# data[].attributes.body
The body mass index (BMI), or Quetelet Index (W/H²), is a calculation for what?

It is a ratio of weight to height, and it estimates body fat and can be used as an initial assessment of nutritional status.

Why do we use it?

We use it as an assessment of nutritional status

How can it help with patient care?

It provides an estimate of the relative risk for diseases that can occur with more body fat, such as heart disease, type 2 diabetes, hypertension, and certain cancers.

# data[].attributes.body
A 24-hour dietary recall (24HR) is a structured interview intended to capture detailed information about all foods and beverages (and possibly, [glossary term:]dietary supplements) consumed by the respondent in the past 24 hours, most commonly, from midnight to midnight the previous day.

A key feature of the 24HR is that, when appropriate, the respondent is asked for more detailed information than first reported. For example, a respondent reporting chicken for dinner or a sandwich for lunch would be asked about the preparation method and type of bread.

This open-ended response structure is designed to prompt respondents to provide a comprehensive and detailed report of all foods and beverages consumed.

# data[].attributes.body
Dietary guidelines are the recommended amount of each form of nutrient we should be consuming each day

They are science-based strategies compiled by the U.S. Department of Health and Human Services and the U.S. Department of Agriculture.

A new edition is published q 5 years

People are encouraged to choose a healthy eating pattern at an appropriate calorie level to help achieve and maintain a healthy body weight, support adequate nutrition, and reduce the risk of chronic disease.

# data[].attributes.body
Food diaries and calorie counts require documentation of actual intake for a specified period of time.

These tools may provide a better overall picture of nutrient intake because all food and beverages consumed in a specified period, usually 3 to 7 days, are recorded.

# data[].attributes.headline
Why would a patient require enteral feedings?

# data[].attributes.subject
Why would a patient require enteral feedings?

# data[].attributes.body
If you can’t eat enough, you’re at risk for malnourishment, weight loss, and very serious health issues. This may happen for a variety of reasons. Some of the more common underlying reasons for enteral feeding include:

a stroke, which may impair the ability to swallow

cancer, which may cause fatigue, nausea, and vomiting that make it difficult to eat

critical illness or injury, which reduces energy or ability to eat

failure to thrive or inability to eat in young children or infants

serious illness, which places the body in a state of stress, making it difficult to take in enough nutrients

neurological or movement disorders that increase caloric requirements while making it more difficult to eat

GI dysfunction or disease, although this may require intravenous (IV) nutrition instead

# data[].attributes.body
● Indicated for clients who do not need dietary restrictions. The diet is adjusted to meet age specific needs throughout the life cycle.
● Many health care facilities offer self‑select menus for regular diets.
● Modify the regular diet to accommodate individual preferences, food habits, and ethnic values.

# data[].attributes.body
1. A nurse is caring for a client who is at high risk for aspiration. Which of the following actions should the nurse take?
A. Give the client thin liquids.
B. Instruct the client to tuck their chin when swallowing.
C. Have the client use a straw.
D. Encourage the client to lie down and rest after meals.

2. A nurse is preparing a presentation about basic nutrients for a group of high school athletes. She should explain that which of the following nutrients provides the body with the most energy?
A. Fat
B. Protein
C. Glycogen
D. Carbohydrates

3. A nurse is caring for a client who requires a low‑residue diet. The nurse should expect to see which of the following foods on the client’s meal tray? A. Cooked barley
B. Pureed broccoli
C. Vanilla custard
D. Lentil soup

4. A nurse is caring for a client who weighs 80 kg (176 lb) and is 1.6 m (5 ft 3 in) tall. Calculate the body mass index (BMI) and determine whether this client’s BMI indicates a healthy weight, underweight, overweight, or obese.

5. A nurse in a senior center is counseling a group of older adults about their nutritional needs and considerations. Which of the following information should the nurse include? (Select all that apply.) A. Older adults are more prone to dehydration than younger adults are.
B. Older adults need the same amount of most vitamins and minerals as younger adults do.
C. Many older men and women need calcium supplementation.
D. Older adults need more calories than they did when they were younger. E. Older adults should consume a diet low in carbohydrates.

# data[].attributes.body
Nutrition and Oral Hydration Nutrients provide energy for cellular metabolism, tissue maintenance and repair, organ function, growth and development, and physical activity. Water, the most basic of all nutrients, is crucial for all body fluid and cellular functions. The proper balance of nutrients and fluid along with consideration of energy intake and requirements is essential for ensuring adequate nutritional status. Early recognition and treatment of clients who are malnourished or at risk can have a positive influence on client outcomes. A nutritional assessment helps identify areas to modify, either through adding or avoiding specific nutrients or by increasing or decreasing caloric intake. When planning a nutritional or hydration intervention, it is important to consider beliefs and culture, the environment, and the presentation of the food, as well as any illnesses or allergies clients might have.

BASIC NUTRIENTS THE BODY REQUIRES Carbohydrates provide most of the body’s energy and fiber. Each gram produces 4 kcal. They provide glucose, which burns completely and efficiently without end products to excrete. Sources include whole grain breads, baked potatoes, brown rice, and other plant foods. Fats provide energy and vitamins. No more than 35% of caloric intake should be from fat. Each gram produces 9 kcal. Sources include olive oil, salmon, and egg yolks. Proteins contribute to the growth, maintenance, and repair of body tissues. Each gram produces 4 kcal. Sources of complete protein include beef, whole milk, and poultry. Vitamins are necessary for metabolism. The fat-soluble vitamins are A, D, E, and K. The water-soluble vitamins include C and the B complex (eight vitamins). Minerals complete essential biochemical reactions in the body (calcium, potassium, sodium, iron). Water is critical for cell function and replaces fluids the body loses through perspiration, elimination, and respiration.

FACTORS AFFECTING NUTRITION AND METABOLISM Religious and cultural practices guide food preparation and choices. Financial issues prevent some clients from buying foods that are high in protein, vitamins, and minerals. Appetite decreases with illness, medications, pain, depression, and unpleasant environmental stimuli. Negative experiences with certain foods or familiarity with foods clients like help determine preferences.
Environmental factors (sedentary lifestyles, work schedules, and widespread access to less healthy foods) contribute to obesity. Disease and illness can affect the functional ability to prepare and eat food. Medications can alter taste and appetite and can interfere with the absorption of certain nutrients. Age affects nutritional requirements.

Young adults (20 to 35 years) and middle adults (35 to 65 years)
● There is a decreased need for most nutrients (except during pregnancy).
● Calcium and iron are essential minerals for women.
● Good oral health is important.

Older adults (over 65 years)
● A slower metabolic rate requires fewer calories.
● Thirst sensations diminish, increasing the risk for dehydration.
● Older adults need the same amount of most vitamins and minerals as younger adults.
● Calcium is important for both men and women.
● Many older adults require carbohydrates that provide fiber and bulk to enhance gastrointestinal function.

EATING DISORDERS Anorexia nervosa
● Significantly low body weight for gender, age, developmental level, and physical health.
● Fear of being fat
● Self-perception of being fat
● Consistent restriction of food intake or repeated behavior that prevents weight gain Bulimia nervosa: a cycle of binge eating followed by purging (vomiting, using diuretics or laxatives, exercising excessively, fasting)
● Lack of control during binges
● Average at least one cycle of binge eating and purging per week for at least 3 months Binge-eating disorder: repeated episodes of binge eating
● Feels a loss of control when binge eating, followed by an emotional response (guilt, shame, or depression)
● Does not use compensatory behaviors (purging)
● Binge-eating episodes can range from one to multiple times per week.
● Clients are often overweight or obese.

