CNA unit 15 [ nutrition and hydration ]

guideline for promoting appetites

-assist residents with grooming/hygiene tasking before dining -oral care -offer elimination before eating -help with washing their hands -check the environment -seat them next to friends -proper positioning -serve food promptly -proper eating tools

guidelines for healthy food choices

-balance calories -enjoy food but eat less -avoid oversized portion -eat healthy food more often -check sodium content in foods -drink water

signs/symptoms of a swallowing problem

-coughing during/after meals -choking -dribbling saliva, food or fluid -having food residue inside mouth of cheeks -gurgling/losing ones voice -avoiding eating -spitting -swallowing several times per mouthful -clearing the throat frequently -watering of eyes -food or fluid coming up into nose -visible effort to swallow -breathing rapidly -difficulty chewing food -difficulty swallowing medications

observing/reporting dehydration

-if they drink less than 6, 8 oz glasses of liquid per day -resident drinks little or no fluids at meals -if they need help drinking -toruble swallowing liquids -frequent vomiting, diarrhea, or fever -easily confused or tired -dry mouth -cracked lips -sunken eyes -dark urine -strong smelling urine -weight loss -abdominal pain

guideline for preventing aspiration

-position resident properly -offer small pieces of food or small spoonfuls -feed slowly -put food in stronger side of the mouth -make sure the mouth is empty before offering another bite or sip -keep residents upright for 30 mins after eating/drinking

observing and reporting tube feedings

-redness or drainage around opening -skin sores or bruises -cyanotic skin -resident complaints of pain or nausea -choking or coughing -vomiting diarrhea -swollen abdomen -fever -tube falling out -problems w equipment -sound of feeding pump alarm -change of residents inclined position

modified calorie diet

-reduced calories to lower weigh tor prevent weight gain -increased calories because of malnutrition, surgery, illness or fever

guidelines for preventing unintended weight loss

-report observations and warning signs to the nurse -food should look, taste, and smell good -encourage residents to eat -honor residents food likes and dislikes -offer different foods and beverages -help residents who have trouble feeding themselves -season to their preference -record meal/snack intake -provide oral care before and after meals -position residents upright for eating -ask about loss of appetites -provide oral care before and after meals

observing/reporting unintended weight loss

-resident needs to help eating or drinking -resident eats less than 75% of meals served -resident has mouth pain -resident has ill fitting dentures -resident has difficulty chewing or swallowing -resident coughs or chokes while eating -resident is confused, wanders, or paces -resident is sad, has crying spells or withdraws from others

problems that affect nutritional intake

-slow metabolism -loss of vision -weakened sense of smell and taste -less saliva production affecting chewing and swallowing -denture, tooth loos, and poor dental health -digestion takes longer and is less efficient -constipation -unintended weight loss

conditions that make eating or swallowing difficult

-stroke which can cause facial weakness and paralysis -nerve and muscle damage from head and neck cancer -multiple sclerosis -parkinsons disease -alzheimers disease

observing/reporting fluid overload

-swelling/edema of extremities -weight gain -decreased urine output -shortness of breath -increased heart rate -anxiety -skin that looks tight, smooth, shiny

guideline for assisting a resident with eating

-verify you have the right resident -sit at eye level -allow time for prayer -test the temperature of food by putting hand over teh dish -cut foods adn pour liquids -identify food adn fluid infornt of resident -ask what they would prefer to eat first -dont mix foods -dont rush the meal alternate offering food and drink

guidelines for tube feedings

-wash hands carefully before assisting -make sure the tubing isn't coiled, kinked or resting under the resident -be aware if the resident has an order for nothing by mouth -the tube is only inserted and removed by a doctor or nurse -a resident with a feeding tube should always have the head of the bed elevated 30 degrees, but during the feeding it should be elevated at least 45 degrees -after feeding keep the resident upright for atleast 30 mins

3 basic thickened consistencies

1. nectar thick- thickness of a thick juice 2. honey thick- thickness of honey 3. pudding thick- liquid is semi solid

6 nutrients the body needs

1. water: it is the most essential nutrient for life, it is needed by every cell in the body 2. carbohydrates: supply the body with energy and extra protein and help the body use fat efficiently, they also provide fiber, it is divided into complex and simple carbohydrates 3. protein: are part of everybody cell, essential for tissue growth and repair, they also supply energy for the body 4. fats: help the body store energy, important for the absorption of certain vitamins, they have 4 categories saturated, trans, monounsaturated and polyunsaturated 5. vitamins: are substances that are needed by the body to function, most are not made by the body and need to be absorbed through foods 6. minerals: maintain body function, help build bones, make hormones, help in blood formation, they provide energy and control body functions

bland diet

Gastric and duodenal ulcers can be irritated by foods that produce or increase levels of acid in the stomach so these foods are eliminated, also used for people who have intestinal disorders -alcohol, caffeinated beverages, citrus juices, spicy foods should be avoided

vegetarian diet

a diet in which vegetables are the foundation and meat, fish, and poultry are restricted or eliminated, for those who are obese or diabetic or for religious reason or dislike of meat, compassion for animals,etc

