients. Foods that should not be eaten and the reasons for this are also identified. repair. and regulation of function. absorbs. Physiologic Importance of Food Nutrition provides information about how much of each nutrient is needed and under what circumstances. rebuilding. Food Maintains Life . b.the quality of the bone (amount of calcium and phosphorus it contains) and its capability for growth are influenced by nutrition. Role of Nutrition on Growth and Development a. 22 . uses and excretes the end-products of food eaten are included in the science of nutrition.When a child is poorly nourished.The combination of severe malnutrition and infection may result in permanent growth retardation and increased susceptibility to disease. Skeletal Growth and sexual Development . excess or an imbalance of nutrients. .Certain nutrients in food are required by the cells for growth. . what happens when there is a lack.The growth pattern of a child is useful means for judging nutritional well being. the growth rate diminishes partly because of a delay in bone development. and about the types and quantities of food that provide the necessary nutrients. ASSESSING NUTRITIONAL NEEDS A. . .
Poorly nourished babies have fewer and smaller brain cells. E. Mental Development • 5 months before birth and 10 months after birth . have little energy. confusion. 23 . .Poorly nourished persons who tire easily. mental. . irritability. . and physical and mental apathy (loss of interest) are associated with certain deficiency diseases and may influence learning ability.Other factors that affect mental development > Heredity > Presence of disease > Emotional state > Home development . • At the end of the first year of life .Iron deficiency may cause a reduction in iron-containing enzymes in brain tissue which is turn cause alterations in brain function.Severe deficiencies of specific nutrients can cause adverse structural changes and impaired functioning of the central nervous system.c.Period wherein most rapid growth of the brain occur. and are unable to concentrate will have difficulty achieving their intellectual potential. . Iron deficiency anemia among school children may interfere with motivation and the ability to concentrate for extended periods of time.g.The brain is the first organ to attain full development. . depression.Symptoms such as anxiety.
eggs and cheese are high biologic value and should be used liberally.C rich foods with meals increases the absorption o nonheme Fe. 24 . and 4x at 18 months. hormonal secretions (progesterone maintains pregnancy and prepares breast for lactation) • Prepare for lactation. lungs. green leafy vegetables and whole grain cereals are good sources of Fe. brain 1st trim) • Task of the body during pregnancy: changes in the respiratory and circulatory systems (increase blood volume leads to the accumulation of fluid and increase in plasma = dilutional anemia dec.D/ quart. • Each additional cup of milk (ANMUM 2x) add 8g of CHON to the diet. 3x at 12 months. Pregnancy and Lactation • The nutritional status exerts its greatest influence during pre-natal life and infancy (weight increase 2x at 6 months. provide for growth and development • A gain of about 24 lbs. fish. • Lean meat. milk. poultry.1. prune juice. milk also provides Ca and P which are needed for the development of the fetal bony structure and teeths as well as for mother. Required Nutrition Across the Lifespan a. • The caloric increases about 300kcal/day during pregnancy. or 10.) for an average normal woman • Requirements for all nutrients increases. RBC).9 kgs (22-28 lbs or 10-12. Meat. dried peas and beans. Including Vit. Fortified milk also supplies 400IU of vit.7 kgs.) • Within 2-3 months all the major body systems are formed (heart. • The recommendation for folacin increases substantially for brain development of the fetus.
Ca. The need of water is also increased. Vit. CHO. I.preterm milk – high in nitrogen • Colostrum – 2 days high in CHON. high in CHO and fats • Maternal diet – all women – enough with high quality BM. D. B6. 3-6 – low CHON. enzymes. modulators of immune systems and anti-inflammatory • Colostrums – first breast milk FACTORS AFFECTING MILK COMPOSITION • Stage of lactation. Se. Mg and CHON concentration is not affected . Se – depends on maternal reserves BREASTFEEDING • Best for babies – all essential nutrients are present • Natural – no flavoring and preservatives • Presence of anti-infections 25 . which can be obtained from a variety of beverages. D • Increase water and fluid intake – 87% of BM is water. Vit. B6. P. Iodized salt should be used because of the increased need of iodine in pregnancy. low in fats and CHO. Vit. I. Several glasses of water should be drunk each day.• • Moderate use of salt is recommended since the tissues of both mother and fetus requires salt. • Breast milk – unique in concentration of macro and minerals.Concentrated FA. hormones. NUTRITION IN LACTATION • (+) 15g in 6 months and (+) 12g in months for the CHON requirement • Vitamins and minerals – increases Vit. induces. the diet should include 6-8 cups of fluid.
underused (Ca of the ovary) • Contraception: LACTATIONAL AMMENORHEAL MENSTRUATION – 0-6 months GUIDELINES IN FORMULA FEEDING • Avoid putting the child to be with bottle –destroy teeth. 26 . proper temperature Better for jaw 7 teeth development Maternal and child bonding MOTHER • Mobilize fats • Early stage (immediate post-partum).prevents hemorrhage and thromboembolism • Readily available • Childbirth and BF is a protection against CA – overuse (Ca of the cervix). otitis media • Hold baby as if mother is breast feeding – bonding • Do the right mixing of formula and water as indicated in the commercial formula WEANING – breastfeeding is gradually reduced with infant formula or foods appropriate to infants 4-6 months.• • • Sterile. promotes uterine contraction (oxytocin and prolactin secretion). INTRODUCTION OF SOLID FOODS • Infant cereal (4th) – veg and fruits (5th) – strained meats/ egg yolk (6th-7th) • Introduction to table foods – 9th months coarsely textured foods.
BREASTFEEDING: lactose = 2-3 hours or 8-10 feeding 27 . vomiting.GUIDELINES IN INTRODUCING SOLID AND TABLE FOODS 1. baby is 3 kg 120 kcal/ 1 kg = x /3kg = 360>360 kcal/x ml x 67 kcal/100 ml = 537 ml/day FAT REQUIREMENT: not specific = 48% BM and 46% FM CHO REQUIREMENT: . diarrhea) .2 g/ kg = 0-6 months. e. Introduce new foods one at a time at least 4-5 days of interval for child to adjust to new food and to determine food allergies. 1 8g/kg in 6 months and above. 2. Increase fluid intake once solid foods are introduced. Infancy ENERGY REQUIREMENT: 12 kcal / kg – 0-11 months (3x higher than adult req’t = 40 kcal in adult) – inc growth and development. b.If extra water is excreted – increase fluid intake (fever. 3. 100 kcal/kg in year old BREASTMILK AND FORMULA MILK.g. Introduce plain/ simple foods.if (+) solid foods – increase fluid intake CHON REQUIREMENT: 2. 67 kcal/ 100 ml FLUID REQUIRMENT: 150 ml/ kg in 24 hours .
arachidonic and DNA (decoxahexaenoic acid) helps the utilization of fats especially cholesterol. D so expose the baby to enough sunlight proper Vit. llinoleic. breastfed children are smarter with shaper cognitive abilities and sharper vision.PHYSIOLOGY OF BF: sucking reflex > release of PROLACTIN > signals mammary gland to be filled with milk> Release of OXYTOCIN> contraction of breast and release of milk a. 4. 7. MINERALS CALCIUM – for bone and teeth formation. LOW IRON and ZINC – HIGH BIOAVAILABILITY = maximum utilization/ absorption of minerals. 2. Lactose – well tolerated by the baby = efficiently digested and used by the GIT of the baby. 3. VITAMINS – all vitamins are present except for Vit. DHA is abundant in the brain and retina of the eye. CHON – alpha lactalbummi – concentration is low – efficiency used by the baby – if high concentration will increase kidneys workload.k.a LET DOWN REFLEX 0-6 months supplement bottle for 1st 4 months is discouraged BM is already enough. CONTENTS OF BREAST MILK 1. Essential fatty acids – linole. D usage. iron binding CHON and antibiotic LACTADITERIN – antiviral in the GIT FORMULA MILK 28 . IMMUNOLOGICAL PROTECTIONS COLOSTRUM – serum with antibodies and WBC’s (1st line of defense) LACTOFERRIN – prevents bacteria to get Fe from the blood. 5. 6.