OBESITY A BMI of 25 is the upper boundary of a healthy weight, 25 to 29.9 is overweight, 30 to 34.9 is obesity class 1, 35 to 39.9 is obesity class 2, and 40 and above is obesity class 3.

ASSESSMENT/DATA COLLECTION Dietary history should include the following.
● Number of meals per day
● Fluid intake
● Food preferences, amounts
● Food preparation, purchasing practices, access
● History of indigestion, heartburn, gas
● Allergies
● Taste
● Chewing, swallowing
● Appetite
● Elimination patterns
● Medication use
● Activity levels
● Religious, cultural food preferences and restrictions

CLINICAL MEASURES
● Height, weight to calculate BMI and ideal body weight BMI = weight (kg) ÷ height (m2 ) Step 1: Determine the client’s weight in kg and height in m. Step 2: Multiply the client’s height by itself to determine the m2 value. Step 3: Divide the weight in kg by the height value from step 2. The result is the client’s BMI.
● Skin fold measurements
● Laboratory values of cholesterol, triglycerides, hemoglobin, electrolytes, albumin, pre-albumin, transferrin, lymphocyte count, nitrogen balance

EXPECTED FINDINGS OF POOR NUTRITION
● Nausea, vomiting, diarrhea, constipation
● Flaccid muscles
● Mental status changes
● Loss of appetite
● Change in bowel pattern
● Spleen, liver enlargement
● Dry, brittle hair and nails
● Loss of subcutaneous fat
● Dry, scaly skin
● Inflammation, bleeding of gums
● Poor dental health
● Dry, dull eyes
● Enlarged thyroid
● Prominent protrusions in bony areas
● Weakness, fatigue
● Change in weight
● Poor posture

NURSING INTERVENTIONS
● Assist in advancing the diet as the provider prescribes.
● Instruct clients about the appropriate diet regimen.
● Provide interventions to promote appetite (good oral hygiene, favorite foods, minimal environmental odors).
● Educate clients about medications that can affect nutritional intake.
● Assist clients with feeding to promote optimal independence.
● Individualize menu plans according to clients’ preferences. ● Assist with preventing aspiration.
◯ Position in Fowler’s position or in a chair.
◯ Support the upper back, neck, and head.
◯ Have clients tuck their chin when swallowing to help propel food down the esophagus.
◯ Avoid the use of a straw.
◯ Observe for aspiration and pocketing of food in the cheeks or other areas of the mouth.
◯ Observe for indications of dysphagia (coughing, choking, gagging, and drooling of food).
◯ Keep clients in semi-Fowler’s position for at least 1 hr after meals.
◯ Provide oral hygiene after meals and snacks.
● Provide therapeutic diets.
◯ NPO (nil per os): no food or fluid at all by mouth, not even ice chips, requiring a provider’s prescription before resuming oral intake
◯ Clear liquid: liquids that leave little residue (clear fruit juices, gelatin, broth)
◯ Full liquid: clear liquids plus liquid dairy products, all juices. Some facilities include pureed vegetables in a full liquid diet.
◯ Pureed: clear and full liquids plus pureed meats, fruits, and scrambled eggs
◯ Mechanical soft: clear and full liquids plus diced or ground foods
◯ Soft/low-residue: foods that are low in fiber and easy to digest (dairy products, eggs, ripe bananas)
◯ High‑fiber: whole grains, raw and dried fruits
◯ Low sodium: no added salt or 1 to 2 g sodium
◯ Low cholesterol: no more than 300 mg/day of dietary cholesterol
◯ Diabetic: balanced intake of protein, fats, and carbohydrates of about 1,800 calories
◯ Dysphagia: pureed food and thickened liquids
◯ Regular: no restrictions

Administer and monitor enteral feedings via nasogastric, gastrostomy, or jejunostomy tubes.
● Administer and monitor parenteral nutrition to clients who are unable to use their gastrointestinal tract to acquire nutrients. Parenteral nutrients include lipids, electrolytes, minerals, vitamins, dextrose, and amino acids.
● Maintain fluid balance.
◯ Administer IV fluids.
◯ Restrict oral fluid intake (maintaining strict I&O).
■ Remove the water pitcher from the bedside.
■ Inform the dietary staff of the amount of fluid to serve with each meal tray.
■ Inform the staff of each shift of the amount of fluid clients may have in addition to what they receive with each meal tray.
■ Record all oral intake, and inform the family of the restriction. (Encourage oral intake of fluids).
■ Provide fresh drinking water.
■ Remind and encourage a consistent fluid intake.
■ Ask about beverage preferences.

# data[].attributes.body
Complete the study guide.

# data[].attributes.body
The most common complications related to the placement of nasogastric tubes are discomfort, sinusitis, or epistaxis, all of which typically resolve spontaneously with the removal of the nasogastric tube.[25] Other complications associated with use of an NG tube range from minor to more severe and may include the following conditions:

Trauma to the nares, larynx, esophagus, and/or stomach during insertion.

Trauma to or erosion of gastric mucosa, especially if gastric suctioning is prolonged.

Mucosal pressure injury of the nares.

Placement-related issues: Inadvertent placement in the trachea that can lead to pleural injury, pneumothorax, tracheobronchial aspiration, pneumonia, and death. Respiratory distress is a medical emergency, and emergency assistance must be obtained immediately.

Esophageal perforation, evidenced by neck or chest pain, dysphagia, dyspnea, subcutaneous emphysema, or hematemesis.

Inadvertent intracranial placement through a fractured cribriform plate.

Knotting of the NG tube around an endotracheal tube or retrograde positioning (i.e., the proximal tip of the tube curves upward through the esophagus).

# data[].attributes.body
Click to log in. Go to Chapter 38 and watch insertion video.

# data[].attributes.attachment_link.title
Water Soluble Vitamins: B-complex vitamins, vitamin C - Nutrition Essentials | @LevelUpRN

# data[].attributes.body
The study of the intake of food and how food nourishes the body.

# data[].attributes.body
What does this mean?

BMR is the energy number (number of calories) required to fuel involuntary activities of the be=ody at rest after a 12-hour fast; the energy needed to sustain the metabolic activities of cells and tissues.

Why is this important?

These activities include actions such as maintaining body temperature and muscle tone, producing and releasing secretions, propelling food through the GI tract, inflating the lungs, and contracting the heart muscle.

The greater the muscle mass... the higher the BMR

# data[].attributes.body
Click to view chart

# data[].attributes.body
A gastrostomy tube, often called a G tube, is a surgically placed device used to give direct access to your child's stomach for supplemental feeding, hydration or medicine.

G tubes are used for a variety of medical conditions, but the most common use is for feedings to enhance your child’s nutrition. When a child is unable to eat enough food by mouth, a G tube helps deliver enough calories and nutrients to support their growth.

# data[].attributes.body
the transfer of digested nutrients into circulation

# data[].attributes.body
Increased food intake may lead to overweight and obesity.

Obesity presents a serious health problem physically, socially, and emotionally.

