Unit 11 Food and Nutrition

Chapter 1  Patients’ Diets

Basic Diets

Basic diets are suit for general patients, which includes general, soft, semi-liquid, and liquid diets.

General diet

General diets are normal diets. Since all patients are relatively inactive, calorie intake should be consistent with their level of activity.

Soft diets

Soft diets usually are regular diets that have been modified to eliminate foods that are hard to digest and to chew, including those high in fiber, high in fat, and highly seasoned. Soft diets are adequate in calories and nutrients and may be used on a long-term basis.

Semi-liquid diets

Semi-liquid diets used in fever, or after surgery, contain milk, plain frozen desserts, pasteurized eggs; Cereal gruels, and milk and egg substitutes in addition to clear liquids.

Liquid diets

A liquid diet, as the name suggests, consists entirely of liquids. These diets are used most often as transitional diets when eating resumes after surgery as a patient's first step toward taking solid住院医师 foods. Feedings may be given every 2, 3 or 4 hours, as prescribed.

Therapeutic Diets

Types of special diets

High-calorie diet  Food is burned rapidly in fever, so the body needs more, not less, food. The high calorie diet for fever is high in fats, carbohydrates, and proteins. However, fever depresses appetite, so you may need to give smaller and more frequent feedings. The high calorie diet may also be used whenever it is necessary to replace lost weight, as in hyperthyroidism, or general undernutrition.

Controlled carbohydrate diet  The controlled carbohydrate diet is prescribed mainly for the diabetic patient. Regulation of carbohydrate intake is an important part of treatment.

High-pwww.med126.comrotein diet  In conditions in which large areas of body tissue must be replaced, such as following a severe burn, or in a high fever or an infection, large amounts of protein are needed to aid tissue building.

Controlled-sodium diet The low-sodium diet has a decreased sodium content, but is otherwise normal. It is prescribed in cardiovascular disease and some kidney diseases, such as nephritis and nephrosis.

Chapter 2  The Nursing for Improving Nutrition

Assessing Patients’ Nutrition

The nurse considers the following when assessing nutritional status:

Anthropometric data

Anthropometric measurements are used to determine body dimensions. A client should be weighed on the same scale and at the same time of the day each time, preferably before breakfast. Weight should be compared with IBW and usual body weight. Because actual weight may be inflated if the client has edema, hydration status should be considered. In China, the following is used widely:

Man: desirable weight (Kg) =height (cm) –105

Female: desirable weight (Kg) =height (cm) –105 –2.5

Actual weight –desirable weight

  ×100%

Desirable weight

Biochemical data

Laboratory tests, which measure blood and urine levels of nutrients or biochemical functions that are dependent on an adequate supply of nutrients, can objectively detect nutritional problems in their early stages.

Interventions of Improving Nutrition

General measures of improving nutrition

●  The patient may not like the food served, he may resent having to follow a particular diet, or the food served may not be in keeping with his religious or cultural customs.

●  Provide encouragement and a pleasant eating environment.

●  Schedule procedures and medications at times when they are least likely to interfere with appetite.

●  Control pain, nausea, or depression with medications. A tired patient, or one in pain, will not take or digest food well. Offer a medication for pain about 1/2 hour before a meal.

Chapter 3  Enteral Nutrition

Enteral Nutrition (Tube Feeding) is the solution that pouring liquid diets, nutrients, water or medicine, by feeding tube directly into the gastrointestinal tract either by way of a tube inserted through the nose and into the stomach (nasogastric feeding) or by way of a tube surgically inserted directly into the stomach (gastrostomy feeding). Another method is to insert the tube directly into the intestine either by way of a tube through the nose (nasoduodenal or nasojejunal) or by way of a tube surgically inserted into the small intestine (jejunostomy).

Inserting Tubes

Nasogastric or nasointestinal tubes are inserted nonsurgically through the nose and into the stomach or small intestine. The nasal method of insertion is commonly used; it requires a smaller tube and skill in insertion. Gastrostomy tubes or jejunostomy tubes are surgically implanted, not easily dislodged, and avoid any upper gastrointestinal obstructions that may be present, such as tumors.

Nursing responsibilities in enteral feedings

Agency protocols may differ, but nursing actions that contribute to successful tube feedings include the following:

●  Check the placement of a nasogastric tube before beginning a new or intermittent feeding.

●  Irrigate the tube before and after medication administration to prevent clogging of the feeding tube.

●  Enteral feeding tubes occasionally become clogged, particularly the smaller tubes.

●  Administer oral hygiene frequently to prevent drying of tissues and to relieve thirst. Lubricate the lips generously.

●  Keep the nares clean, especially around the tube where secretions tend to accumulate. Using a lubricant after cleaning the nares is recommended.