Commercial – cow’s milk modified to BM. Toddler (1-3 years old) 2 years old – low growth rate. Pre-schooler (3-6 y/o) Prone to food rituals 29 . Spina bifida – failure of some parts of the spinal column to close > CSF > Meningitis 2.1. 3 year old – 1. low birth weight FOLATE DEFICIENCY DURING PREGNANCY – NEURAL TUBE DEFECTS 1. Specialized formula – formula given to children with extraordinary problems a.Nutritious between meals snacks are encouraged.Avoid bribing by rewarding them with sweets – decreases appetite. errors in metabolism – lactose intolerance> starch + sucrose b.300 kcal/ day Vitamins and minerals – increase with age especially Fe Eating habits: . E requirements: 1 year old – 1000 kcal/ day. anencephaly – small / no brain formation c. 1 pint of milk/ 12 ounces of meat provides the recommended daily allowance of a toddler for CHON. goats milk – low folate (brain development) 3. premature babies. Home prepared formula – evap milk H2) + sugar > high CHON concentration. soy or cow based 2. birth weight quadruples and length doubles. d. Ca.They can learn to feed themselves between 1-2 y/o . skim milk – low calories.Changes in appetite is normal . P and Mg. .
5 per year. weight by 4. serve variety of food and prevent argumentation in the table. weight/ obese. texture and temperature – prepare nice. FEEDING PROBLEMS OF PRE-SCHOOLERS Eating too little – same food served everyday. What a child thinks about himself and his world shows his sentiments on food. Not all children have the same responses toward food – think of what / how much they’ll like it. School Age Slow growth rate. 6. Satisfy his curiosity by giving him an opportunity to handle ingredients and acquainting him with pictures and names of food – interest. flavor. NI. b/t 2-3 y/o there is the presence of rebellion 3 y/o stage of emotional development GUIDELINES 1.Plan for diet: 3x regular meals + 2-3 snacks each day Rule and principles: at 2 y/o they are fond of imitation. Eating too much – heredity (vocarious). Dawdling – lingering with food > to get attention from authoritative figures (parents) or indicates loss of appetite due to infections present > let child be checked.5 lbs between 6-8 y/o 30 . Associate food with love and understanding – provide accurate information 3. e. 2. Allergy – observe for 4-5 days to give way for allergies to come out. colorful food. emotional problem. 5. A child is keen on taste. clean plate principle> inc. indigestion. Set good examples of eating right food – avoid showing them your dislike on food. 4. Gagging – feels like vomiting especially with coarse foods> neglect to introduce food at the right time. attractive. height is increased by 2-2.
increase Fe intake. weight gain. Monitor food eaten by child at home. Nutritious snacks at hand 31 . weight d. parents have no control over them. weight gain. children who eat chips or cookies between meals have low appetite during meals.Skipping meals. b. Males: lean body mass.Parents continue to encourage good eating habits by having: a. equal distribution c. snacks with low nutritional value RECOMMENDATIONS . Adolescence Period when there is growth spur Female growth spurts starts from 10-11 years old while a male starts from 12-13 years old. fast food. age. height. Females. 35 lbs. Regular meals with pleasant and relaxed atmosphere f. increase fat deposits. maximum bone growth EATING HABITS . 45 lbs. fe-myglobin present for muscle formation Calcium should also increase. RESPONSIBILITIES a. Regular meals b. once the child is in school. 6”taller (but hereditary limits determination of height).Eating habits. 8” taller. Enhance nutritional status – monitor growth rate. Promote good eating habits – do not skip meals.
Set good example for children. Gastrointestinal – decreased taste threshold. DISADVANTAGE: manual expression for some uncomfortable for inverted nipples. decreased number of absorbing cells. decreased BUN and waste excretion.c. diminished secretions of the digestive enzymes. loss of elasticity of vessels. Excretory – diminished amount of the nephrons. (21-50) Senescence – the process of growing old Gerontology – the scientific study of aging and its effects Geriatrics – the branch of medicine that deals with the illnesses and medical care of senior citizens Senile – often clinically associated with an old man with physical and mental weakness PHYSICAL FEATURES 1. decreased blood flow (renal. Circulatory – decreased myocardial ability to use oxygen. 2. decreased motility. drug can contaminate BM CONTRAINDICATIONS / CONSIDERATIONS Error in metabolism (lactose intolerance) Chronic illness Mother under medication Psychiatric disorders CA with chemotherapy/ Radiation therapy 32 . slow glomerular filtration rate. cerebral). Nutrition for Adults and the Elderly Adulthood – is the period of life when one has attained full growth and maturity. increased pressure and systolic pressure. 3. GI. increase in gastric pH. g.
Avoid too much fatty foods 6. 33 . Small frequent feeding 2.A condition resulting from the lack of intake of energy or protein or both. FORMS OF MALNUTRITION a. pregnancy. (ex. cocoa before going to bed can induce sleep (TRYPTOPHAN). malungay) 5. Malnutrition . balut. A glass of milk.Condition of the body resulting from lack or excess of one or more important nutrients. pureed or chopped are given to those without teeth. or flavored with malt. physical growth. Soluble fiber fruits. vegetables and whole grain cereals will promote normal elimination. 4. lactation and resisting or recovering from illness. small shrimps. Protein-Energy Malnutrition (PEM) . Dilis.Mastitis Pregnant and lactating at the same time NOT CI for cracked nipples – saliva can heal GUIDELINES IN FEEDING THE ELDERLY 1. 3. tinapa. Mashed. Those who cannot tolerate milk. Coffee and tea before going to bed may prevent a good sleep 7. characterized by marked loss of weight and failure to grow.Also condition in which an individual cannot perform well at such things as physical work. . 2. excellent local food sources can provide the major minerals.
A condition where there is not enough hemoglobin in the red blood cells due to lack of iron. death * Lower academic performances * Lower levels of productivity b.Effects/Clinical Manifestations * Stunted physical and mental development * High risk to infection * In extreme cases. sea foods and seaweeds) and may be prevented through the regular use of iodized salt. and sleepiness and reduced work capacity.IDA increases the risk of infections and even dying especially among pregnant and lactating women as well as infants.. iodine levels in the body are reduced.Hemoglobin – reddish protein containing iron.The deficiency may be due to low intake of foods rich in iodine (e. Iron Deficiency Anemia (IDA) .A condition resulting from iodine deficiency or the failure of the thyroid gland to obtain a supply of iodine sufficient to maintain normal structure and function. Characterized by feeding of fatigue. even before goiter becomes visible. anxiety. . .g.Characterized by the swelling of the neck or goiter (BOSYO). Iodine Deficiency Disorder (IDD) . SERIOUS CONSEQUENCES OF IDD 34 . c. . However. RBC – also known as erythrocytes .