More than two-thirds of adults in the U.S. are considered to be overweight or have obesity.

An imbalance between calories consumed and calories expended, resulting from an excess caloric intake and decrease in energy expenditure, leads to the gradual accumulation of weight. An increase in physical inactivity due to lifestyle is also a cause of weight gain.

People whore are overweight or obese may be subject to weight bias and stigma and this could lead to feelings of rejection, shame or guilt, depression, isolation, and perceiving oneself as a failure.

Obesity is resistant to treatment, and requires modification of behavior and lifestyle.

# data[].attributes.body
This guideline covers identifying and caring for adults who are malnourished or at risk of malnutrition in hospital or in their own home or a care home.

It offers advice on how oral, enteral tube feeding and parenteral nutrition support should be started, administered and stopped. It aims to support healthcare professionals identify malnourished people and help them to choose the most appropriate form of support.

# data[].attributes.body
Some rules for assisting residents with eating would include:

1. Do not rush

2. Wash hands before beginning to assist and perform hand hygiene between residents

3. Serve one course at a time

4. Use a metal or hard plastic teaspoon or parfait spoon for those on minced or pureed diets

5. Ensure foods are not dangerously hot by placing a small amount of food on forearm to determine if temperature is safe for resident

6. Offer small bites at a time, bring the spoon to where the resident can see it and give resident time to open his/her mouth

7. Allow time for chewing/swallowing and try to observe the swallow taking place

8. Check that resident’s chin remains slightly tucked for safest swallowing

9. Check that there is minimal amount of food residue in the mouth after swallow.

10 .Alternate liquids with solids unless the plan of care indicates otherwise

11. Do not mix foods together unless the resident requests this or the care plan allows this

12. Cue resident to open mouth if necessary

13. Encourage resident to wipe his/her mouth with a damp cloth or napkin throughout the meal. Assist as required

14. Reheat food if it becomes cold

15. If resident begins to cough or choke- stop providing food and allow time before starting again

16. Report coughing, choking, pocketing, drooling, spitting to Registered staff overseeing the dining room service

17. Record intake as soon as possible after assisting resident

# data[].attributes.body
A nasogastric tube (NG tube) is a thin, flexible tube that is inserted through the nose and down the esophagus into the stomach. NG tubes are used to deliver food and medication to people who are unable to eat or drink by mouth, and to remove stomach contents to relieve pressure or remove poisons.

NG tubes are often used for short-term tube feeding and to deliver oral medications to hospitalized people. They can also be used to suction out stomach contents to relieve pressure or remove poisons. In some cases, NG tubes may also be used to deliver fluids to people who are dehydrated.

# data[].attributes.body
● Consists of foods or fluids that have no residue and are liquid at room temperature.
● Primarily to prevent dehydration and relieve thirst, the diet consists of water and carbohydrates. This diet requires minimal digestion, leaves minimal residue, and is non-gas-forming. It is nutritionally inadequate and should not be used long-term.
● Indications include acute illness, reduction of colon fecal material prior to certain diagnostic tests and procedures, acute gastrointestinal disorders, and some postoperative recovery.
● Acceptable foods are water, tea, coffee, fat‑free broth, carbonated beverages, clear juices, ginger ale, and gelatin.

# data[].attributes.body
insertion of an NGT is typically a clean (not sterile), “blind” procedure, meaning the person performing the procedure can’t visualize where the tube is going in the client’s body as they are inserting it. Insertion involves passing the tube through the nose, along the nasal floor, through the pharynx and down the esophagus until the proximal tip of the tube rests in the client’s stomach

NG tubes are inserted and removed by nurses and other health care providers. Due to the invasive nature of the placement process, privately ask the client if they desire visitors to leave the room during placement or removal of the NG tube.

Nurses provide the daily care of NG tubes, as well as the administration of nutritional formulas, medications, and other substances through the tube.

# data[].attributes.attachment_link.title
What Are Macronutrients? | Macros Explained

# data[].attributes.body
The specific biochemical substances used by the body for growth, development, activity, reproduction, lactation, health maintenance, and recovery from illness or injury.

# data[].attributes.body
Other factors that increase BMR include:

Men usually have a higher muscle mass and higher BMR

Highly active

Other factors that increase BMR include growth, infections, fever, emotional tension, extreme environmental temperatures, and elevated levels of certain hormones; especially epinephrine and thyroid hormones

Why do you think BMR is increased?

The more active a person is, the more active their BMR needs to be.

# data[].attributes.body
Kids need G-tubes for different kinds of health problems, including:

congenital (present at birth) problems of the mouth, esophagus, stomach, or intestines

sucking and swallowing disorders (due to premature birth, injury, a developmental delay, or another condition)

failure to thrive (when a child can't gain weight and grow normally)

extreme problems with taking medicines

# data[].attributes.body
lack of appetite

# data[].attributes.body
Key Recommendations of the Dietary Guidelines for Americans 2015–2020

# data[].attributes.body
Food intake may decrease for various reasons. Patients with a BMI of less than 18.5 are considered underweight.

Anorexia, or lack of appetite, may be related to systematic or local diseases; numerous psychosocial causes, such as fear, anxiety, depression, or pain; and impaired ability to smell and taste-- or it may occur secondary to drug therapy or medical treatments.

Others who may have a limited food intake include those who have limited food intake include those who have difficulty chewing and swallowing, those with GI problems, those who undergo certain procedures, and those with some chronic illnesses, and those with inadequate food budgets.

# data[].attributes.body
A growing number of patients are turning to vegetarianism as a diet-based therapy to manage symptoms and promote wellness.

Although a vegetarian diet is included in the National Center for Complementary and Alternative Medicine’s biologically based practice domain, little is known about relationships among vegetarian diet-based therapies and the management of symptoms and/or promoting wellness.

Vegetarian diets are totally devoid of red or white meat. However, there are numerous non–meat diet variations. For example, some vegetarian diets are restricted to plant products (plant based) only, whereas others include eggs and dairy products.

# data[].attributes.body
According to BMI guidelines, a person with a BMI below 18.5 is underweight, a person with a BMI of 18.5-24.9 is a healthy weight, and a person with a BMI of 25-29.9 is overweight, a person with a BMI of 30-39.9 is obese, and a person with a BMI of 40 or higher indicates extreme obesity.

# data[].attributes.body
Ask how your patients want materials (recorded, large print [18-point type], via e-mail, etc.). Also, figure out a system that works for the patient to mark medications. For example, have the pharmacist put three rubber bands on a bottle of pills that should be taken three times a day.

Always read aloud what you write in the medical record.

Have all staff give their names and titles when entering the examination room, even if they have name tags.

Speak directly to the patient rather than asking the sighted person in the room, “Does he...?”

If the patient has a guide dog, ask before petting or greeting the animal.

Tell the patient what procedure you are about to do, and let him or her feel the equipment first if possible. Have the patient perform dressing changes, etc., that he or she will need to do at home, so you can coach.

Say “goodbye” before leaving the room so the patient is not left talking to himself or herself.

If you forget any of these tips and the interaction goes poorly, apologize and try again. It won't be the first time someone has been awkward about the patient's visual impairment, and it won't be the last. We appreciate being allowed to tell you how we prefer things.

