01 Physiology of Digestion
Path of Food:
➔ Mouth
➔ Esophagus (peristalsis)
➔ Stomach (holds, digests with acids/enzymes)
➔ Small Intestine (nutrients absorbed into bloodstream)
➔ Large Intestine (removes/water/electrolytes, forms feces)
➔ Rectum (stores feces temporarily)
➔ Anus (elimination)
Major Organ Functions
● Stomach: holds and digests food using acids and enzymes
● Liver: filters toxins, produces bile (breaks down cards, proteins, fats)
● Gallbladder: stores and releases bile
● Pancreas: produces insulin (regulates sugar metabolism)
● Small intestine: primary site of nutrient absorption into the bloodstream
● Large intestine: removes water/electrolytes; converts remaining waste into feces
Altered DIgestion Signs:
● Nausea, vomiting, diarrhea, constipation, abdominal pain, gas, bloating
Digestion breaks down food into simple substances, converting them to energy for organs and tissues.
Nutrients like protein provide building blocks for cell regeneration, repair, and immune support. Digested
nutrients (carbohydrates/sugars) become the body's primary fuel. The large intestine concentrates
waste. Understanding normal function helps identify deficiencies; poor nutrient absorption may indicate
a small intestine issue, guiding assessment.
02 Caloric Intake and Energy Expenditure
● Calorie: Energy unit from food, used for body processes (metabolism, activity, digestion).
● Weight Balance:
○ Maintenance: Intake equals expenditure.
○ Gain: Intake exceeds expenditure (intentional gain focuses on muscle/bone mass via
nutrient-rich foods).
○ Loss: Intake is less than expenditure.
● Safe Weight Change: 1-2 lbs loss/week via lifestyle/diet/exercise (expenditure > intake).
● Assessment: Estimate caloric intake (24-hour recall/food frequency), expenditure
(activity/gender/age), and calculate BMI.
● Planning: Aim for safe, gradual change (1-2 lbs loss/week). Create sustained caloric deficit (or
surplus for gain) through diet and activity.
● Evaluation: Monitor for sustained, healthy change (weight, BP, glucose, cholesterol). Adjust as
needed.
03 Macronutrients – Protein, Carbohydrates, and Fats
Macronutrient Main Function Sources Key Notes / Health Tips
Protein - Body’s major building block Meat, fish, eggs, - Essential for muscle and tissue
- Provides amino acids for tissue beans, soy, nuts repair
structure, function, repair, - Helps maintain immune health
maintenance, and growth
- Supports fluid balance and
immune function
Carbohydrates - Body’s primary fuel source Vegetables, fruits, - Choose complex/healthy carbs
- Digestive system converts whole grains, milk, (low glycemic index: legumes, whole
carbs into glucose for energy legumes grains)
- Limit refined sugars and
processed grains (high glycemic
index: white bread, sweets)
Fats - Provides energy Healthy fats: - Monounsaturated fats = healthy
- Aids in absorption of fat-soluble avocados, olive oil, (heart-protective)
vitamins (A, D, E, K) nuts Unhealthy - Saturated fats = limit (raise total
- Impacts cholesterol levels fats: fried foods, cholesterol and increase heart
processed snacks, disease risk)
fatty meats - Trans fats = avoid (raise LDL,
lower HDL)
Macronutrients work together to restore and maintain body stability after stress, illness, or injury:
● Protein: Repairs tissues, supports immune defense, and maintains fluid balance.
● Carbohydrates: Provide quick energy for healing, immune function, and metabolism.
● Fats: Supply concentrated energy and aid absorption of fat-soluble vitamins (A, K), which support
clotting, immunity, and recovery.
04 Micronutrients – Vitamins
Category Vitamins Included Key Facts
Water-Soluble B-complex (B₁, B₂, B₃, B₅, B₆, B₇, B₉, - Not stored in the body; excess excreted in urine.
Vitamins B₁₂) and Vitamin C - Must be consumed regularly.