nutrient

a necessary substance that provides energy, promotes growth and health, and helps regulate metabolism

grains

a person should make half their grain intake whole grains -two groups of grain : whole and refined -wheat, rice, oats, cornmeal, and barley

gastronomy

a surgically-created opening into the stomach that allows insertion of a tube

percutaneous endoscopic gastrostomy (PEG)

a tube that is placed into the stomach through the abdominal wall

dairy

all milk products and foods made from milk that retain their calcium content, they provide nutrients such as calcium, potassium, vitamin D, and protein

protein

are part of everybody cell, essential for tissue growth and repair, they also supply energy for the body

vitamins

are substances that are needed by the body to function most are not made by the body and need to be absorbed by the body

diabetic diet

calories and carbohydrates are carefully controlled and protein and fats are also regulated

diet cards

cards that list residents' names and information about special diets, allergies, likes and dislikes, and any other dietary instructions

fluid overload

condition in which the body is unable to handle the amount of fluids consumed, affects people with heart or kidney disease

whole grain

contain bran and germ as well as the endosperm ex: brown rice, oatmeal,whole grain corn, whole oats, whole wheat, whole rye

low fiber diet

decreases amount of fiber, whole grains, raw fruits/vegetables, seeds, diary used for people with bowel disturbances

gluten free diet

diet is free of a protein found in wheat, rye, and barley and for people with gluten intolerance or celiac disease whose intestine can be damaged if gluten is consumed

modified/special diets

diet where certain nutrients or fluids may be restricted or eliminated, some medications may also interact with certain food which must e restricted

dysphagia

difficulty swallowing, a stroke or CVA, nerve and muscle damage, MS, parkinsons disease or alzheimers can contribute to dysphagia

low sodium diet

excess sodium causes the body to retain more water in the tissues and circulatory system than necessary which causes the heart to beat harder

pureed diet

foods have been blenderized to the consistency of baby food, thick enough to hold its form in the mouth and often used for people who have trouble chewing and swallowing textured foods

complex carbohydrates

found in bread, cereal, potatoes, rice, pasta, vegetables and fruits

simple carbohydrates

found in foods such as sugar, sweets, syrups and jellies

fats

help the body store energy, important for the absorption of certain vitamins, they have 4 categories saturated, trans, monounsaturated and polyunsaturated

folic acid

helps the body form red blood cells

nutrition

how the body uses food to maintain health, bodies need a well balanced diet containing essential nutrients and plenty of fluids which help it grow new cells, maintain body function and have energy

vitamin c

important for growth and repair of body tissues

output

includes urine, feces, vomit, perpsiration, moisture in air, wound drainage

high fiber diet

increased the intake of fiber and whole grains which helps with constipation and bowel disorder

aspiration

inhaling food, fluid or foreign material into lungs

nasogastric tube

is inserted into the nose and goes to the stomach when a person is unable to swallow

endosperm

is the tissue within flowering plants it surround and nourishes the plant embryo

water

it is the most essential nutrient for life, it is needed by every cell in the body

minerals

maintain body function, help build bones, make hormones, help in blood formation, they provide energy and control body functions

fluid balance

maintaining equal input and output

parenteral nutrition (PN)

may be necessary when the digestive system doesn't function properly, a solution of nutrients is administered directly into the bloodstream -the nutrients is administered directly are in their most basic forms of carbohydrates, proteins and fats and absorbed directly by the cells

low fat/cholesterol diet

people who have high levels of cholesterol are at risks for heart attacks adn heart disease, and those with gall bladder disease or a disease that interfere with fat digestion or liver disease are these diets -eat lean cuts of meat -limit egg yolks to 3 a week -avoid organ meats, shellfish, fatty meats or processed meats -avoid fried food and sweets

refined grain

retain only the endosperm

vegetables and fruits

should make up half a plate -5 subgroups of vegetables : dark green, red&orange, dry beans and peas, starchy vegetables and others -vegetables are low in fat and calories and have no cholesterol, they are good sources of dietary fiber, potassium, vitamin A,E, and C -fruits are also low in fat, sodium and calories, have no cholesterol, important sources of dietary fiber and have many nutrients including folic acid, potassium, and vitamin C

high potassium diet

some residents take certain blood pressure medication (diuretics) which are medication that reduce fluid volume, these residents may be excreting os much fluid that their bodies could be depleted of potassium

carbohydrates

supply the body with energy and extra protein and help the body use fat efficiently, they also provide fiber, it is divided into complex and simple carbohydrates

edema

swelling caused by excess fluid in body tissues

intake

the fluid a person consumes; also called input

soft mechanical diet

this diet is soft in texture and consists of soft or chopped food that are easier to hew and swallow

low protein diet

those who have kidney disease may be on these diets because protein breaks down into compounds that may lead to further kidney damage

liquid diet

usually ordered for a short time due to a medical condition or before or after a test or surgery

fluid restricted diet

when fluid intake is greater than fluid output body tissues become swollen with excess fluid