# data[].attributes.attachment_link.title
Basal Metabolic Rate (BMR) - Explained - Part 1

# data[].attributes.headline
There are two types of Nasogastric tubes.

# data[].attributes.subject
There are two types of Nasogastric tubes.

# data[].attributes.body
There are various tubes used in GI intubation but the following two are the most common:

Levin tube. Is a single-lumen multipurpose plastic tube that is commonly used in NG intubation.

Salem sump tube. A double-lumen tube with a “pigtail” is used for intermittent or continuous suction.

# data[].attributes.body
● Consists of foods that are liquid at room temperature including plain ice cream and strained cereals. Some facilities include pureed vegetables.
● Offers more variety and nutritional support than a clear liquid diet but might require supplementation of protein and calories if used more than 3 days.
● Indications include a transition from liquid to soft diets, postoperative recovery, acute gastritis, febrile conditions, and intolerance of solid foods.
● Use cautiously with clients who have dysphagia (difficulty swallowing) unless liquids are thickened appropriately.
● Many dietary manuals have removed the full liquid diet, so it might be used infrequently

# data[].attributes.body
There are two types of contraindications for any procedure or intervention and are referred to as absolute and relative. An absolute contraindication means the procedure or intervention may produce a life-threatening situation and should be avoided if possible.

A relative contraindication means caution should be used because the possibility of an adverse event is possible; therefore, benefits must outweigh the risks.

Relative contraindications include esophageal trauma, especially if caustic substances were ingested. Coagulation abnormalities or anticoagulation therapy may cause bleeding from the tissue trauma from tube placement. For clients with previous gastric bypass surgery, hiatal hernia repair, or abnormal GI anatomy (such as esophageal varices or strictures), NG tubes should be placed by a provider under endoscopy

# data[].attributes.headline
Dumping Syndrome NCLEX Practice Question Nursing

# data[].attributes.subject
Dumping Syndrome NCLEX Practice Question Nursing

# data[].attributes.attachment_link.title
Dumping Syndrome NCLEX Practice Question Nursing

# data[].attributes.body
They are either not synthesized in the body or are made in insufficient amounts.

Must be provided in the diet through supplements, and they supply energy and build tissue (such as carbs, fats, and proteins)... these are referred to as macronutrients.

Micronutrients are vitamins and minerals and are required in smaller amounts to regulate and control body processes.

# data[].attributes.body
Explain intake vs energy expenditure. Overweight vs underweight?

If a person's energy intake doesn't equal energy expenditure, weight will fluctuate.

Healthy body weight is an estimate of optimal weight for optimal health.

The preferred methods to establish weight status include body mass index for adults and children and measurement of waist circumference for adults.

According to BMI guidelines, a person with a BMI below 18.5 is underweight, a person with a BMI of 18.5-24.9 is a healthy weight, and a person with a BMI of 25-29.9 is overweight, a person with a BMI of 30-39.9 is obese, and a person with a BMI of 40 or higher indicates extreme obesity.

# data[].attributes.body
Click here.

# data[].attributes.headline
Why do you check for residual and how often?

# data[].attributes.subject
Why do you check for residual and how often?

# data[].attributes.body
Frequency of GRV measurement (e.g. every six hours) and the intervention strategy for large GRVs (e.g. if GRV is above 500 mL, hold feeding for two hours and re‐check GRV) is usually decided as per institution‐specific protocols and needs of the inpatient population

Gastric residual volume is usually monitored in the ICU during nasogastric feeding or gastrostomy tube. Gastric residual volume monitoring is a well‐established and common nursing practice in the ICU.

# data[].attributes.body
They are either not synthesized in the body or are made in insufficient amounts.

Must be provided in the diet through supplements, and they supply energy and build tissue (such as carbs, fats, and proteins)... these are referred to as macronutrients.

Micronutrients are vitamins and minerals and are required in smaller amounts to regulate and control body processes.

# data[].attributes.body
measurement of the size and proportion of the human body

# data[].attributes.body
Click on the video to view

# data[].attributes.body
Click to view video

# data[].attributes.body
BMI may not be accurate for certain groups of people, such as athletes, people with muscular build, people with edema or dehydration, and older people and others who have lost muscle mass.

Ethnic differences exist in the relationship between BMI and health risks.

# data[].attributes.headline
Special Considerations and Interventions for Feeding Patients With Dysphagia

# data[].attributes.subject
Special Considerations and Interventions for Feeding Patients With Dysphagia

# data[].attributes.body
● Consists of liquids and foods that are pureed to liquid form.
● The composition and consistency of a pureed diet varies, depending on the client’s needs.
● Modify with regard to calories, protein, fat, or other nutrients based on the dietary needs of the client.
● Adding broth, milk, gravy, cream, soup, tomato sauce, or fruit juice to foods in place of water provides additional calories and nutritional value.
● Each food is pureed separately to preserve individual flavor.
● Indications include clients who have chewing or swallowing difficulties, oral or facial surgery, and wired jaws.

# data[].attributes.body
A nasogastric tube is irrigated regularly to determine and ensure the tube’s patency. It will help release any formula stuck to the inside of the tube.

1. Check physician’s order for irrigation. Explain procedure to client. Clarifies schedule and irrigating solution. An explanation encourages client cooperation and reduces apprehension.

2. Gather necessary equipment. Check expiration dates on irrigating saline and irrigation set. Provides for organized approached to task. Agency policy dictates safe interval for reuse of equipment.

3. Wash your hands. Handwashing deters the spread of microorganisms.

4. Assist client to semi-Fowler’s position unless this is contraindicated. Minimizes risk of aspiration.

5. Check placement of NG tube using the following techniques:

5. Check placement of NG tube using the following techniques:

A. Attach Asepto or Toomey syringe to the end of tube and aspirate gastric contents. The tube is in the stomach if its contents can be aspirated.

B. Place 10mL-50ml of air in syringe and inject into the tube. Simultaneously, auscultate over the epigastric area with a stethoscope. A whooshing sound can be heard when the air enters the stomach through the tube.

C. Ask client to speak. If tube is misplaced in trachea, client will not be able to speak.

6. Clamp suction tubing near connection site. Disconnect NG tube from suction apparatus and lay on disposable pad or towel. Protects client from leakage of NG drainage.

7. Pour irrigating solution into container. Draw up 30 ml of saline (or amount ordered by physician) into syringe. Delivers measured amount of irrigant through NG tube. Saline compensates for electrolytes lost through NG drainage.

8. Place tip of syringe in NG tube. Hold syringe upright and gently insert the irrigant (or allow solution to flow in by gravity if agency or physician indicates). Do not force solution into NG tube. Position of syringe prevents entry of air into stomach. Gentle insertion of saline (or gravity insertion) is less traumatic to gastric mucosa.

# data[].attributes.attachment_link.title
Nursing Care Plan Tutorial | How to Complete a Care Plan in Nursing School

# data[].attributes.body
Nonessential nutrients don't have to be supplied through dietary sources because they either are not required for body functioning or are synthesized in the body in adequate amounts.

Some nutrients can be converted to others in the body. For example, the body converts excess carbohydrates and proteins into fat and stores them as triglycerides.

