Content

FOR
PRACTICE TEACHING
ON
Nutritious ladoo

SUBMITTED TO : LT COL R K BHATTI

ASSOCIATE PROFESSOR
COLLEGE OF NURSING
AFMC, PUNE-40

SUBMITTED BY : MAJOR. VISHALAXI TOTKAR

1ST YR MSC NURSING
COLLEGE OF NURSING
AFMC, PUNE-40

SUBMITTED ON : 24th Feb 2015

Nutritious Laddoo
Introduction

Malnutrition refers to the situation where there is an unbalanced diet in which some nutrients are
in excess, lacking or wrong proportion.
The world bank estimates that India is one of the highest ranking countries in the world for the
number of children suffering from ‘malnutrition’. The prevalence of underweight children in
India is among the highest in the world, more than one third of the world's malnourished children
live in India. Among these, half of them, under 3years of age are underweight and
undernourished.

 Each year an estimated 45,000 children die from malnutrition in the State of Maharashtra,
India.
 The Laddoo Project was developed as a home-grown solution designed to address this
issue.
 A traditional "laddoo" is a small, ball-shaped snack, often eaten during festivals.
 The Laddoo Project has developed as a high-nutrition variant of this familiar snack that is
inexpensive and provides a vital combination of protein and iron—essential nutrients for
healthy, growing children.
 As the laddoo is a familiar food throughout India and easily made with local ingredients,
it is well accepted by parents and children alike.

Definition

Nutritious Ladoo, as the name suggests, is a fortified Ladoo for the supplementation of
carbohydrates, proteins, fats and iron. This is a very simple, and easil aaSZQWfy made, home
recipe which has high nutritive value.

Indications

The indications of prescribing nutritious ladoo in the community are:-

 Malnourished (undernourished) children

 Undernourished adults.
 Lactating mothers
 Underfed children
 Anemia in pregnancy
 Anemic child/adolescent
Advantages

The advantages of consuming nutritious ladoo are as follows:-

 Highly nutritious
 High energy density
 Economical/cost effective
 Easy to prepare.
 Pleasing to the taste
 Right nutrition for all age groups

Ingredients required for making Nutritious Ladoo

The ingredients used in making the nutritious ladoos are as follows:-

1. Whole wheat flour – 100 grams
2. Whole Bengal Gram (Black Chana) – 100 grams
3. Whole Green Gram (Moong) – 100 grams
4. Ghee/Dalda/cooking Oil – 100 ml
5. Ground nuts with peel – 50 grams
6. Jaggery – 150 grams
7. Black/white Sesame seeds (Til) – 10 grams

Cost of making 30 Laddoos

S. No. Ingredients Quantity Cost

1 Whole Wheat Flour 100 gms र 4.50/-

2 Roasted Bengal Gram 100 gms र 20.00/-
3 Green Gram 100 gms र 12.00/-
4 Ghee 100 ml र 40.00/-
5 Ground Nuts 50 gms र 5.00/-
6 Jaggery 150 gms र 8.00/-
7 Til/Sesame/Gingelly 10 gms र 10.00/-
Seeds
Total 610 gms र 99.50/-
Calorific Value of the Ingredients

The calorie content of each ingredient is as mentioned in the following table:

Calories Chart
(in grams)

Ingredients Proteins Fats Fibre CHO K.Cals

Whole Wheat Flour 12.1 1.7 1.9 53 341
Roasted Bengal Gram 22.5 5.2 1.0 9.5 369
Green Gram 24.0 1.3 4.2 4.4 334
Ghee - 100 - - 900
Ground Nuts 13.1 39.8 3.1 26.2 570
Jaggery 0.4 0.1 - 26.4 383
Til/Sesame/Gingelly Seeds 1.83 4.33 2.9 9.3 563

Calories per gram of the following Nutrients:-

1. Cardohydrates – 4 KCals
2. Proteins - 4 KCals
3. Fats - 9 Kcals

Nutritive value and calorie content for total of 610 grams of the total ingredients:

