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Nursing Management: Nursing Management: Nutritional Problems Nutritional Problems Chapter 40 Overview Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
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Nursing Management:Nursing Management:
Nutritional ProblemsNutritional Problems
Chapter 40 Overview
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
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Nutritional ProblemsNutritional Problems
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
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Normal NutritionNormal Nutrition
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Fig. 40-1. In the MyPyramid, each food group is characterized by varying widths, representative of the proportion of each group that should be eaten. The person climbing the stairs on the side of the pyramid indicates the need to include daily physical activity in a healthy lifestyle.
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Normal NutritionNormal Nutrition
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Table 40-3. Good Sources of Protein.
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Normal NutritionNormal Nutrition
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Table 40-4. Major Minerals and Trace Elements.
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Special DietsSpecial Diets
•Vegetarian Diet
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Culturally Competent Culturally Competent Care:Care:
NutritionNutrition
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MalnutritionMalnutrition
• Types of Malnutrition Protein-calorie malnutrition Marasmus and kwashiorkor
• Etiology of Malnutrition Socioeconomic factors Physical illnesses Incomplete diets Food-drug interactions
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MalnutritionMalnutrition
•Pathophysiology: Starvation Process
•Clinical Manifestations•Diagnostic Studies
History and physical examination
Laboratory studies Anthropometric measurements
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Nursing Management:Nursing Management:
Malnutrition Malnutrition
•Nursing Assessment
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Nursing Management:Nursing Management:
Malnutrition Malnutrition
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Fig. 40-2. Patient with malnutrition.
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Nursing Management:Nursing Management:
Malnutrition Malnutrition
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Table 40-9. Desirable Body Weight Based on Hamwi Formula (Rule of Thumb).
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Nursing Management:Nursing Management:
Malnutrition Malnutrition
•Nursing Diagnoses•Planning•Nursing Implementation
Health promotion Acute intervention Ambulatory and home care
•Evaluation
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Gerontologic Considerations: Gerontologic Considerations:
Malnutrition Malnutrition
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Types of Specialized Types of Specialized Nutrition SupportNutrition Support
•Oral Feeding
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Types of Specialized Types of Specialized Nutrition SupportNutrition Support
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Fig. 40-3. Nutrition support algorithm.
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Types of Specialized Types of Specialized Nutrition SupportNutrition Support
•Enteral Nutrition
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Types of Specialized Types of Specialized Nutrition SupportNutrition Support
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Fig. 40-4. Common enteral feeding tube placement locations.
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Types of Specialized Types of Specialized Nutrition SupportNutrition Support
•Enteral Nutrition, continued Nasogastric and
nasointestinal tubes Gastrostomy and
jejunostomy
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Types of Specialized Types of Specialized Nutrition SupportNutrition Support
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Fig. 40-5. Placement of a gastrostomy tube.
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Types of Specialized Types of Specialized Nutrition SupportNutrition Support
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Fig. 40-6. Percutaneous endoscopic gastrostomy. A, Gastrostomy tube placement via percutaneous endoscopy. Using endoscopy, a gastrostomy tube is inserted through the esophagus into the stomach and then pulled through a stab wound made in the abdominal wall. B, A retention disk and bumper secure the tube.
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Types of Specialized Types of Specialized Nutrition SupportNutrition Support
•Enteral Nutrition, continued Procedures for tube feedings Complications related to
tubes and feedings
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Gerontologic Gerontologic Considerations: Considerations: Enteral Nutrition Enteral Nutrition
•Parenteral Nutrition
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Gerontologic Gerontologic Considerations: Considerations: Enteral Nutrition Enteral Nutrition
Copyright © 2011, 2007 by Mosby, Inc., an affiliate of Elsevier Inc.
Table 40-14. Common Indications for Parenteral Nutrition.
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Gerontologic Gerontologic Considerations: Considerations: Enteral Nutrition Enteral Nutrition
•Parenteral Nutrition, continued Composition
• Calories• Protein• Electrolytes• Trace elements• Vitamins
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Gerontologic Gerontologic Considerations: Considerations: Enteral Nutrition Enteral Nutrition
•Parenteral Nutrition, continued Methods of administration
• Central PN• Peripheral PN• Comparison of central and peripheral PN
Administration of solution
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Nursing Management:Nursing Management:
Parenteral Nutrition Parenteral Nutrition
•Home Nutrition Support
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Eating DisordersEating Disorders
•Anorexia Nervosa•Bulimia Nervosa
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