The deficiency also results to poor growth.. .Shows delayed wound healing. .Susceptible to infection and complications of illness .Unable to withstand and handling medical treatments. d.Results because of low intake of animal foods. which are rich sources of vitamin A. 3. .May also be due to poor absorption and utilization due to low intake of fats in the diet.Cretinism . squint (Pagkaduling) .Irreversible mental retardation . . and green leafy and yellow vegetables and yellow fruits. Vitamin A Deficiency (VAD) .Physical abnormalities such a deaf-mutism.Increased miscarriages . .Common consequence is NIGHT BLINDNESS (matang manok).Iodine deficient adults have lower levels of productivity.Increased mortality among children . Measuring Nutritional Status 35 . Frequent and severe infections may occur which may result to death in extreme cases.It may result from severe infections.Spontaneous abortions . . Undernourished persons do not tolerate illness well.Stillbirths .
) the examiner looks for physical signs and symptoms associated with malnutrition. It could also be caused by non-traditional factors such as lack of rest or emotional stress.During physical examination (examine skin. surgery.They are alert. Anthropometric measurements . .Well nourished person have general energy appearance of vitality and well being. Height and Weight . .A carefully taken medical history provides much information that is useful in the nutritional assessment.. or physical disability. (May reflect the effect of nutrition on brain growth). and eyes.Vital signs such as pulse rate. E. have sufficient energy to perform physical activities.An important measurement when assessing infants and young children. etc. respiration. a hormone imbalance. a medical history is taken. . alcoholism. History of hypertension. mouth. it doe not mean that it is only due to lack of nutrition. However. Head Circumference .Body measurements such as height.height and weight tables are used to evaluate an individuals weight as it corresponds to his or her weight. and mid arm circumference that reflect growth and development or an increase in body fat and muscle tissue.g. . skin fold thickness. Medical History .Before the physician examines the client. and recover rapidly from periods of stress. a. weight. temperature and blood pressure provided additional physical data. 36 . or chemotherapy.
When protein intake is inadequate. urine. wrist of bones of children are particularly useful. Serum Transferring Levels The amount of this iron-carrying protein in the blood increases above normal if iron stores is low. These bones appear earlier and develop earlier in well-nourished children. Laboratory Serum Albumin levels Measurement of the amount of this main protein in the blood is used to determine protein status. . Laboratory Data Blood. the lymphocyte count decreases.Skinfold Thickness . the quantity of certain nutrients in the body stores.A measurement of a double layer skin and subcutaneous fat using a skinfold caliper. and stool tests reveal much about what foods have been eaten. Total Lymphocyte Count The count of white blood cells. and how the nutrients are being used. which defend the body against infection. and may or may not reflect nutritional status. 37 . is a measure of the body’s immune function. it decreases when the body is lacking protein.The amount of fat in the body is an important indicator of nutritional status. Radiographic Studies Radiographic of the bones.
the patient must have an optimal nutritional status. c) To shorten period of hospitalization. frequency of consumption of food. 38 . Diet Hx and Food Intake Record Diet recall. food diary.Nutritional such as rickets and scarring can be detected by radiograph. a) To enable them to withstand the stress of surgery. Existed for a long time. b) To speed up the recovery time. SURGERY NUTRITION • Before surgery. food frequency record.
Burns over 20% of the body may be fatal. 6.• Diet Management Before Surgery 1. 2. Provide a high-calorie. 3. Promote a liberal intake of nutrients important for wound healing. 2. NPO Clear liquid. BURNS CLASSIFICATIONS Are classified according to the degree or extent of the damage. Give IV fluids and electrolytes. NPO for at least 8 After Surgery 1. 4. 5. is flatus is Ful liquid Soft diet Diet is tolerated. or depending on the case of the patient 39 . high protein diet. specially Vitamin C and Vitamin K. 3.
1. 3. white. Relieved by cooling. start as oral diet. The affected area appears pink to red with slight edema and no blisters. e) Fruit juice high in potassium and Vitamin C. (liquids) and observe for signs of intolerance then to diet as tolerated. d) Adequate fluid intake. Third degree burn – the epidermis. 2. Second degree burn – burn that includes the epidermis with redness and blisters. • First-degree burn – burn destroys the epidermis. Pain is present. c) High calorie intake to meet increased energy requirement. dermis and nerve are destroyed so there is no pain. The burned area may appear red. Diet Management a) When bowel sounds return. 40 . b) High protein intake to facilitate wound healing and to replace the loss of lean body mass. black or brown. Causes Thermal Electrical Chemical Radioactive • • Treatment depends on the extent of the burn. Pain is felt.
f) Work with the client and family for food preferences. h) Reschedule debridement and other medical or surgical procedures that may interfere. CANCER • it is a condition that is characterized by the uncontrolled growth and spread of abnormal cells unknown cause for the change in normal cell structure Predisposing Factors 1) 2) 3) 4) 5) 6) 7) Repeated or prolonged exposure to radiation or carcinogens Cigarette smoking Excessive exposure to sunlight Alcohol Ingestion of food with carcinogens Genetic factors Viral infection • Diet Management 1) Avoid obesity 2) Cut fat intake to 30% of total calories 3) Eat food that are high in fiber 41 . g) Ask family to bring food from home.
2. 3. 3. Type non-B Alcohol abuse Drugs Early Symptoms 1. vomiting headache fever 42 . nitric cured foods DISORDERS OF THE LIVER • The liver is involved in the metabolism of all nutrients. smoked. it will cause a devastating effect on the metabolism of almost all nutrients. Type B. 2. Type non-A. I. • Probable Cause 1. HEPATITIS is an inflammation of the liver. • Viral infection: Type A. If the liver is damaged.4) Eat food that are rich in Vitamins A and C 5) Include the cabbage family in your diet because they produce powerful enzymes in the liver that breakdown cancer-promoting chemicals 6) Moderate intake of alcohol 7) Decrease intake of salt-cured.
decrease protein to the maximum amount tolerated by the patient. • weight loss Later Symptoms dark-colored urine jaundice liver tenderness possible liver enlargement • Diet Management Moderate protein intake (80-100 g/day) for liver cell regeneration * Emphasizing sources: milk and eggs * If hepatic coma is impending. Provide small frequent meals and encourage the client to eat all meals and snacks. Increase in calories to spare protein liberal intake of carbohydrate (300 – 400 g) * Moderate fat-restrict fat if steatorrhea develops. pepper. Limit sodium and fluid for patients with ascetics. Eliminate alcohol Avoid spices.4. caffeine and coarse foods as they will cause irritation to the esophageal areas Monitor intake and output balances Monitor weight 43 .
LIVER CIRRHOSIS • Causes alcoholism untreated hepatitis chronic biliary obstruction malnutrition • Early Symptoms fever anorexia weight loss fatigue • Later Symptoms 1. portal hypertension 2. jaundice is characterised by extensive loss of liver cells. fibrosis and fatty infiltration of the liver. Liver function is impaired as liver cells are replaced by scar tissue. 44 . dyspepsia 3.II. diarrhea or constipation 4.
CHOLECYSTITIS • Causes gall stone (cholelithiasis) obstructing the cystic duct trauma previous surgery • Signs and Symptoms 1. 8. • esophageal varices hemorrhoids ascitis bleeding tendencies hepatic coma Diet Management – same as hepatitis DISEASE OF THE GALL BLADDER I. 7. 9.5. 2. abdominal pain nausea and vomiting is the inflammation of the gall bladder 45 . 6.
If the function of the T-cells is lost. 2. 5.3. CHOLELITHIASIS Is characterized by the presence of stones in the gall bladder. Low fat diet (20 – 60 g/day of fat) Promote weight loss if indicated Avoid any food not tolerated II. T-cells are white blood cells that protect the body from infection and other diseases. 46 . • • Case: Unknown Early Symptoms are the same with Cholecystitis ACQUIRED IMMUNODEFICIENCY SYNROME (AIDS) It is an infection of human T-cell lymphotropic retrovirus referred to as human immunodeficiency syndrome. the body becomes susceptible to many diseases. 3. 6. • jaundice fever fat intolerance flatulence Diet Management – objective or role of the diet is to minimize gall bladder stimulation 1. which infects Tcells. 4.
