LISA B. FLATT, RN, MSN, CHPN
Nursing &
Nutritional Needs of Patients
Terminology
Gastrointestinal system – GI systemAlimentary canal – ‘tube’ that food/fluid
follow from the mouth to the anusPeristalsis – muscles of the alimentary canal
move in waves and push the food/fluid through
Follow the Path of the Alimentary Canal!
MouthEsophagusStomachSmall Intestine
Duodenum Jejunum Ileum
Large Intestine Ascending colon Transverse colon Descending colon
Sigmoid ColonRectumAnus
Anatomy & PhysiologyThe Gastrointestinal (GI) System
Mouth – dentition breaks down food into small enough pieces that enzyme-containing saliva begins breaking down the food (& fluids)
EsophagusStomach – secretes gastric acids to further
breakdown the foodSmall intestine – most of digestion happens here,
the villi and microvilli line the mucosal surface, from which enzymes, acids and proteins are secreted and nutrients are absorbed
And then there’s more…….
Large intestine – water is absorbed and digestive wastes are converted into feces
Sigmoid (pelvic) colon – waste/feces travels through to reach rectum
Rectum – contains vertical folds (each contain an artery and vein), these folds help hold feces in the rectum
Anus – internal sphincter muscles are stimulated by the autonomic nervous system and external sphincter muscles are stimulated by the somatic nervous system
The Basic Four Food Groups
Eat Healthier!
Grains Group – ½ of grains should be whole grains
Fruits – Focus on fruitsVegetables – Vary your veggiesDairy – Calcium richProtein - Go lean with your proteinGo Red!
Servings per day Sample diet
Fruit &Vegetables 5-10
Meat 2-3Dairy 2-4Grains 5-12
Daily Requirements
What do we eat to be healthy?
Proteins - CarbohydratesFatsVitamins
Grains
Whole grains: Brown Rice: Buckwheat: Millet: Oatmeal: Popcorn:Bulgur (cracked wheat): Whole-wheat cereal flakes: Meuslix: Rolled oats: Quinoa: Wheat Pasta
Refined grains: corn tortillas: grits: pasta: pita: noodles: corn flakes
Examples of refined grains you have eaten today/this week?
Examples of whole grains you have eaten today/this week?
Fruits
Apples, Apricots, Bananas, Berries, Cherries, Grapes, Melons, Fruit cocktail, pears, mangoes, pineapple, peaches, plums, raisins, tangerines
100% Fruit juices
Can you think of some fruits you might want someone with low potassium to eat?
What are some fruits that are high in roughage? What does GO RED have to do with Fruits?
Vegetables
Dark green: spinach: kale: Mustard/turnip/collard greens
Red & orange vegetables: acorn/butternut squash: carrots: pumpkin:sweet potatoes: tomatoesbutternut squash
Beans and peas: lentils: kindey beans: soy beansStarchy vegetables: corn: black-eyed peas (not dry)Other Vegetables: beets: cucumbers: egg plant: turnips
People who are low in iron might eat which vegetables?
Dairy
Milk: Cheese: Ice Cream: Yogurt: soy milk (Calcium fortified)
What are some dairy desserts?
Why would you want to restrict dairy products with a patient who is in kidney failure?
Protein
Meats - lean Seafood/ Fish/ ShellfishOrgan MeatsPoultry EggsGame MeatsSoy products – bean curdsBeansNuts
Oils & Fats
Oils are fats (they are liquid at room temperature). They may come from plants and fish. They provide essential nutrients.
What are some examples of oils found in plants?What are some nuts that may contain oil?Oils found in plants do not contain cholesterol.Most oils are low in saturated fats. They are high in
monounsaturated and/or polyunsaturated fats.Solid fats (solid at room temperature) for example butter
and shortening. These can be made through hydrogenation.
Others are: lard, milk fat, chicken fat, meat/beef fat
Solid Fats Added Sugars
Fats that are solid at room temperature
Processed sugars added to beverages and syrups
Empty Calories
Exercise
What types of physical activity do you engage in?
Give some examples that are ‘low impact’Give some examples of ‘aerobic’ exercisesWhat are some things we can do in our daily
activities that are exercise?How many times a week and how much
exercise is recommended? Does it ever vary?
Vitamin = what do I do? Where can I find it?
A = growth & development, tooth & bone development, epithelial tissue functions
B =C =D=E=K=
Egg yolks, butterfat from milk
Name that Vitamin!
THAT’S RIGHT!THE SUN!
It’s light is absorbed through the skin and converted to which
vitamin?
What rises in the east?
Sets in the west?
Has solar flares?
Creates energy?
Gives us light?
Is eclipsed by the moon, on rare occasions?
The ancients thought this heavenly body revolved around the earth?
Minerals
Fiber & Fluid
Influencing Factors
PreferencesSocio-economic factorsCulture and EthnicitySpiritual BeliefsPhysical ActivityWork HabitsCooking HabitsHealth HabitsPsychological FactorsPeer pressureMental Status
Nutrition through the Ages
InfantPre-school-agedSchool agedAdolescentsYoung AdultsMiddle-aged adultsElderly
Nutritional Disturbances
Pg 21
Nursing Promotions
Nursing Interventions
Special Diets
Laboratory Data
Complete Blood Count (CBC) Hemoglobin (Hgb) Hematocrit (Hct)
Total Iron Binding Capacity (TIBC)Blood Urea Nitrogen (BUN)CreatinineLymphocytes
Applying the Nursing Process
Case Scenarios
Creating Care Plans
References