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