Administer drugs after meals Pain while eating 1. 4. 2. 6. Decreased appetite 1. 3. Encourage small frequent meals 2.• Signs and Symptoms 1. 47 . a. fever chills diarrhea oral lesions weight loss poor nutritional status anorexia • Diet Management * The objective of the diet management is to prevent further weight loss and maintain strength and level of functioning. Nutritionally complete liquid formula b. 5. Determine what the client can tolerate 2. Nutritionally dense liquid supplements 3. * Provide high caloric and high protein adequate fluid based on individual requirements. 7.
If cause is unknown 2. fluid intake d. If cause can be treated. low fiber 2. total parental nutrition to give the colon time to rest and heal. 2.d.b.c.e. add fermented daily products 2. normal 2.c. a low lactose 2.a. Neurologic – depends on the care 1. may need special utensils 3. low fat diet 2. an advance case may need to be fed or tube fed Gastrointestinal care 1. 48 .
e. or strained fruit juices. Diarrhea Nutritional Considerations: a. honey. Used to feed a malnourished person or a person that has not had any oral intake for some time. Indications: a. Is deficient in energy and most nutrients. b. b. bouillon. d. clear broth. Post surgical diet. and may be semisolid when cooled. c. g. lemonade. Bowel preparation for surgery or tests. gelatin. f. Serve a primary function of providing fluids and electrolytes to prevent dehydration. Foods include water. carbonated beverages. d. 49 . either regular or decaffeinated coffee. Initial feeding after complete bowel rest.ROUTINE HOSPITAL DIETS A. Consists of foods that are relatively transparent to light. e. fruit drinks. f. Can be unappetizing and boring. Contributes to little or no residue in the GIT. popsicles and tea. The body digests and absorbs clear liquids easily. c. Patient should not stay on a clear liquid diet for more than 1 to 2 days. hard candy. 2. CLEAR LIQUID DIET 1. are in liquid form at body temperature.
SOFT DIET 1. cream. Includes both clear and opaque liquid foods and those that liquefy at body temperature. mashed potatoes. 50 . margarine. Patient may have salt or sugar. C. milk. Nursing Considerations: a. Nutritionally deficient in energy and most nutrients. 2. cooked strained cereals. b. breakfast drinks. Used in patients with dental problems. Foods include all clear liquids. soft cooked or scrambled eggs. strained vegetables and fruit juices. cream custard. or for the patient is unable to chew or swallow. sherbet. plain ice cream.h. strained soups. butter. FULL LIQUID DIET 1. Indications: a. B. Dairy products are not allowed. i. pudding. Patients with poor-firming dentures and patients who have difficulty chewing or swallowing. c. Indications: May be used as a second diet after clear liquids following surgery.
Nursing Considerations 51 . b. Encourage the patient to eat a variety of foods. acquired immunodeficiency syndrome (AIDS). all foods and seasonings are permitted. and whole grains. congestive heart failure (CHF) and myocardial infarction (MI). c. Used for ulcerations of the mouth or gums. 2. Sucking fluids through a straw may be easier than drinking them from a cup or glass. fried foods. g. D. oral surgery. or regular foods with a soft consistency are best tolerated. Liquid. stroke. dysphagia. Therapeutic for patients with impaired digestion and/or absorption due to conditions such as ulcerative colitis and Crohn’s disease. h. plastic surgery of head or neck. BLAND DIET 1. broekn jaw.b. Patients who have difficulty chewing and swallowing due to a reduced flow of saliva can increase salivary flow by sucking of sour candy or chewing gum. 2. Avoid raw fruits and vegetables. chopped. e. Patients with mouth sores should be served foods at cooler temperature. Provide plenty of fluids with meals to ease chewing and swallowing of foods. ulcers. pureed. Avoid foods that contain nuts or seeds because these can become easily trapped in the mouth and cause discomfort. c. Indications: Used for gastritis. f. Nursing Considerations: a. d. reflux esophagitis.
Nursing Indications: a. or diarrhea. fried foods. Bland foods are less likely to form gas than regular diets. pepper and spicy foods. and whole grains. Eliminate foods that are irritating to the gastric mucosa. HIGH-FIBER DIET 52 . plant fiber. Used for inflammatory bowel disease. c. Dairy products are eliminated to two servings a day. b. or when GI motility is slowed. Indications: a. b. partial obstructions of the intestinal tract. Foods to be avoided include alcohol. vegetables. caffeine-containing beverages such as cola. c. Foods to be avoided are raw fruits (except bananas). coffee. ileostomy. F. cocoa. b. d. Eliminate foods that stimulate gastric acid secretions. enteritis. 2. E. Supplies foods that are least likely to form an obstruction when the intestinal tract is narrowed by inflammation or scarring. LOW RESIDUE / LOW FIBER DIET 1. seeds. Foods high in carbohydrates are usually low in residue and include white bread. tea.a. colostomy. cereals and pasta.
Nursing Considerations: 53 . b. Indications a. Helps regulate blood glucose in patients with heart disease. Indications a. 2. Reduces the risk of heart disease. Consists of fruits and vegetables. b. G. Used in irritable bowel syndrome and when the primary symptom of irritable bowel syndrome is alternating constipation and diarrhea. Indicated for atherosclerosis. hyperlipidemia. FAT-CONTROLLED DIET 1.1. b. Adds volume and weight to the stool and speeds the movement of undigested materials through the intestine. MI. Nursing Considerations a. 2. c. c. hypertension. diabetes. Provides 20 to 25 g of dietary fiber daily. nephrotic syndrome. and renal failure. Used in constipation.
CHF. Indications: Hypertension. human immunodeficiency virus (HIV) and AIDS. kidney diseases. burns. saturated fats and cholesterol. 54 . HIGH-CALORIE DIET 1. cancer. Add sugar to food and encourage high calorie desserts. c. I. respiratory failure. Add nuts and dried fruits such as raisins to desserts or cereals. Indications: Severe stress. cardiac diseases.Limit the total amount of fats as well as amounts of polyunsaturated. monounsaturated. d. Nursing Considerations: a. and cirrhosis. Encourage snacks between meals. H. e. SODIUM-RESTRICTION DIET 1. chronic obstructive pulmonary disease (COPD). 2. such as milkshakes and instant breakfasts. Add fats to foods whenever possible. High-calorie diets are also high-protein diets because the purpose of the diet is to build or maintain lean body mass. b.
2. 55 . 2. and shredded wheat. cirrhosis and hepatic coma. An adequate total energy intake is critical for patients on protein-restricted diets because without adequate energy. The amount of sodium allowed varies from 250 mg to about 4 g daily. c. b. b. Provide enough protein to maintain nutritional status but not enough to allow the build-up of waste products from protein metabolism (40 – 60 g of protein daily). puffed wheat. A No-Added-Salt Diet includes no salt at the table and lightly salting foods during cooking. chronic renal disease. the more important it becomes that all protein included in the diet be of high quality. PROTEIN-RESTRICTED DIET 1. Foods allowed on a sodium-restricted diet include dried or instant cereals. Nursing Considerations: a. The lower the amount of protein allowed. c. puffed rice. Nursing Considerations: a. J. protein will be used for energy rather than in protein synthesis. Indications: Acute renal failure.
