NURS 201 Spring 2020-21

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Nutrients

Are specific biochemical substances used by the body

for growth, development, activity, reproduction,
lactation, health maintenance, & recovery from illness.
1. Essential nutrients
2. Nonessential nutrients

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Essential / Non- essential Nutrients

Essential Non-essential
Are not synthesized by Are synthesized in the
the body; need to be body from food
provided in the diet or sources in adequate
through supplements amounts such as
triglycerides
a) Macronutrients:
Carbohydrates, fats,
proteins

b) Micronutrients:
vitamins & minerals.
required in small amounts
to regulate body
processes ;water
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Six Classes of Nutrients

Nutrients • Carbohydrates
that supply • Protein
energy • Lipids

Nutrients
that • Vitamins
regulate • Minerals
body • Water
processes

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 Metabolic Requirements

 Basal metabolism is the energy required to carry on

the involuntary activities of the body at rest—the energy
needed to sustain the metabolic activities of cells and
tissues (Grossman & Porth, 2014).
 These activities include actions such as maintaining body
temperature and muscle tone, producing and releasing
secretions, propelling food through the gastrointestinal
(GI) tract, inflating the lungs, and contracting the heart
muscle.

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Factors Affecting
Basal Metabolic Rate (BMR)

Males have a higher BMR

due to larger muscle
mass
o BMR is about 1
cal/kg of body
weight per hour for
men
o BMR is about 0.9
cal/kg of body
weight per hour for
women

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 Factors that affect BMR

BMR BMR
1. Growth 1. Aging
2. Infection 2. Prolonged fasting
3. Fever 3. Sleep
4. Emotional tension
5. Extreme environmental
temperature
6. level of thyroid
hormone or epinephrine

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Energy balance

The body needs energy to function. Energy is derived from

foods (macronutrients) consumed. It is measured in
Kilocalories (cal.)
1 gm of:

Carbohydrates Protein Fat

4 calories 4calories 9 calories

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Body Mass Index: BMI

 The body mass index (BMI), is a ratio of weight (in

kilograms) to height (in meters).
 The BMI is a reliable indicator of total body fat stores in
the general population.
 Health care providers use it as an initial assessment of
nutritional status.
 BMI also provides an estimation of relative risk for
diseases such as heart disease, diabetes, and
hypertension.

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Body Mass Index: BMI

According to the BMI

guidelines:
 A person with a BMI below
18.5 is underweight,
 18.5 to 24.9 is a healthy
weight,
 25 to 29.9 indicates an
overweight person
 a BMI of 30 or greater
indicates obesity, and a BMI
of 40 or greater indicates
extreme obesity (NIH,
2012a).

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Carbohydrates

 Sugars and starches

 Organic compounds composed of
carbon, hydrogen, and oxygen
 Most abundant and least expensive
source of calories in the world
 Classified as simple or complex
sugars
 Converted to glucose for transport
through the blood
 Cells oxidize glucose to provide
energy, carbon dioxide, and water.
 It is recommended that
carbohydrates provide 45% to 65%
of total calories for adults, focusing
on complex carbohydrates, such as
whole grains.

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Protein

 Required for the formation of all body

structures ( genes, enzymes, muscles..)
 Labeled complete (high quality) or
incomplete (low quality), based on
amino acid composition
 Animal proteins are complete; plant
proteins are incomplete.
 Tissues are continuously being broken
down (catabolism) and replaced
(anabolism).
 RDA ( recommended dietary allowance)
for adults is 0.8 g/kg of body weight,
10% to 35% total calorie intake

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Question #1

Tell whether the following statement is true or false.

Red meat is an incomplete protein.
A. True
B. False

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Answer to Question #1

Answer: B. False

Rationale: Red meat is a complete protein.

