raises serum cholesterol

trans fat

are fats in the diet

lipids

are the predominant form of fat in food and the major storage form of fat in the body

Triglycerides

is a fat-like substance found only in animal products.

Cholesterol

affects visual acuity, skin and mucous membranes, and immune function

Vitamin A

provides calcium and phosphorus metabolism and stimulates calcium absorption

Vitamin D

is an antioxidant that protects Vitamin A

Vitamin E

helps the synthesis of certain proteins necessary for blood clotting.

Vitamin K

Provide most of the body’s energy & fiber 45-65% of total calories for adult Classified as complex and simple (1g=4cal)

Carbohydrates

Needed for healing & growth Soy is the only complete plant protein 0.8g/kg of body weight or 10-35% of total calories (1g=4cal)

protein

Insoluble in water & blood Intake is 35% of total calories Saturated – raises cholesterol (animal fats) Unsaturated – lowers cholesterol (vegetable fats) (1g=9cal)

Fats

Gastrostomy, jejunostomy, nasoduodenal, nasojejunal , Long term, Requires surgery, Complication: diarrhea 3x or more in a 24hr period, Gastrostomy is the preferred route for enteral nutrition for coma patients

Tube feedings

Naogastic Short term , Confirm placement – X Ray, #1 complication – Aspiration, Prevention: Elevate head of the bed for an hour after feedings

NG Tube feedings

intravenous feedings, requires a central line, Complications: infection, metabolic alterations, fluid & electrolyte, imbalances, phlebitis, hyperlipidemia, liver and gallbladder disease.

TPN (Total Parenteral Nutrition):

may be ordered if you’re eating normal but still have malnutrition

PPN (Partial Parenteral Nutrition):

nothing by mouth

NPO

nothing floating in it, no dairy

Clear liquids

same as clear + dairy & juices

Full liquids

pureed meats, fruits, & scrambled eggs

Pureed

diced or ground foods

Mechanical soft

low in fiber, easy to digest (ex. Dairy, eggs, ripe bananas)

Soft/low residue

whole grains, raw & dried fruits

High fiber

no added salt, under 2g/day

Low Na

no more than 300 mg/day

Low cholesterol

bout 1800cal per day (proteins, fats, and carbs)

Diabetic

pureed food & thickened liquids (DO NOT delegate first feed)

Dysphagia

no restrictions

Regular

increased % of water

Lean body mass

decreased % of water

Adipose tissue (fat)

usually water, holds a substance until dissolved in it

Solvent

substances that dissolve in a solution, ex: electrolytes

Solute

2/3 intracellular 1/3 extracellular

Fluid distribution

brain; regulates volume of body fluids

Sodium (Na)

heart; chief regulator of cellular enzyme activity and water content

Potassium (K)

muscle & bones; nerve impulse, blood clotting, muscle contractions

Calcium (Ca)

concentration of plasma, urine, and bodily fluids

Osmolality

neuromuscular; metabolism of carbs & proteins

Magnesium (Mg)

same osmolality

Isotonic

water moves INTO cell – swelling & cell bursts Hypertonic = water moves OUT of cell – shrinks & dies

Hypotonic

regulate Ca in ECF

Parathyroid glands

absorbs water and nutrients

GI tract

make bicarbonate

Kidneys

hold on to or blow off CO2

Lungs

the continuous delivery of an adequate blood supply containing oxygen, nutrients, and hormones to the body's tissues and organs

Tissue perfusion

water loss in ECF, resulting in poor tissue perfusion, Caused by: hemorrhage, severe vomiting, diarrhea, diuretics, burns, excessive sweating

Hypovolemia

total water loss (ICF & ECF), results in hypernatremia Caused by: hyperventilation, diabetic ketoacidosis, prolonged fever

Dehydration

excessive retention of H2O & Na in ECF Caused by: excess intake of fluids, abnormal fluid retention (ex: heart & renal failure)

Hypervolemia

bove normal amounts of H2O going in & not enough going out. S/S: tacky, SOB, AMS, elevated BP, anorexia, crackle sounds in lungs, bounding pulse, JVD

Over-hydration

High BUN, Na, Hct, HR, low BP

Deficit

Low BUN, e-lytes, Hct, Na within expected range in hypervolemia, Pulses will be full, bounding, neck vein distention, including CVP and BP, possible S3

excess

Maintain heart rhyme, skeletal and smooth muscle contraction. High K = kidney failure, low K= high aldosterone, 3.5-5 mEq/L, regulated by kidneys

potassium

Control ECF osmolarity, muscle contraction and fluid balance. 135-145 mEq/L. Regulated by aldosterone and ADH

Sodium

Fluid overload. Gi losses, hypotonic fluids , lethargy and general weakness, Severe = seizures, shallow resp., cerebral edema & coma. Monitor LOC & BP, eizure precautions, Monitor for cerebral edema

Sodium HYPOnatremia

dehydration. Fluid losses (ex. fever and burns), Hypertonic fluids

sodium HYPERnatremia

Teeth & bone formation, Blood clotting, Nerve impulses, Needs vit. D for absorption. 9-10.5 mg/dl, regulated by PTH and Calcitonin

Calcium

Regulates neuromuscular activity , Cardiac function, Glucose control, BP regulation. 1.3 -2.1 mg/dl. Regulated by kidney and intestines.

Magnesium