Specially low-protein products such as pastas. burns. Vegetables and fruits contain some protein and for very-low-protein diets. Nursing Considerations: 56 . hard candy. creamed butter. these foods must be calculated into the diet. liver disease and maternity patient. jelly and sugar whenever possible. and gelatin made with wheat starch can improve energy intake and add variety to the diet. patients may use fats and concentrated sweets from margarine.d. g. e. f. wafers. K. To boost energy intake. Foods are limited from the milk. cookies. HIGH-PROTEIN DIET 1. h. Indications: Tissue building. meat. break and starch exchanges. breads. 2. Carbohydrates in powdered or liquid forms can also provide additional energy.
a. High-protein diets correct protein loss or assist with tissue repair. b. Indications: Used to treat gout. 2. Purine is a precursor for uric acid that forms stone and crystals. c. Avoid whole grains. and dairy products. dairy products and green leafy vegetables. Client may need protein supplements. Nursing Considerations: a. fish. LOW-PURINE DIET 1. L. fowl. Indications: To prevent renal calculi. Decrease the total intake of calcium to prevent further stone formation. 2. LOW CALCIUM DIET 1. Increase foods such as meat. Nursing Considerations: a. milk. b. 57 . M.
dried beans. peas. egg yolks. milk. Restrict carbonated beverages. and liquid medications. DIET FOR DIVERTICULAR DISEASE 1. tea. Foods to avoid include whole grain breads and cereals. cream. hepatic coma. and nuts. juices. and legumes. dried fruit. MI. 2. 2. Gas-forming foods should be avoided in patients with irritable bowel syndrome. fruits. P. soup. whole wheat products. Foods with seeds need to be avoided as they get trapped in the diverticula and cause irritation. Indications: Acute renal failure oliguric phase. CARBOHYDRATE-CONTROLLED DIET 58 . chronic renal disease. gelatin. frozen yogurt. 3. b. sherbet. FLUID RESTRICTIONS DIET 1. coffee. ice cream. meat. Include organ meats. leafy vegetables. vegetables. cirrhosis. ice milk. popsicles. CHF. Nursing Considerations: a. Q. O.b. usually this diet restricts those foods that are composed largely of water. water.
2. The exchange list system most frequently used to plan carbohydrate-controlled diets. b. Used for diabetes mellitus. such as diabetes or hypoglycemia. hypoglycemia. ENTERNAL NUTRITION A. Adjust energy intake from foods to provide specific amounts and types of carbohydrates. obesity and overweight. Indications: a. dumping syndrome. b. galactosemia. Help maintain normal glucose levels in-patients with disorders that cause blood glucose levels to rise or fall abnormally. Description 59 . Nursing Considerations: a. lactose intolerance.1.
C. 6. or severe malnutrition. hold the feeding. Usually. 3. burns. Administered continuously or intermittently. Check for bowel sounds. Tube feedings that consists of blenderized food or prepared products that provide carbohydrates. B. if residual is less than 100 to 150 mL. liver failure. feeding is administered. if greater than 150 mL. 2. cancer. Aspirate all stomach contents (residual). When the gastrointestinal (GI) tract is functional but oral intake is not feasible. Indications: 1. major trauma. Administering Enternal Feedings 1. 8. fat. measure the amount. hold the feeding if bowel sounds are absent and report the findings. Administered through nasogastric or gastrostomy tube. protein and water. Use a feeding pump for continuous feedings. Flush turbing with water following feeding to maintain fluid balance and patency of tube.1. 9. 5. 60 . 7. Warm feeding to room temperature to prevent diarrhea and cramps. 3. Keep the head of the bed elevated to prevent aspiration. Used for patients with swallowing problems. Do not allow feeding to hang longer than 8 hours and change feeding bag every 24 hours to avoid contamination. 2. and return contents to the stomach to prevent electrolytes imbalance. Check placement of tube every 4 hours by aspirating gastric contents and measuring the pH (should be 4 or less). 2. 4.
monitor temperature for aspiration pneumonia. Diarrhea a. Flush with water every 4 hours for continuous feeding. b. Use fiber-containing feedings. b. monitor for dyspnea. Keep the head of the bed elevated. 61 . 2. Do not administer feeding if residual is greater than 150 mL. Clogged Tube a. Is aspiration occurs. make feeding last for 30 minutes. and for bolus feedings. b. Measure abdominal girth. Flush the tube with 20 to 50 mL of water before and after feeding administration. b. Administer feeding slowly and at room temperature. Vomiting a. 3.D. Verify tube placement. Administer feeding slowly. suction as needed. Aspiration a. 4. monitor RR and prepare the patient for a chest radiograph. Prevention of Complications 1. d. c.
Elevate the head of the bed. TOTAL PARENTERAL NUTRITION (TPN) A. place in side-lying position. 2. 3. Patients who can take some oral nutrition. Do not allow air to enter the tubing. d. 62 . e. 4. but not enough to meet the body’s needs. If patient vomits. vitamins and minerals. B. GI trauma. Supplies carbohydrates in the form of dextrose. Supplies necessary nutrients via veins. intestinal obstructions. Patients with AIDS. 3. Administer feeding at room temperature. h. Description 1. f.c. fats in a special emulsified form. Prevents subcutaneous fat and muscle protein from being catabolized by the body for energy. 2. Administer antiemetics as prescribed. cancer. When the GI tract is severely dysfunctional or nonfunctional. Indications 1. Do not allow feeding to run dry. severe intolerance to enteral feedings. g. proteins in the form of amino acids. Patients with multiple GI surgeries. or when the bowel needs to rest for healing. or malnutrition.
C. Intravenous Sites 1. Peripheral Parental Nutrition (PPN) a. b. 2. Administered through a peripheral vein. Used for short periods (5-7 days) and when the patient needs only small concentrations of carbohydrates, fats and proteins.
Central Parenteral Nutrition (CPN) a. b. Administered through the subclavian or internal jugular vein. Used when feeding must last longer than 7 days.
D. Complications Infection Hyperglycemia Fluid overload Air embolism E. Precautions
1. 2. 3. 4. 5. 6. 7.
Assist with insertions of catheter, position the patient in trendelenburg position with a towel under the scapula. Ask the patient to perform the valsalva maneuver insertion to prevent air emboli. When the central line is inserted, placement is confirmed by chest x-ray. TPN catheter is not use for blood draws or the administration of other medications or fluids. TPN is always delivered via electronic infusion device. Solutions should be stored under refrigerator. TPN solution is changed every 24 hours.
F. Nursing Interventions 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. Maintain aseptic technique. Monitor vital signs. Monitor weight, intake and output daily. Monitor site for redness, swelling, tenderness or drainage. Monitor urine for sugar and acetone four times per day. Electrolytes, glucose and blood urea nitrogen (BUN) are monitored as prescribed. Monitor rate hourly. If sepsis is suspected, a blood culture will be drawn, and the tip of the catheter will be cultured for bacteria. Monitor rate hourly. If sepsis is suspected, a blood culture will be drawn and the tip of the catheter will be cultured for bacteria. Monitor for signs of fluid overload such as bounding pulse, jugular vein distention, headache, increased blood pressure, and lung crackles. 12. Keep tubing connections taped. 13. If the intravenous (IV) tubing disconnects, instruct the patient to perform the valsalva maneuver.
14. Monitor for the signs of an air embolous such as confusion, pallor, light-unresponsiveness. 15. Place the patient in the left side-lying position with the head lower than the feet if air embolism is suspected and contact the physician. G. Fat Emulsion 1. 2. 3. Assess for allergy to eggs, a contraindication for lipid infusion. Administer slowly for the first 15 to 30 minutes and monitor the patient for adverse reactions such as dyspnea, cyanosis and allergic responses. Monitor for signs and symptoms of fat overload, which include fever, leukocytosis, hyperlipidemia, pruritic urticaria and possibly.