# data[].attributes.headline
What are nursing interventions for a g-tube?

# data[].attributes.subject
What are nursing interventions for a g-tube?

# data[].attributes.body
Feeding intolerance is highly prevalent and is associated with worse outcomes, especially in critically ill patients. It is thus imperative to standardize assessment of GI function and a bedside examination of the abdomen

Gastric residual volume monitoring is considered to be a simple and effective method of monitoring FI, and a recent systematic review showed that a large GRV was used to define FI in 83% of studies

The main purpose of monitoring GRV is to improve safety in patients receiving EN. The administration of more enteral nutrients via the feeding tube while the stomach is already full (a high GRV) is not advisable in patients with reduced GI tolerance.

# data[].attributes.body
Food intake may decrease for various reasons. Patients with a BMI of less than 18.5 are considered underweight.

Anorexia, or lack of appetite, may be related to systematic or local diseases; numerous psychosocial causes, such as fear, anxiety, depression, or pain; and impaired ability to smell and taste-- or it may occur secondary to drug therapy or medical treatments.

Others who may have a limited food intake include those who have limited food intake include those who have difficulty chewing and swallowing, those with GI problems, those who undergo certain procedures, and those with some chronic illnesses, and those with inadequate food budgets.

# data[].attributes.body
the misdirection of oropharyngeal secretions or gastric contents into the larynx and lower respiratory tract

# data[].attributes.headline
PHYSIOLOGIC AND PHYSICAL FACTORS INFLUENCING NUTRIENT REQUIREMENTS

# data[].attributes.subject
PHYSIOLOGIC AND PHYSICAL FACTORS INFLUENCING NUTRIENT REQUIREMENTS

# data[].attributes.body
Throughout the life cycle, nutrient needs change in growth, development, activity, and age-related changes in metabolism and body composition.

Periods of intense growth and development, such as during infancy, adolescence, pregnancy, and lactation, can cause an increase in nutrient needs.

Infants: Nutritional needs per unit of body weight are greater during infancy and childhood than at other developmental stages. The period from birth- to age 1 is the most rapid period of growth.

Toddlers and Preschoolers: There is continued growth and development during this stage, but the growth rate slows.

Mobility, autonomy, and coordination increase, as do muscle mass and bone density,

Toddlers and preschoolers can feed themselves verbalize food likes and dislikes, and occasionally use food to manipulate their parents.

Children in this age group often experience an inadequate intake of fruits and vegetables and excessive intake of sweetened fruit drinks.

School-age children: The 6-12-year-old children have and uneven individualized and sometimes erratic slow progressive physical growth. Permanent teeth erupt, the digestive system matures, socialization and independence increase, and at this stage, the body accumulates reserves in prep for the upcoming adolescent growth spurt.

The focus is on health promotion. Increasing energy requirements need to be balanced with food of higher nutritional value.

The appetite improves but still may be irregular

Adolescents: ages 11-20, this is a period of rapid physical, emotional, social, and sexual maturation.

It is marked by intense psychosocial growth, family/caregiver conflict, and social and peer pressure.

Children in this age group tend to consume inadequate amounts of fruits vegetables, whole grains, and dairy products.

Nutrient needs especially calories, protein, calcium, and iron increase to support growth.

Health consciousness in teenagers could lead to an eating disorder.

Adults: With adulthood, growth ceases. This age is also marked by a decline in the BMR with each decade.

Adults may become more aware of the preventative role of exercise, or pressures of work and family may lead to a decline in physical activity and exercise.

Pregnant and Lactating Persons: During pregnancy, the fetus, maternal tissues, and placenta grow dramatically. Weight gain occurs, and GI changes as a result of the pregnancy may result in nausea, vomiting, heartburn, or constipation.

Nutrient needs during pregnancy increase to support growth and maintain maternal homeostasis, particularly during the second and third trimesters.

Older Adults: Because the BMR decreases and physical activity and loss of lean body mass, energy expenditure decreases.

Because of the changes related to aging, the caloric needs of the body decrease.

The need for nutrients however increases especially protein, calcium, b12, and vitamin D.

# data[].attributes.body
Overweight and obesity are defined differently for children and teens than for adults.

Children are still growing and boys and girls mature at different rates.

BMIs for children and teens compare their heights and weights against growth charts that take age and sex assigned at birth into account. This is called the BMI-for-age percentile.

Less than 5th percentile=underwieght

5th percentile to less than 85th percentile=helath weight

85th percentile to less than 95th percentile- overweight

95th percentile or greater=obese

# data[].attributes.body
Delayed gastric emptying (DGE) is a major cause of undernutrition that can be overcome using nasointestinal (NI) feeding, but tube placement often fails.

nasointestinal (NI) feeding, from duodenum to the jejunum, delivers more nutrition in patients with refractory to metoclopramide treatment when compared with nasogastric (NG) feeding plus prokinetics. However, aspiration risk appears to decline as NI placement becomes more distal

# data[].attributes.body
● Contains whole foods that are low in fiber, lightly seasoned, and easily digested.
● Food supplements or snacks in between meals add calories.
● Food selections vary and can include smooth, creamy, or crisp textures. Raw fruits and vegetables, coarse breads and cereals, beans, and other potentially gas-forming foods are excluded.
● Indications include clients transitioning between full liquid and regular diets, and those who have acute infections, chewing difficulties, or gastrointestinal disorders.
● Predisposes clients to constipation.

# data[].attributes.headline
How would you administer medications through a nasogastric tube?

# data[].attributes.subject
How would you administer medications through a nasogastric tube?

# data[].attributes.body
In patients dependent on nasogastric or PEG tubes, drugs are often crushed into a powder and suspended in water to enable its passage through the tubes. Typically, when drugs are crushed, multiple tablets are crushed together and then mixed and put in one sachet.

# data[].attributes.body
3 supply nutrients: (carbohydrates, proteins, lipids)

3 are needed to regulate body processes (vitamins, minerals, and water)

# data[].attributes.body
Anthropometric measurements are noninvasive quantitative measurements of the body. According to the Centers for Disease Control and Prevention (CDC), anthropometry provides a valuable assessment of nutritional status in children and adults. Typically they are used in the pediatric population to evaluate the general health status, nutritional adequacy, and the growth and developmental pattern of the child. Growth measurements and normal growth patterns are the gold standards by which clinicians assess the health and well-being of a child. In adults, body measurements can help to assess health and dietary status and future disease risk. These measurements can also be used to determine body composition in adults to help determine underlying nutritional status and diagnose obesity.

# data[].attributes.body
basal metabolic rate is the energy required to fuel the involuntary activities of the body at rest after a 12hr fast- the energy needed to sustain the metabolic activities of cells and tissues.

# data[].attributes.body
Males differ from females in their nutrient requirements due to differences in body composition and reproductive function.

Their larger muscle mass translates into higher caloric and protein requirements (therefore, slightly higher needs for B vitamins that metabolize calories and protein) because muscle is more metabolically active than adipose tissue (females have proportionately more adipose tissue).

Females of childbearing age have higher iron requirements related to menstruation.

In addition, evidence indicates there are biologic sex-associated differences in the metabolism of some nutrients, including fatty acids, proteins, and carbohydrates.

# data[].attributes.body
A significant intentional or unintentional change in the patient's weight can also indicate poor nutritional status and health problems.