Fat-Soluble Vitamins A, D, E, K - Absorbed with dietary fat.
- Stored in liver/fat tissue.
- Toxicity possible with high intake.
Vitamin Function Major Food Sources
Vitamin C (Ascorbic Acid) Iron absorption, wound healing, collagen & bone Citrus fruits, berries, tomatoes
formation, immune support
Vitamin B₁₂ (Cobalamin) Red blood cell production, nervous system health Clams, beef, salmon, milk
Vitamin A Vision, immune function, bone health Beef liver, dairy, leafy greens
Vitamin D Calcium & phosphorus absorption, bone Fish oil, fortified milk, sunlight
development
Vitamin K Blood clotting, bone health Spinach, kale, liver
Assessment/Diagnosis of signs of deficiency
- Poor wound healing - Vitamin C, Zinc
- Easy bruising or bleeding - Vitamin K
- Fatigue, pale skin - Vitamin B12 or Iron
- Dry skin, night blindness - Vitamin A
- Brittle hair, frequent infections - general vitamin deficiency
Planning/Implementation
- Collaborate with provider/dietitian for supplementation
- Encourage vitamin-rich foods
- Educate client about drug-nutrient interactions
05 Micronutrients – Minerals
Type Definition Examples
Macrominerals Needed in larger amounts for body structure Calcium, Phosphorus, Magnesium,
and major functions Sodium, Potassium
Trace Minerals Needed in smaller amounts but still essential Iron, Zinc, Iodine, Copper
for health
Mineral Main Functions Major Food Sources
Calcium (Ca) Bone and tooth strength, muscle contraction, blood Milk, dairy, leafy greens
clotting, BP regulation
Iron (Fe) Oxygen transport (hemoglobin), energy metabolism, Organ meats, red meat, leafy
immune support greens
Potassium (K) Fluid balance, nerve transmission, muscle and Bananas, fruits, legumes, whole
heart function grains
Sodium (Na) Fluid balance, nerve impulses, muscle contraction Salt, processed foods, meats
Magnesium (Mg) Muscle contraction, nerve transmission, immune Legumes, green vegetables,
function seafood
Zinc (Zn) Immune function, wound healing, growth and tissue Meats, fish, whole grains
repair
Mineral Effect of Imbalance Clinical Implications
Potassium (K⁺) ↑ High = Hyperkalemia → Heart dysrhythmias, cardiac Monitor in renal disease
arrest Administer K⁺ cautiously
↓ Low = Hypokalemia → Muscle weakness,
arrhythmias
Phosphorus (P) ↑ High = Bone demineralization (pulls calcium from Common in kidney disease
bones) → Fracture risk Requires P restriction
Iron (Fe) ↑ Excess = Liver damage (toxic storage in tissues) Monitor with long-term
supplementation or transfusions
Sodium (Na⁺) ↑ High = Fluid retention → Hypertension, edema Regulates total body fluid
↓ Low = Hyponatremia → Confusion, seizures balance
Calcium (Ca²⁺) ↓ Low = Tetany, muscle spasms Works inversely with
↑ High = Lethargy, kidney stones phosphorus
Sodium and potassium are key electrolytes that regulate fluid distribution (fluid balance) and nerve/muscle
signals. Too much sodium leads to fluid retention and high blood pressure.
Potassium is critical for heart function. Imbalances (both too high and too low) can cause life-threatening
dysrhythmias.
06 Healthy Eating Patterns
● MyPlate: 5 food groups — Fruits, Vegetables, Grains, Protein, Dairy.
○ Adult guideline: 2 cups fruit, 2.5 cups vegetables, 6 oz grains, 5.5 oz protein, 3 cups dairy.
● Nutrient-Dense vs. Empty-Calorie Foods:
○ Nutrient-dense: rich in vitamins/minerals (fruits, veggies, whole grains).
○ Empty-calorie: low in nutrients, high in sugar/fat (soda, cookies).
● Nutrients to Limit: Sodium ≤ 2,300 mg/day, saturated fats, and added sugars.