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Fats

 Insoluble in water and blood

 95% of lipids in diet are triglycerides
 Contain mixtures of saturated (raise
cholesterol levels) and unsaturated
(lower cholesterol levels) fatty acids
o Most animal fats are saturated.
o Most vegetable fats are unsaturated.
 The Dietary Guidelines 2015–2020
recommends that individuals limit intake
of saturated fats and trans fats, with less
than 10 % of calories per day from
saturated fats and intake of trans fats to
as low as possible.
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Saturated versus Unsaturated Fat

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Question #2

What is the name for the product that occurs when

manufacturers partially hydrogenate liquid oils?
A. Lipids
B. Triglycerides
C. Cholesterol
D. Trans fat

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Answer to Question #2

Answer: D. Trans fat

Rationale: Trans fat occurs when manufacturers

partially hydrogenate liquid oils; trans fat raises serum
cholesterol. Lipids are fats in the diet. Triglycerides are
the predominant form of fat in food and the major
storage form of fat in the body. Cholesterol is a fat-like
substance found only in animal products.

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 Vitamins

 Organic compounds needed by

the body in small amounts
 Most are active in the form of
coenzymes.
 Needed for metabolism of
carbohydrates, protein, and fat
 Classified as water soluble or fat
soluble
 Absorbed through the intestinal
wall directly into bloodstream

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Water

 Accounts for between 50% and

60% of adult’s total weight.
 Two-thirds of body water is
contained within the cells
(intracellular fluid [ICF]).
 The remainder of body water is
extracellular fluid (ECF), body
fluids (plasma, interstitial fluid).
 Provides fluid medium
necessary for all chemical
reactions in the body
 Acts as a solvent and aids
digestion, absorption,
circulation, and excretion

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Question #3

Tell whether the following statement is true or false.

Food is more vital to life than water because it provides
the medium necessary for all chemical reactions and it is
not stored in the body.
A. True
B. False

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Answer to Question #3

Answer: B. False

Rationale: Water is more vital to life than food because it

provides the medium necessary for all chemical reactions
and it is not stored in the body.

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Factors Affecting Food Habits

Economics

Culture/ religion

Personal preferences

Lifestyle / Social status

Stage of development

Medications

State of health
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Food Intake

 Decreased: anorexia (lack of appetite)

 Increased: Obesity (BMI ≥30)

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Components of Nutritional Assessment

Physical
History taking Laboratory data
assessments
• Dietary, • Anthropometric • Protein status,
medical, ( weight, body vitamin,
socioeconomic height, waist mineral, and
data circumference, trace element
and clinical status
data

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Positioning of Measuring Tape for Waist
Circumference

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Nursing Interventions

 Teaching nutritional information

 Monitoring nutritional status
 Stimulating appetite
 Assisting with eating
 Providing oral nutrition
 Providing long-term nutritional support

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 Nutritional Support

 Short-Term: Using the

nasogastric or naso-
intestinal route
 Long-Term: An entero-
stomal tube may be placed
through an opening created
into the stomach
(gastrostomy) or into the
jejunum (jejunostomy).
 A gastrostomy is the
preferred route to deliver
enteral nutrition in the
patient who is comatose.

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 Total parenteral Nutrition

 Total parenteral nutrition

(TPN), also known as
parenteral nutrition (PN) is a
form of nutritional support
given completely via the
bloodstream, intravenously
with an IV pump. TPN
administers proteins,
carbohydrates, fats,
vitamins, and minerals. It
aims to prevent and restore
nutritional deficits, allowing
bowel rest while supplying
adequate caloric intake and
essential nutrients.

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 Nursing Considerations

 TPN are regarded as large volume

medication (Need to perform a double
check to ensure accuracy)
 Accurate daily monitoring: V/S and infusion
rate at least Q 4 hrs
 Always use a pump and keep rate
constant; never D/C abruptly, but taper
 Intake and output totalled Q8-12 hrs
 Bedside glucose testing Q 6 hrs
 Daily weight and patient’s strength
 Utilize strict sterile technique during
catheter insertion and management- to
prevent infection
 TPN/PPN administration via a tubing with
filter, changed Q 72 hrs [Q24 hrs when
transfusing with Lipids]
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Complications of TPN

 Insertion problems
 Infection and sepsis
 Metabolic alterations
 Fluid, electrolyte, and acid–base imbalances
 Phlebitis
 Hyperlipidemia
 Liver and gallbladder disease

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Types of Food

 Clear liquid diet

 Full liquid diet
 Soft diet
 Diabetic diet
 Low salt low fat diet

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Feeding formulas

 Original / regular
 High Fiber
 High Protein
 Diabetic

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