# data[].attributes.headline
Focus on the Older Adult: Nursing Strategies to Assess Age-Related Changes Affecting Nutrition 

# data[].attributes.subject
Focus on the Older Adult: Nursing Strategies to Assess Age-Related Changes Affecting Nutrition 

# data[].attributes.body
Altered ability to chew related to loss of teeth, ill-fitting dentures, and gingivitis

Loss of senses of smell and taste

Decreased peristalsis in the esophagus

Gastroesophageal reflux

Decreased gastric secretions

Slowed intestinal peristalsis

Lowered glucose tolerance

Reduction in appetite and thirst sensation

Nutritional deficiencies related to alcohol intake

Loss of appetite associated with depression and loneliness

Physical handicaps

Low income

Malnutrition

Increased risk for drug-nutrient interactions

# data[].attributes.headline
Nursing Measures for nasogastric and nasoenteric intubation:

# data[].attributes.subject
Nursing Measures for nasogastric and nasoenteric intubation:

# data[].attributes.body
They must understand the manner in which these devices work, their purpose, and ways to prevent complications. Although inserting an NG tube is a commonly performed procedure, it can cause significant risk to the client if performed improperly.

Nursing responsibilities associated with caring for a client with an enteral tube include the following:

Assessing tube placement and patency

Assessing and cleansing the insertion site

Administering tube feeding

Administering medication via the enteral tube

Irrigating/flushing the tube

Managing gastric tube suctioning

Monitoring and responding to potential complications

# data[].attributes.body
● A regular diet that is modified in texture. The diet composition is altered for specific nutrient needs.
● Includes foods that require minimal chewing before swallowing (ground meats, canned fruits, softly cooked vegetables).
● Butter, gravies, sugar, or honey can be added to increase calorie intake.
● Excludes harder foods (dried fruits, most raw fruits and vegetables, foods containing seeds and nuts).
● Indications include limited chewing ability; dysphagia, poorly fitting dentures, and clients who are edentulous (without teeth); surgery to the head, neck, or mouth; and strictures of the intestinal tract.

# data[].attributes.headline
What are the steps to administer medications via a nasogastric tube?

# data[].attributes.subject
What are the steps to administer medications via a nasogastric tube?

# data[].attributes.body
Verify order Crush and dissolve medication in 20 mL water in an individual medication cup Hand hygiene Flush NG Tube with 30 mL of water Administer medications with 10 mL water flushes between each medication Flush with 30-60 mL water when complete Document administration

# data[].attributes.body
Energy in the diet is measured in kilocalories.

only carbs, proteins, and fat provide energy.

Vitamins and minerals needed for metabolism energy don't provide calories

Energy in the body is used to carry out any kind of activity whether that be voluntary or involuntary

# data[].attributes.body
Nutritional risk screening tools are very helpful in the daily routine to detect potential or manifest malnutrition in a timely manner. Such tools should be easy to use, quick, economical, standardized, and validated. Screening tools should be both sensitive and specific, and if possible, predictors of the success of the nutritional therapy. Nutritional screening should be part of a defined clinical protocol that results in a plan of action if the screening result is positive.

# data[].attributes.body
a ratio of weight to height, it provides an estimate of body fat and can be used as an initial assessment of nutritional status.

# data[].attributes.body
The alteration in nutrient requirements that results from illness and trauma varies with the intensity and duration of the stress.

For instance, fevers increase the need for calories and water.

Trauma such as major surgery, burns, and crush injuries, is followed by hormonal changes that profoundly affect the body's nutrients.

To preserve or replenish body nutrient stores and to promote healing and recovery, nutrient requirements increase dramatically in the adaptive phase after stress.

Chronic disorders can also alter nutrient requirements.

Mental health problems, such as depression and confusion, can cause pt to forget to eat or lack motivation to eat, leading to malnutrition.

# data[].attributes.body
Click below to view chart

# data[].attributes.body
● Prescribed when swallowing is impaired (following a stroke).
● Manifestations of dysphagia are drooling, pocketing food, choking, or gagging.

LEVELS OF SOLID TEXTURES
● Level 1: Pureed. Foods are totally pureed to a smooth consistency with a pudding-like texture (pureed fruits, vegetables, meats, soups, scrambled eggs, pudding, custard, applesauce).
● Level 2: Mechanically altered. Soft-textured, moist, semi-solid foods that are easily chewed and swallowed (ground meat served with gravy, chicken or tuna salad, well-moistened pancakes with syrup, poached eggs, soft canned or cooked fruit).
● Level 3: Advanced. Near-normal textured foods that are moist (moist tender meats or casseroles, breads that are not crusty, moist potatoes, soups, rice, and stuffing). Hard, sticky foods are eliminated.

LEVELS OF LIQUID CONSISTENCIES
● Thin: Non-restrictive. Consists of all unthickened beverages and supplements (clear juices, frozen yogurt, ice cream, milk, soda, and broth).
● Nectar-like: Liquids that are thin enough to sip through a straw but thicker than water. Consistency of a heavy syrup (nectars, cream soups, buttermilk, and thin milkshakes).
● Honey-like: Liquids that do not maintain their shape when poured but are thickened. They can be eaten with a spoon but cannot be sipped through a straw (honey, tomato sauce, and yogurt).
● Spoon-thick: Liquids thickened to maintain their shape and need to be eaten with a spoon (pudding, custard, hot cereals).

# data[].attributes.body
Commonly known as sugars, starches, are organic compounds composed of carbon, hydrogen, and oxygen

They are relatively easy to store, making them the most abundant and least expensive source of calories in the diet worldwide

The number of molecules within the structure determines the classification of carbohydrates. They are classified as simple (monosaccharide and disaccharide) or complex (polysaccharide) sugars.

Carbohydrates are more easily digested than fats and proteins. All carbs are converted to glucose for transport through the blood or the use of energy.

Glucose is transported from the GI tract, through the portal vein, to the liver. The liver stores glucose and regulates its entry into the blood. Hormones insulin and glucagon are responsible for keeping glucose levels fairly constant.

Through a series of steps, cells oxidize (burn) glucose to provide energy, carbon dioxide, and water.

Unlike protein and fat, glucose is burned efficiently and completely and does not leave a toxic product for the kidneys to excrete.

When the supply of glucose exceeds what is needed for energy and for maintaining serum levels, it is stored.

When glycogen stores are adequate, the body converts excess glucose to fat and stores it as triglycerides in adipose tissue.

4 calories per gram. It is recommended that carbs provides 45%-65% of total calories for adults

# data[].attributes.body
Statistical approaches to evaluate the reliability of biochemical data objectively are presented; including evaluation of the quality of data, analysis of variance and linear regression/correlation analysis.

# data[].attributes.body
The GI system breaks down the food into particles small enough to pass into the cells and be used by the cells.

# data[].attributes.headline
Alcohol Abuse, Medication Use, and Megadoses of Nutrient Supplements

# data[].attributes.subject
Alcohol Abuse, Medication Use, and Megadoses of Nutrient Supplements

# data[].attributes.body
Alcohol Use Disorder: It is a pattern of alcohol use that includes any alcohol that puts your helath or safety at risk or causes other alcohol-related problems and includes binge drinking ( a drinking pattern where a minimum of 4-5 drinks are consumed within 2 hours)

Alcohol can alter the body's use of nutrients and thereby its nutrient requirements, by numerous mechanisms

The toxic effect of alcohol on the intestinal mucosa interferes with normal nutrient absorption; thus, requirements increase as the efficiency of absorption decreases.