MEAL PLANNING Planning meals includes not only the listing of food to serve at any one meal, known as the menu, but also these considerable factors. FACTORS TO CONSIDER IN PLANNING MEALS
1. Nutritional adequacy or the provision of palatable foods that is rich in essential nutrients. Nutrition needs of an
individual is affected by age, sex, body built and activities engage in by the individual.
2. knowledge of the family market shopper’s shopping skills. Physiological Aspects – The meal to be prepared must be based on the health status of each member of the family. The food budget – The food budget is influenced by the family income. 8. Equipment available for food preparation – It must be clean and in variation. 3. like therapeutic diet. 6. family food likes and dislikes and their goals and values. texture and shapes as well as variety in color. form and arrangement. 4. PRINCIPLES IN PLANNING MEALS 66 . cultural and religious food pattern and the socioeconomic background. Differences in Food Habits – These includes the dietary habits of nationality groups. 5. The Time and Skill in Planning Meals – The length of meal preparation. the amount of experience and the time available are to be considered. Availability and Quality of food to be served – The flavor to be prepared must be in season and should be possessing essential organic and non-organic substances considering the health condition and ages of the family members. 7. Aesthetic and Psychological aspects of food or the proper combination of flavor. religion food pattern. Suitable.
sautéed vegetable with serving portion of meat. 67 . e. Avoid dishes requiring last minute attention in one meal. Plan meals that have interesting variety in color. d. Utilized leftover or meats that require a short time to cook. “tinola”. plan the menu for nutrient adequacy. Include more of one-dish meals like “sinigang”. g. Serve simple dessert. i. texture. Plan several days’ meals at one tome. Plan dishes that do not entail too much preparation at one time. and flavor. Plan to serve foods that are not only in season but also enjoyed by the diner. Make out a market list to avoid extra trips to the food stores. variety and flexibility and make a shopping list. Consider palatable foods that are rich in essential nutrients. Consult the different food groups. Check and see if all ingredients are available and equipment are in good working condition. utilizing simple meals that are easy to prepare and serve.CONVENTIONAL MEAL a. If possible. k. Before purchasing. f. ECONOMIC MEAL BETTER BUYING PRACTICES a. preparation is done the day before dish is served. b. j. c. h. “nilaga”.
food value and appearance. c. fish poultry. cereals. Keeping the plans from week to week because each old plan is evaluated in the light of its merits and gives ideas of new plans. Store dried beans. Keep meat. Keep them away from animals such as rodents. and planning each meal. vegetable and some fruits in refrigerator. loosely covered. by knowing specification of food products. between fresh and canned goods. d. b. and root crops in cool dry places where there is air circulation. BENEFITS OF MEAL PLANNING 1. d. Choose foods that are available and in season. by reading label. 68 . PROPER FOOD STORAGE a. between cuts of meats. between cuts of meats. Composing menu and shopping list and drafting plans for preparing and serving meals save time and energy in shopping. between one brand and another. Know how much money you have to spend. between whole and ready-made items. Compare prices among market place. Avoid impulse buying by not shopping when you are tired or in a hurry. groceries. roaches and ants. c. Plan to use them as soon as possible or freeze them. Food items should be stored properly to protect them from contamination and to preserve their flavor. Plan your menu in such a way that fresh items are served on marketing days such as vegetables and fruits and salads. e. Cooking.b.
B9). 4.. how much to spend. pH CHANGES In general. FOOD PREPARATION It has been proven by experiments that there can be considerable nutritive loss in food after processing and cooking. (Vit. and too long holding after cooking. Folic Acid. B1). Folic acid can be stabilized by an alkaline medium. 69 . while for ascorbic acid and thiamin.2. Planned meals include a wider variety of food than meals hurriedly compose and prepared. 3. and how much time and energy to invest in meals favors the development of good judgment in meal management. Experience in deciding what to serve. most nutrients are stable at pH neutral medium except Ascorbic Acid (Vit. Meals planned on the spur of the moment may or may not provide for good nutrition. FACTORS THAT AFFECT NUTRIENT RETENTION DURING FOOD PREPARATION 1. Precise planning made it easier to control the expenditure of money because meals planned in the market on the spur of the moment tends to be costly. Planning for meals is to achieve the goal of good nutrition. and Thiamin (Vit. alkalinity even in slight degree is distinctly destructive. It is proven to be the needed stimuli for people with poor appetite and lack of interest in eating Planning meals is to help from good planning habits. 5. C).
2. To destroy anti-digestive factors especially in beans. 3. To inactive or destroy enzymes which is found in certain fishes that have anti-thiamine factors. bones and cellulose. To soften tissue. HEAT Food is cooked to bring about desirable result namely: To kill microorganism and parasites. To prolong shelf life or to preserve the food. or in fruits and vegetables to halt the action of maturing enzymes. To bring out color and flavor changes and develop a more palatable products. 4. OXIDATION Pigments in food like tannin in fruits like mangoes and carotene in yellow vegetable like squash and carrots oxidize upon exposure to air causing darkening and decrease in nutritive value The formation of metmyoglobin or pigments in beef is accelerated at high humidity and lower air velocity attributes to the stimulated bacterial growth under these condition. peas. 70 . cereals making this food utilizing by man. only trytophan is affected by light and the rest are relatively stable. LIGHT Among the amino acids.
Nutrients are found in the skin or just beneath the skin of the fruits like apple and banana and other foods like peanuts and carrots. 2. Buy products that needed refrigeration but do not store it long in the refrigerator. COLD STORAGE AND FREEZING Nutrient looses are insignificant during refrigeration and freezing as long as the food are properly processed. 5. Minimize soaking in water to prevent darkening of certain fruits and vegetable that decrease or diminish the nutrient contents. 5. preparation and service of food should be useful to fundamentals of nutrient ion. Avoid long exposure to air or light. 3. To have variety in food preparation which makes eating an art. Select fresh fruits and vegetables at the right maturing and buy the peak of the seasons. Prepare fruits and vegetables at the time needed. 71 . PRACTICAL GUIDES TO CONSERVE NUTRIENTS IN FOOD PREPARATION After a general review of the affects of various factors and conditions on nutrients. C. 4. DRYING New techniques of drying such as puff drying freeze during and foam-mat drying in insignificant nutrient losses except in Vit. 6. 1. well packed and correct temperature steadily maintained. the following hints on proper selection.
In preparing vegetables and fruits.6. they should be prepared with minimum heat as to preserve the delicate flavors present in the form of volatile compounds. Avoid stirring and keep pan covered except for some greens and strong flavored vegetables. Look for the shorter possible time. 9. 7. 72 . 10. When cooking in water. Dry heat method for meat is preferable. Boiling and baking result in less thiamine loss compared to long stewing. twice enough. 8. The shorter the time between cooking and serving the more nutrients ingested. Use dripping of meats and fish. Avoid overheating fats and reusing cooking oil many times. keep skin intact.
This makes blood glucose normal. • • 2 Types of Diabetes Type I – Insulin dependent diabetes mellitus (IDDM) is characterized by lack of insulin secretion (without insulin. CAUSES. serum glucose level increases. • 1. Exact Cause – Unknown Possible cause – Viral infection 73 . Insulin binds with insulin receptors in the blood stream and enables the cells to absorb glucose. THEIR DEFINITIONS. Glucose is then spilled into the urine. The cells break down some of the glucose to energy. The rest are converted to fat and stored in the cells. blood glucose levels rise. and NURSING DIET MANAGEMENT ENDOCRINE DISEASE DIABETES MELLITUS * Diabetes Mellitus is a chronic disease characterized by elevated blood glucose • Normal Physiology After ingestion of food.DISEASES. and all cells are unable to use glucose for energy. This rise in glucose signals the b-cells in the Islets of the Langerhans of the pancreas to secrete insulin. SYMPTOMS.