Ingredient Qnty Proteins Fats CHO Iro K Cals

s grams n
1 100 12.1 1.7 69.4 4.9 341
2 100 22.5 5.2 58.1 9.5 369
3 100 24.0 1.3 56.7 4.4 334
4 100 - 100 - - 900
5 50 13.1 19.9 13.4 1.25 283.5
6 150 0.6 0.15 142.5 3.96 574.5
7 10 1.83 4.33 2.5 0.93 56.3
Total 610 74.13 130.5 342.6 24.9 2807

A maximum of 30 Ladoos of equal size can be prepared from this mixture of total ingredients

Nutritional value of one Ladoo

 Weight(grams) - 610/30 = 20.3 grams

 Energy - 2807.63/30 = 93.58 K Cals
 Proteins - 74.13/30 = 2.471 grams
 Fats - 132.58/30 = 4.419 grams
 Carbohydrates - 342.6/30 = 11.42 grams
 Iron - 24.94/30 = 0.831 grams
 Home Procedure – Preparation of Nutritious Ladoo

Prerequisite

 Conduct the home visit, greet its members pleasantly

 After assessing the need for making Nutritious Ladoos for the client/family, explain to
the client and family the need for the procedure.
 Inform the client and family to purchase and keep ready all the required ingredients for
making the Nutritious Ladoos.

Preparation of environment

 Select convenient area in the sides of the room of the house away from busy area to keep
the community health bag
 Keep the area neat and tidy
 Spread the newspaper and keep the bag on it
 Follow principles of bag technique at each step.
 Keep the hand washing articles near water source
 Arrange the articles for the demonstration

Preparation of articles

Articles Required:-
 Community bag
 Kidney Tray
 Hand washing articles
 Whole wheat flour – 100 grams
 Whole Bengal Gram (Black Chana) – 100 grams
 Whole Green Gram (Moong) – 100 grams
 Ghee/Dalda/cooking Oil – 100 ml
 Ground nuts with peel – 50 grams
 Jaggery – 150 grams
 Black/white Sesame seeds (Til) – 10 grams

Note : Articles such as a source of fuel(LPG Gas Stove), grinder, cooking vessel(kadai), tongs,
Plates and Bowls, Spatulas etc. can be utilized from the family itself.
 Steps of the Procedure
S. No Steps of Procedure
1 Wash hands
2 Arrange and keep all the articles and
ingredients required for the procedure in the
kitchen as suitable to the client/family.
3 Dry roast the following:
 Whole wheat flour
 Whole Bengal Gram
 Whole Green Gram
 Ground nuts with peel
 Black/white Sesame seeds (Til)
4 Let the ingredients cool after dry roasting.
5 Fine grind all the above ingredients
seperately into fine powder, except wheat
flour(off Course) , the ground nuts and
sesame seeds.
6 Coarse grind the ground nuts and do not
grind the sesame seeds
7 Mash Jaggery and add 1-2 tsp of water to
make it as a thick paste.
8 Heat the Ghee/Dalda/cooking Oil (cooking
medium) in the Kadai
9 To the heated cooking medium add the
roasted wheat flour and mix it well
10 Add all the other ingredients soon after and
mix it well
11 After mixing well, when the mixture still
stays hot, quickly make equal sized 30
ladoos out of the mix.
12 Let the ladoos cool.
13 Store the ladoos in an air tight container.
Note:- It is important to give necessary health education to the client/family after the
procedure regarding nutrition and balanced diet as well.
Rationale
To prevent contamination
To be organized while doing the
procedure.
To preserve the nutritional value
To cook the ingredients by dry
roasting to powder them easily.
Hot ingredients will not be grounded
well, as desired
Preparation for making laddos
To give taste and texture to the
laddoos
Jaggery will be cooked well when
made into a thick paste than in
granules/chunks
To make the ladoos.
So, that rest of the ingredients do not
stick to the kadai/cooking vessel
Wheat flour is added first and mixed
well to avoid any lump formations.
To avoid lump formation
Cooled mixture will not make ladoos
as in desired shape and size.
For storing them.
For preserving its natural taste and
fragrance
After care of the articles

 Dispose the waste in the appropriate paper bag.