The need for B vitamins increases because they are used to metabolize alcohol.

Alcohol can also influence nutrient metabolism by impairing nutrient storage, increasing nutrient catabolism, and increasing nutrient excretion.

Medication Use: Many drugs have the potential to influence nutrient requirements, Nutrient absorption may be altered by drugs that 1.) change the pH of the GI tract 2.) increase GI motility, 3.) damage the intestinal mucosa, or 4.) bind with nutrients, rendering them unavailable to the body

Nutrient metabolism can be altered by drugs that 1.) act as nutrient antagonists 2.) alter the enzyme systems that metabolize nutrients, or 3.) alter nutrient degradation.

Some drugs alter renal reabsorption of nutrients and therefore, may increase or decrease nutrient excretion.

Megdoses of Nutrient Supplements: Because some nutrients compete against each other for absorption, an excess of one nutrient can lead to a deficiency (or increase the requirement) of another, especially if one is absorbed preferentially.

Dietary supplements can have a drug-like effect and may interact with food and medications.

# data[].attributes.attachment_link.title
EASY :: HOW TO CALCULATE YOUR BMI & WHAT IT MEANS?

# data[].attributes.body
A vital component of every living cell.

More than 1000 different proteins are made by combining various amounts and proportions of the 22 basic building blocks known as amino acids.

Protein is required for the formation of all body structures, including genes, enzymes, muscle, bone matrix, skin, and blood

Complete proteins contain sufficient amounts and proportions of all the essential amino acids to support growth, whereas incomplete proteins are deficient in one or more essential amino acids.

In general, animal proteins are complete, and plant proteins are incomplete. Except for soy and quinoa

The major function of protein is to maintain body tissues that break down from normal wear and tear and to support the growth of new tissue

Protein intake should contribute to 10%-35% of total caloric intake

# data[].attributes.body
difficulty swallowing or the inability to swallow

# data[].attributes.headline
Physical, Sociocultural, and Psychosocial Factors That Influence Food Choices

# data[].attributes.subject
Physical, Sociocultural, and Psychosocial Factors That Influence Food Choices

# data[].attributes.body
Dietary choices or restrictions also are influenced by social determinants of health, cultures, religion, and personal feelings and meanings associated with food.

Healthcare providers need an understanding of a patient's cultural values, beliefs, and practices to provide culturally acceptable care.

# data[].attributes.headline
Nursing Interventions for Obese Patients

# data[].attributes.subject
Nursing Interventions for Obese Patients

# data[].attributes.body
Click below to view 4 different Care Plans for the Obese Patient

# data[].attributes.attachment_link.readable_text
Obesity is a complex disorder involving an excess accumulation of body fat at least 20% over average desired weight for age, sex, and height or a body mass index of greater than 27.8 for men and greater than 27.3 for women. Obesity isn't just a cosmetic concern. It increases your risk of diseases and health problems such as heart disease, diabetes, and high blood pressure.

It is different from being overweight, which means weighing too much. The weight may come from muscle, bone, fat, and/or body water. Both terms mean that a person's weight is greater than what's considered healthy for his or her height.

Obesity occurs over time when you eat more calories than you use. The balance between calories-in and calories-out differs for each person. Factors that might affect your weight include your genetic makeup, overeating, eating high-fat foods, and not being physically active.

Nursing Care Plans

Nursing care management for patients with obesity includes identification of inappropriate behaviors that cause obesity, preparing a diet plan, determining nutritional knowledge, and providing information.
Here are four (4) nursing care plans (NCP) and nursing diagnosis for obesity:

1. Imbalanced Nutrition: More Than Body Requirements

2. Disturbed Body Image

3. Impaired Social Isolation

4. Deficient Knowledge

Imbalanced Nutrition: More Than Body Requirements
Nursing Diagnosis May be related to

Food intake that exceeds body needs

Psychosocial factors

Socioeconomic status

Possibly evidenced by

Weight of 20% or more over optimum body weight; excess body fat by skinfold/other measurements

Reported/observed dysfunctional eating patterns, intake more than body requirements

Desired Outcomes

Client will identify inappropriate behaviors and consequences associated with overeating or weight gain.

Client will demonstrate a change in eating patterns and involvement in individual exercise program.

Client will display weight loss with optimal maintenance of health.

Review individual cause for obesity (organic or nonorganic).

Identifies and influences choice of some interventions.

Carry out and review daily food diary (caloric intake, types and amounts of food, eating habits).

Provides the opportunity for the individual to focus on a realistic picture of the amount of food ingested and corresponding eating habits and feelings. Identifies patterns requiring change or a base on which to tailor the dietary program.

Explore and discuss emotions and events associated with eating.

Helps identify when patient is eating to satisfy an emotional need, rather than physiological hunger.

Formulate an eating plan with the patient, using knowledge of individual's height, body build, age, gender, and individual patterns of eating, energy, and nutrient requirements. Determine which diets and strategies have been used, results, individual frustrations and factors interfering with success.

Although there is no basis for recommending one diet over another, a good reducing diet should contain foods from all basic food groups with a focus on low-fat intake and adequate protein intake to prevent loss of lean muscle mass. It is helpful to keep the plan as similar to patient's usual eating pattern as possible. A plan developed with and agreed to by the patient is more likely to be successful.

Emphasize the importance of avoiding fad diets.

Elimination of needed components can lead to metabolic imbalances like excessive reduction of carbohydrates can lead to fatigue, headache, instability and weakness, and metabolic acidosis (ketosis), interfering with effectiveness of weight loss program.

Discuss need to give self permission to include desired or craved food items in dietary plan.

Denying self by excluding desired or favorite foods results in a sense of deprivation and feelings of guilt and failure when individual "succumbs to temptation." These feelings can sabotage weight loss.

Be alert to binge eating and develop strategies for dealing with these episodes (substituting other actions for eating).

The patient who binges experiences guilt about it, which is also counterproductive because negative feelings may sabotage further weight loss efforts.

Identify realistic increment goals for weekly weight loss.

Reasonable weight loss (1-2 lb per wk) results in more lasting effects. Excessive and rapid loss may result in fatigue and irritability and ultimately lead to failure in meeting goals for weight loss. Motivation is more easily sustained by meeting "stair-step" goals.

Weigh periodically as individually indicated, and obtain appropriate body measurements.

Provides information about effectiveness of therapeutic regimen and visual evidence of success of patient's efforts. (During hospitalization for controlled fasting, daily weighing may be required. Weekly weighing is more appropriate after discharge.)

Determine current activity levels and plan progressive exercise program (walking) tailored to the individual's goals and choice.

Exercise furthers weight loss by reducing appetite; increasing energy; toning muscles; and enhancing cardiac fitness, sense of well-being, and accomplishment. Commitment on the part of the patient enables the setting of more realistic goals and adherence to the plan.

Develop an appetite reeducation plan with patient.

Signals of hunger and fullness often are not recognized, have become distorted, or are ignored.

Emphasize the importance of avoiding tension at mealtimes and not eating too quickly.