Diet management Objectives: To maintain weight To avoid hypoglycemia To match calorie intake an expenditure with insulin therapy (budget) 74 .• Symptoms: Itchy skin Poor wound healing If left untreated will Untreated ill lead to ketosis or ketonsidosis that may lead to death Polyuria Polydipsia Polyphagia Rapid weight loss Muscle wasting Fatigue Weakness Irritability • • • Goal of Diabetic treatment – to achieve metabolic control as near normal possible .to prevent onset of complications.
Remove skin from chicken.the delayed glucose – insulin response • • Contributing factor . Meals and snacks must be consistent in number. 5.1.it is characterized by normal or above-normal insulin level . 2. Diabetic diet 2) Type II – insulin dependent . Food does not have to be prepared separately from the rest of the family. timing. 2. Just don’t add extra sugar and fat. 6. Drowsiness Fatigue 75 . 4. Need to eat sources of protein and fat to slow down the digestion and absorption of carbohydrates Must carry with him hard candy or sugar cubes at all times for unexpectedly delayed meal. and composition daily to avoid hypoglycemia (patient is taking insulin) Need extra food to avoid hypoglycemia depending on the activity Example: each hour of moderate exercise – 1 serving of fruit Each hour of vigorous exercise – 2 serving of fruit or 2 servings of bread 3.obesity Signs and symptoms 1.
Low cholesterol to reduce risk of cardiac arrest. and connective tissue at the arterial walls. Diabetic diet Cardiovascular diseases 1. 4.decrease weight. Low calories diet until blood sugar is controlled maintain normal weight . 76 . Meal spacing – 4 to 5 hours apart to allow postprandial glucose levels return to normal. 2. mostly of fat. 3. I. 3.3. blood components. 4. if obese 2. Atherosclerosis Hypertension Congestive heart failure ATHEROSCLEROSIS – it is formation of plagues. • Blurred vision Tingling or numbness of the extremities Diet Management * Goal – to attain normal blood glucose levels through weight reduction 1.
plaques develop that narrow the artery that restricts the flow of blood. b.With the accumulation of fats in the arterial wall. These plaques may become so large that will totally occlude the artery. brain – cerebral hemorrhage c. d. • 3 most common afflicted by atherosclerosis a. c. heart – coronary heart disease myocardial infarction may lead to death • Causes a. This will result in damage to the tissues and organs. Narrowed blood vessels will reduce blood flow thereby reducing the flow of oxygen to the tissues and organs. legs b. • Familial hypercholesterolemia – caused by defective genes Diet Various diseases Drugs Diet Management 77 .
II. saturated fat and cholesterol Increase intake of CHO Moderate use of alcohol HYPERTENSION . e. d. c. not a disease • • Causes 1.It is sustained elevated blood pressure above 140/90 mmkg.It is a symptom. .a. Adjust calorie intake to attain or maintain “healthy” weight High fiber – lowers cholesterol level Reduce total fat. e. d. stemosis of aorta renal disease endocrine imbalances sodium retention during pregnancy increased intracranial pressure 78 . Predisposing factors of essential hypertension: obesity familial tendencies 2. b. b.) 5-10% cases of HPN are secondary to a. c.) 95% of HPN are from unknown causes and its classified as essential hypertension that can be controlled but not cured.
All organic heart diseases like MI. overworked and enlarged heart.initial restricted sodium intake is 200 to 250 mg a day. • advanced collagen disease Diet Management 1) a) For weight loss – decrease weight b) For overweight – reduce sodium intake between 2 to 4 g to promote a drop in blood pressure. • Causes 1. HPN. 3.f. depending on dry therapy 3) Modify fat intake by: a) increasing polyunsaturated fat b) decreasing saturated fats 4) Discourage alcohol intake and limit caffeine containing beverages to 3 to 4 cups a day. Circulatory deficit such as hemorrhage and dehydration and pulmonary diseases 79 . OMP. Circulatory overload related to excessive IV fluids or renal failure. 2) Adjust potassium intake. 2. etc. c) Acute care setting l. Leads to decreased blood flow to the kidneys. 5) Monitor fluid and electrolyte balance of diuretics used III. excessive sodium and fluid retention. peripheral and pulmonary edema. CONGESTIVE HEART FAILURE it is syndrome characterized by the inability of the heart to maintain adequate blood flow through the circulatory system.
2. 4.caused by inefficient oxygenation of the blood related to lung congested. 4. 6. 5. dyspnea orthopnea paroxysmal nocturnal dyspnea pleural effusion pulmonary edema • Right sided heart failure caused by inefficient oxygenation of the blood related to lung congested. 3. 2. Left sided heart failure . 80 . 3. Symptoms 1. 5. 2. dependent edema of the feet and ankles pitting edema ascites sudden weight gain related to fluid retention • Symptoms 1. Classification 1.4. • Any condition that increases metabolic demands like hyperthyroidism Pregnancy Obesity.
Caffeine-free drinks. anorexia and nausea. Nocturia Weakness Diet Management Objective: . • upper abdominal pain related to liver congestion. 4. 3 PHASES OF CHRONIC RENAL FAILURE 81 .5. 7. 3. 5.minimize cardiac overload 1. 2. Fluids are limited to 3 liters depending on the clients response to sodium restriction. RENAL DISEASE I. • CHRONIC RENAL FAILURE It is a progressive loss of renal function related to irreversible nephron deterioration. Limit sodium intake Decrease calories for weight loss Provide 5 to 6 meals a day of non-irritant and non-gas forming food limit gastric distention and pressure on the heart. 6.To reduce sodium and fluid retention .
HIGH FAT 82 . Urinary tract obstruction 5. Others • Diet Management 1. It is a symtomatic. Chronic glomerulonephritis 2. 2) Renal insufficiency – the general filtration rate decreased by 70-75 • Signs and symptoms 1. Chronic pyelonephritis 4. LOW PROTEIN. Dehydration 10. Creatinine. Nephrotoxic agents 9. blood urea nitrogen levels rise 2. Polycystic disease 3. Infection 6. LOW PHOSPHORUS. Poor circulation related to atherosclerosis heart failure 7. Asymptomatic because the remaining nephrons become hypertrophic to maintain homeostatis 3) Renal failure 80-85% of renal function is lost. Urine becomes more dilute 3. Drugs 8. Increase in serum createnine • Cause / Predisposing Factor 1. HIGH CHO. Mild anemia develops 4.1) Decreased renal function – there is a 50% reduction in the glomerular filtration rate.