● Substitutions: Choose whole grains, lean proteins, low-sodium alternatives, and foods that match client
culture, finances, and lifestyle for adherence.
Influence on Eating:
Cultural traditions, financial limits, and lifestyle demands affect diet compliance — nurses adapt teaching
and care plans to these factors.
07 Hydration and Water Balance
● Functions: Makes up >50% of body weight; regulates temperature, supports brain and joint function,
and removes waste.
● Intake: 2.7–3.0 L/day (females), 3.5–3.7 L/day (males).
● Outtake: 30
● Dehydration: Common in older adults (↓ thirst). Early sign — confusion of thirst with hunger.
● Nursing Care: Encourage fluids, offer before meals, use water-rich foods, monitor I&O, assess mucous
membranes.
System Interplay:
● Water regulates electrolytes (esp. Na⁺).
● Maintains temperature control via sweating.
● Supports cardiovascular stability — dehydration → hypotension, tachycardia.
● Safe care = hydration monitoring = perfusion monitoring.
08 Nutrition Label Interpretation
● Label Review: Serving size, calories, nutrients, %DV (based on 2,000 kcal diet).
○ Low: ≤ 5 % DV High: ≥ 20 % DV
● Limit: Sodium, Saturated Fats, Added Sugars.
● Encourage: Fiber, Vitamin D, Calcium, Iron, Potassium.
Self-Management Applications:
● Hypertension: Identify high-sodium foods (≥ 20 % DV); choose no-salt-added options.
● Diabetes: Monitor total carbohydrates and added sugars for glucose control.
09 Clinical Application and Critical Thinking
Study Focus:
● Heart-Healthy Diet: Limit sodium, saturated/trans fats; increase whole grains; select lean proteins.
● Wound Healing: ↑ Protein & Vitamin C intake.
● Potassium Replacement: Replace K⁺-loss from diuretics with K⁺-rich foods (bananas, legumes).
● Evaluate Outcomes: Use objective data (weight, BP, cholesterol, glucose, wound healing).
Nursing Process Connection:
● Assess: BMI, labs, diet recall, physical signs.
Diagnose: Risk for Imbalanced Nutrition (General), Readiness for Enhanced Nutrition, Imbalanced
Nutrition: Less Than Body Requirements, Imbalanced Nutrition: More Than Body Requirements
● Plan: Set measurable goals (e.g., sodium ≤ 1800 mg/day).
● Implement: Teach label reading, provide diet education, manage feeding.
● Evaluate: Review outcomes (weight, healing, labs) — nutrition drives all recovery.
10 Reflection and Integration
● Cross-System Impact:
○ Cardiovascular: Sodium/fats affect BP & cholesterol; potassium affects rhythm.
○ Immune/Skin: Protein, zinc, vitamins A/C support healing.
○ Nervous/Musculoskeletal: Electrolytes (Na⁺, K⁺) for nerve/muscle function; calcium + vitamin D
for bone strength.
● Retention Strategy: knowing why something happens (the problem) helps me remember what I should
do (the intervention) Even if I don’t remember exactly what to do, knowing why the problem happens
helps guide me to the right answer anyways.
● Personal Application: I know that monitoring my intake and expenditure (it’s hard to get moving but I
need to in order to balance the exercise my brain has to do) and maintaining the right nutrient balance
will help me fuel my body properly through nursing school. Especially since they say that stress eating
and weight gain is common and I know that is not how I want to end the program.
Big Picture Summary:
1. Provides Energy: Carbs, fats, proteins fuel metabolism and recovery.
2. Builds & Repairs: Protein supports tissue growth, enzymes, and hormones.
3. Regulates Homeostasis: Water and minerals stabilize fluids, BP, and temperature.
4. Optimizes Function: Vitamins enable immune defense and cellular activity.
Nutrition is the body’s total operating budget: fuel, materials, and maintenance tools for survival and
healing
(ChatGPT did help with this “big picture” summary but I like it a lot and I wanted to keep it as is)