 Wash clean and dry the articles used
 Replace all articles back in the community bag in their appropriate place.
 Wash hands
 Replace the hand washing articles in the bag.

Terminate the home visit with pleasantries after planning the next home visit

Scientific and Nursing Principles involved

The Scientific and Nursing principles involved in the procedure are as:

Scientific Principles: Nursing Principles :

1. Anatomy and Physiology 1. Individuality

2. Physics 2. Safety
3. Chemistry 3. Comfort
4. Microbiology 4. Resourcefulness
5. Pharmacology 5. Therapeutic Effectiveness
6. Psychology 6. Workmanship/skill.
7. Sociology

Scientific Principles:-

S.No Scientific Principles Rationale

1 Anatomy and Physiology For Nutritional assessment of client and family.
2 Physics
3 Chemistry
4 Microbiology
5 Pharmacology
6 Psychology
7 Sociology
Ingredients should be adequately roasted and cooked to
correct temperatures and consistencies for the ladoos to
be made as desired.
Correct proportions of all ingredients to get correct
consistencies
Hand washing before and after the procedure to
eliminate microorganisms and cross contamination.
Proper disposal of waste.
Advising to continue hematinics, if prescribed by the
doctors
Explain the procedure to the patient in the language and
manner the client and family understands
Build up good rapport with the client and family
Involve family members to be present during the
procedure.
Nursing Principles:-
S.No Nursing Principles
1 Individuality
2 Safety
3 Comfort
4 Resourcefulness
5 Therapeutic effectiveness One laddoo per day gives good amount of vital nutrients
6 Workmanship/Skills
Rationale
Consider clients age, education, any language barriers
etc. while giving health education and doing the
procedure
Avoid any accidental burns during the procedure
Safety with LPG use
Avoid any burns while making the laddoos from the hot
mixture, dip fingers in water to soothe the palms of the
hot mixture
Explain the procedure to the client and using clients
kitchen and kitchen articles as per the clients will and
comfort.
Encourage and instruct the client to keep the ingredients
ready on the day of the procedure.
Use articles and ingredients available in the house for
the procedure.
Adequate use of space available in the house without
disturbing the normal routine of the house.
as discussed earlier.
Studies have also proven increase in Hb levels with
consumption of one laddoo per day
Skill in bag technique.
Skill in preparing the ingredients and mixing properly
And skill in making proper sized laddoos of
approximately 20.3 grams.
Skill in delivering health education.
Role of Community Health Nurse in Nutrtional Programmes

A community health nurse plays a very pivotal role in the Nutritional activities in the
community. These activities are primarily concerned with preventive and promotive aspects of
Nutritional health. She actively participates in all the national Nutrition programmes.

Her activities are:-

 Data collections
The community health nurse collects relevant nutritional data of the families through
Surveys, home visits, screening camps, nutritional camps, school health programs etc.

 Identification of the problem:-

She identifies the various nutritional deficiencies and status of malnutrition among
different vulnerable groups.

 Direct Care Provider

Distribution of nutritional supplements to the benefit groups through programs like ICDS,
School children.
Demonstration of procedures like healthy cooking practices, Nutritious Ladoos
complementary feeding etc

 Health Education
On priority basis she gives health education to the individual/family/community at large
by means of health teaching at home, school health education programs, nutrition camps,
nutritional exhibition.

 Counselor
She acts as a counselor for the client/family/community in giving guidance regarding
faulty eating habits, queries regarding food and nutrition etc.
BIBLIOGRAPHY :

1. Sohi Darshan. Nutrition and Therapeutic Diets. 1st edition.

New Delhi: Jaypee Brothers Medical Publishers; 2013

2. Smeltzer C Suzanne, Bare G Brenda. Medical Surgical Nursing. 8 th ed.

New York: Lippincott-Raven Publishers; 1996

3. Nutritious Ladoo. Community Health Nursing Procedures Record book.

College of Nursing. AFMC.

4. http://www.practicalclinicalskills.com

5. http://www.googlesearch.co.in/images

6. http://www.fatfreekitchen.com/nutrition/iron.html

7. http://naturalhealthmagazine.net/remedies-and-cures-a-z/a-to-b/