7. ACUTE RENAL FAILURE a) decrease in renal blood flow b) glomerular or tubular damage leading to sudden loss of renal function and oliguria • Phases 1) Oliguria – low urine output of less than 400-600 in 24 hours which may deteriorate to anurea. hypertension. Provide adequate non protein calories is needed when protein is restricted to prevent the use of distance protein for energy. 3. 5. Moderately restrict potassium intake to prevent hyperkalemia to 1. should be from high biologic source. symptoms of heart failure). Adjust and modify protein intake to promote nitrogen balance while maintaining BUN levels below 6090 mg/day Approximately 2/3 of total protein. II.2. 9.5 to 2. restrict fluid urine output + 500 ml for insensible losses. Actual requirements are based on urine and serum levels of potassium.0 If sodium retention is present (sudden weight loss. Obese clients may require fewer calories Limit sodium intake to 2. prevent tissue catabolism. 8. Maintain and restore ideal weight. high-output renal failure-large amounts of urine are extracted deposit loss of renal function and nitrogenous wastes 2) Diuretic phase – the kidneys are unable to conserve water 83 . 6. 4.8/day.0-3.
urine volume may double daily until a fixed amount is reached loss of fluid. bladder or prostate cancer 84 . sodium and potassium are extensive last for 14-21 days 3) Recovery phase – there is gradual improvement in kidney function over 3 to 12 months period. • a) b) c) d) e) f) g) h) a) b) c) d) Pre – natal causes: decreased renal blood flow related to: Shock Trauma Hemorrhage Surgery Burn Hypertension Serum dehydration Heart failure • Intra-renal causes: nephron damage due to: Nephrotoxins Autoimmune diseases Infections Acute glomerulonephritis • Post-renal etiologies: obstructed urine outlow due from kidneys due to benign prostatic hypertrophy.
8g/ body weight and increase as renal function improves. the intake and output in over 24-48 hour periods. Protein allowance may begin at 0.a) Calculi b) Trauma c) Medications • Diet Management Objective: To lesson workload of the kidneys and restore optimal nutritional status 1) Adjust protein intake according to renal function. Allow output + 500 ml/day. serum sodium level. III. Provide small. symptoms of sodium imbalance. as needed for clients receiving an oral diet and are weak or fatigued. 3) Adjust sodium intake according to urine output. and concurrent use of dialysis. UROLITHIASIS 85 . Adjust fluid intake to avoid overhydration. 2) Increase calorie intake to approximately 50 cal/kg to promote nitrogen balance and replenish losses. Initially. frequent meals and assistance with eating. Sodium intake may be restricted to 500-100 mg/day. During the oliguria phase sodium requirement increase during diuretic the anuric phase liberalized during the diuretic phase. parental solutions of amino acid and glucose maybe given if client is unable to eat. • • a) b) c) d) Instruct the client and family of the principles and rationale of diet management Monitor the compliance with the diet and follow diet counseling effectiveness of the diet the evaluation of the need for diet modification observe changes in weight.
- Formation of stones n the urinary system • Causes a. b. c. d. e. f. g. idiopathic infections urinary stasis metabolic abnormalities hormone imbalance inadequate fluid intake leads to concentrated urine output symptoms depend on the site of stones 1. nausea 2. vomiting 3. diarrhea 4. abdominal pain
Bladder stones 1. chills 2. fever 3. dyssuria Renal Pelvic Stones a. Renal colic b. Severe pain that radiates down the urinary tract accompanied by sweating, pallor, nausea, vomiting and possible abdominal pain and diarrhea
Stones in the Ureter a. uretal colic b. severe colicky pain c. that radiates down the thigh to the genitalia d. small frequent urination that contain blood Causes 1. 2. 3. 4. 5. 6. 7. 8. Hyperparathyroidism Immobility Excessive use of alkali antacids Renal disease Excessive intake of proteins or Vitamin D Infection Genetic disorders of cystine metabolism Iodophatic
Diet Management 1) Calcium phosphate stones increase fluid intake to 3 to 41/daily avoid excessive protein intake increase intake of acid-forming food
2) Calcium oxate stones avoid foods high in oxate, ex. Eggplant, okra, parsley, peppers avoid Vitamin C supplements, they increase oxalate excretion
3) Magnesium ammonium phosphate stone - increase intake of acid-forming foods 4) Cystine stones 5) Uric acid stones 6) Urinary tract infection Foods lacking in Oxalate that should be avoided: Beets Celery Eggplant Dandelions Peppers-green Sweet potatoes Spinach Soy bean Draft beer Tea Currents Wheat germ Cocoa/ovaltine Red grape Rhubarb increase fluid intake increase intake of base-forming foods low purine diet increase intake of base-forming foods diets low in methonine and protein
Decrease in gastrointestinal motility 4.Leeks Okra Nuts Summer squash Chocolates peanut Lime peel Black raspberry Parsley GASTROINTESTINAL DISEASES I. Drugs 89 . Bacterial and viral infection 7. Acidosis 6. Increased intracranial pressure disorder 8. Liver. Pyloric and intestinal obstruction 11. Gastric irritation 5. Decrease in digestive enzyme activity 3. Decreases in gastric acid secretion 2. pancreatic and gall bladder disorders 10. NAUSEA VOMITING Nausea – it is the sensation of impending vomiting Vomiting – the involuntary expectation of food from the stomach • Causes 1. Equilibrium imbalance 9.
c. bloated sensation. g. f. e. • Causative factors 1) lack of activity 2) chronic laxative use 3) inadequate intake of fluid and fiber 4) metabolic and endocrine disorders 5) bowel abnormalities Diet Management 1) high fiber intake 2) promote adequate fluid intake 3) encourage intake of prunes.• a. Serve food at room temperature II. b. Diet Management Withhold food until nausea or vomiting subsides Feedings given in progress as clients tolerance improves – from clear liquid is to fall liquid to diets as tolerated Elevate head of bed Encourage patient to eat slowly Promote good hygiene Limit liquids with meals because they will cause a feeling a full. prune juice (laxative effects) • 90 . d. CONSTIPATION It is a difficult or infrequent passage of stool that maybe hard or dry.
encourage clear fluids 2. Encourage food high in pectin 5. Rice. Use of laxatives Diet Management 1. 3. give intravenous fluid and electrolytes to provide hydration. Gastro – intestinal disorders and mal-absorption syndromes 3. Apple. Medical treatment 7. For chronic diarrhea. Bacterial viral and parasitic infection 8. Certain drug therapies 6. DIARRHEA It is the frequent excretion of watery stool • Causes 1. withhold food for 24 to 48 hours.III. Food allergies 9. For acute diarrhea. BRAT diet: Banana. Metabolic and endocrine disorders 4. Progress oral intake of patient’s according to her/her tolerance. Emotional or physical stress 2. Use of tube feeding 10. Surgical bowel intervention 5. from clear liquids to full liquid to low residue diet 4. Toast • 91 .
4. alcohol. 2. 7. Decrease gastric acid secretion and eliminate gastric irritants Bland diet with adequate calories. 3. Avoid spices. 4 to 6 small meals in a day. caffeine and cigarette smoking Avoid rigorous activity immediately before and after eating. 5. Avoid milk and milk products Avoid carbonated beverages IV. Ingestion of corrosive or infections substance. 3. Food poisoning Acute alcoholism Uremia • Symptoms depends on source of irritation mild heartburn to severe vomiting. 2. GASTRITIS It is an inflammation of the gastric mucosa 1. hematemesis • Diet Management Objective of Diet Management of peptic ulcer and gastritis is to: 1. protein and Vitamin C.6. Eat in relaxed environment 92 . 4. such as aspirin. bleeding.
burning. Physiologic psychological stress Cigarette smoking Genetic factors Certain medicators. 5. 3. 2.6. or piercing pain when the stomach is empty heartburn nausea vomiting melena 93 . 4. 5. 3. Chew food thoroughly V. 2. 4. PEPTIC ULCER/GASTRIC ULCER The erosion of the mucus lining of the stomach (gastric ulcer) or duoenum (duodenal ulcer) • Cause: Excess secretion of or decreased mucosal resistance to hydrochloric acid. stress • Predisposing factors 1. such as aspirin Excessive coffee and caffeine intake Symptoms dull. • 1.
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