Reducing tension provides a more relaxed eating atmosphere and encourages more leisurely eating patterns. This is important because a period of time is required for the appestat mechanism to know the stomach is full.

Encourage patient to eat only at a table or designated eating place and to avoid standing while eating.

Techniques that modify behavior may be helpful in avoiding diet failure.

Discuss restriction of salt intake and diuretic drugs if used.

Water retention may be a problem because of increased fluid intake and fat metabolism.

Reassess calorie requirements every 2-4 wk; provide additional support when plateaus occur.

Changes in weight and exercise necessitate changes in plan. As weight is lost, changes in metabolism occur, resulting in plateaus when weight remains stable for periods of time. This can create distrust and lead to accusations of "cheating" on caloric intake, which are not helpful. Patient may need additional support at this time.

Consult with dietitian to determine caloric and nutrient requirements for individuals weight loss.

Individual intake can be calculated by several different formulas, but weight reduction is based on the basal caloric requirement for 24 hr, depending on patient's sex, age, current and desired weight, and length of time estimated to achieve desired weight. Note: Standard tables are subject to error when applied to individual situations, and circadian rhythms and lifestyle patterns need to be considered.

Appetite-suppressant drugs like diethylpropion (Tenuate), mazindol (Sanorex), Sibutramine (Meridia)

May be used with caution and supervision at the beginning of a weight loss program to support patient during stress of behavioral and lifestyle changes. They are only effective for a few weeks and may cause problems of addition in some people.

Hormonal therapy like thyroid (Euthyroid), levothyroxine (Synthroid)

May be necessary when hypothyroidism is present. When no deficiency is present, replacement therapy is not helpful and may actually be harmful. Note: Other hormonal treatments, such as human chorionic gonadotropin (HCG), although widely publicized, have no documented evidence of value.

Lipase inhibitor blocks absorption of approximately 30% of dietary fat. Facilitates weight loss and maintenance when used in conjunction with a reduced-calorie diet. Also reduces risk of regain after weight loss.

Vitamin, mineral supplements

Obese individuals have large fuel reserves but are often deficient in vitamins and minerals. Note: Use of Xenical inhibits absorption of water-soluble vitamins and beta-carotene. Vitamin supplement should be given at least 2 hr before or after Xenical.

Hospitalize for fasting regimen and stabilization of medical problems, when indicated.

Aggressive therapy and support may be necessary to initiate weight loss, although fasting is not generally a treatment of choice. Patient can be monitored more effectively in a controlled setting, to minimize complications such as postural hypotension, anemia, cardiac irregularities, and decreased uric acid excretion with hyperuricemia.

Prepare for surgical interventions (gastric partitioning or bypass) as indicated.

These interventions may be necessary to help the patient lose weight when obesity is life-threatening.

Recommended Resources

Recommended nursing diagnosis and nursing care plan books and resources.

Disclosure: Included below are affiliate links from Amazon at no additional cost from you. We may earn a small commission from your purchase. For more information, check out our privacy policy.

See also

Other recommended site resources for this nursing care plan:

Other nursing care plans related to endocrine system and metabolism disorders:

# data[].attributes.attachment_link.description
Obesity is an excess accumulation of body fat at least 20% over average desired weight for age, sex, and height or a body mass index of greater than 27.8 for men and greater than 27.3 for women. Here are 4 nursing care plans for obesity.

# data[].attributes.body
Fats in the diet are insoluble in water, and therefore, insoluble in blood.

Like carbohydrates, they are composed of carbon, hydrogen, and oxygen.

95% of lipids in the diet are in the form of triglycerides, the predominant form of fat in food and the major storage form of eating in the body.

Compound lipids and derived lipids constitute the remainder of the fats ingested.

Food fats contain mixtures of saturated and unsaturated fatty acids. The difference in the degree of saturation depends on the amount of H in fat molecules.

Unsaturated- remains liquid at room temp

Cholesterol is a fat-like substance found only in animal products. It is not an essential nutrient; the body makes sufficient amounts. It is an important component of cell membranes and is especially abundant in the brain and nerve cells.

High cholesterol levels are associated with increased risk for atherosclerosis.

Fat digestion occurs largely in the small intestine.

Bile excreted by the gall bladder emulsifies fat to increase the surface area so that pancreatic lipase can break down fat more effectively.

Fats are the most concentrated source of energy in the diet, providing 9 calories per gram.

# data[].attributes.body
administering nutrients directly into the stomach

# data[].attributes.headline
Communicating Effectively About Nutrition With Culturally Diverse Patients

# data[].attributes.subject
Communicating Effectively About Nutrition With Culturally Diverse Patients

# data[].attributes.body
Acquire basic information about health beliefs and practices of various cultural groups in your health care setting. This provides a basis for assessing patients’ beliefs and practices.

Recognize, however, that within all cultures and ethnic groups, there are members who do not hold all the values of the group.

Ask specifically about the use of folk or home remedies prescribed by nontraditional healers. Determine the patient’s language preferences for spoken and written communication.

Utilize printed or audiovisual information that is in the language spoken by your patients.

Promote healthy food choices by identifying healthy traditional food practices and encouraging their use. Encourage cultural sensitivity in health care workers in your particular setting.

Recognize that diversity exists within cultural groups. For example, the Hispanic population includes Mexicans, Cubans, Puerto Ricans, and other Latino groups. Emphasize threads or messages in health teaching that are common to all cultures (e.g., concern about family, faith, home).

Help culturally diverse patients to value and understand the importance of communicating concerns and asking questions about prescribed dietary practices.

# data[].attributes.body
feeding remaining int the stomach

# data[].attributes.body
Minerals are inorganic elements found in all body fluids and tissues in the form of salts or combined with organic compounds (iron in hemoglobin)

Some minerals function to provide the structure within the body, whereas others help to regulate body processes

Minerals, which are elements, are not broken down or rearranged in the body but rather are contained in the ash that remains after digestion.

excessive soaking and cooking in water can cause loss of minerals from food

Major minerals are present in the body in amounts greater than 5g and include calcium, phosphorus, sulfur, sodium, chloride, potassium, and magnesium

Trace elements of minerals present in the body in amounts less than 5; they are not less important than major minerals and include: iron, zinc, manganese, chromium, copper, molybdenum, selenium, fluoride, and iodide

# data[].attributes.body
an enterostomal tube may be placed through an opening created into the stomach.

# data[].attributes.body
As the major body constituent present in every body cell, water accounts for between 50%-60% of the adult's total weight.

About 2/3 of the body's water is contained within cells (intracellular fluid); the remainder is extracellular fluid.

Water is more vital to life than food bc it provides the fluid medium necessary for all chemical reactions, it participates in many reactions, and it is not stored in the body

Water acts as a solvent that s=dissolves many solutes, thereby aiding in digestion, absorption, circulation, and excretion.

Sources of water in the diet include not only beverages but also solid foods, which contain between 10%-98% water.

Water is also produced through the metabolism of carbs, protein, and fats

# data[].attributes.body
tube inserted through the noes and into the stomach

# data[].attributes.body
passed through the small intestine (nasoduodenal and nasojejunal)

# data[].attributes.body
nothing by mouth

# data[].attributes.body
specific biochemical substances use by the body for growth, development, activity, reproduction, lactation, health maintenance, and recovery