- General Notes
- Focused Review Notes
- ATI Rationale with Additional/Supported Information
PART 1: GENERAL NOTES (Important Facts)
Vitamin B12 is f... [Show More] or pernicious anemia Ferrous sulfate for iron deficiency 18.5-24.9 bmi is healthy weight Below 18.5 BMI is underweight
25-29.9 is overweight
30 BMI or greater is obese rangea 10-20 is normal BUN level
<200 is ok for blood glucose
Celiac disease remove any gluten from diet, wheat rye and barley Pregnant woman increase iron to be able to promote RBC growth to fetus Stomatitis you want to avoid spicy, acidic foods and salty foods
• Be wary of questions regarding children drinking too much milk i.e. more than 3-4 cups of milk each day. Too much milk intake reduces intake of other essential nutrients, especially iron. Watch for anemia with milk-aholics.
• Vitamin D’s presence is required by the parathyroid gland, in order for it to function.
• If the patient is taking digoxin or K-supplements, avoid salt substitutes because many are potassium based
• Potassium Sources: bananas, potatoes, citrus fruits
• No milk (as well as fresh fruit or veggies) on neutropenic precautions.
• Nondairy sources of calcium include RHUBARB, SARDINES, COLLARD GREENS 24
• Nonfat milk reduces reflux by increasing lower esophageal sphincter pressure
• Yogurt has live cultures, so do not give to immunosuppressed patients
• No phenylalanine with a kid positive for PKU (no meat, no dairy, no aspartame).
• Acid Ash diet: cheese, corn, cranberries, plums, prunes, meat, poultry, pastry, bread
• Alk Ash diet: milk, veggies, rhubarb, salmon
PART 2: Focused Review Notes
Manifestations of Vitamin A Toxicity
• Can cause teratogenic effects on fetuses
• Blurred vision
• Bone pain or swelling
• Hypercalcemia
• ICP
• Liver damage
• Skin peeling, itching
• Nausea and vomiting
• Abnormal softening of the skull bone (children) and bulging fontanels
Planning Care for a Client Who Follows Seventh-Day Adventist Dietary Laws
• Vegetarianism
o Do not consume animal products of any type INCLUDING eggs and milk products.
o Vitamin B12 and Vitamin D supplements may be needed with a pure vegan diet.
• Vegan diets are adequate in protein due to intake of nuts and legumes (dried peas and cooked beans).
Initiating Continuous Enteral Feeding
• This is recommended for critically ill patients because it is associated with small residual volumes, and a lower risk of aspiration and diarrhea.
• Residual volumes should be measures q4-6hrs.
• Feeding tubes should be flushed with water q4hr to maintain patency and hydration.
• If patient’s gastric volume exceeds 500ml, the continuous feeding should be HELD and tolerance reassessed.
o In children, residual volumes should be measured and held if the amount is equal to or greater than ¼ the prescribed feeding amount.
• Residual should be returned and the amount rechecked in 30min to 1hr.
Recommendations for Nutritional Supplement
• Add skim milk to powder milk (double strength milk)
• Use whole milk instead of water recipes
• Add cheese, peanut butter, chopped hard-boiled eggs, yogurt.
• Dip meats in eggs or milk and coat with bread crumbs before cooking.
• Nuts and dried beans are significant sources of protein great alternatives to dairy allergy or lactose intolerance!
Assessing Caloric Intake
• Toddlers: 1 to 3 years old
o Limit 100% juice 4 to 6oz a day
o The 1 to 2-year-old requires whole cow’s milk to provide adequate fat.
o Food serving size is 1 tablespoon for each year of age.
• Preschoolers: 3 to 6 years old
o Preschoolers need 13 to 19 g/day of complete protein.
o 1 tablespoon per year of age for size of foods.
o May switch to skin or 1% low-fat milk after 2 years.
• School-Age Children: 6 to 12 years old
o Weight loss program is directed for children 40% overweight.
• Adolescence
o Energy requirements average 2,000 calorie/day for a 12 to 18-year-old female.
o Energy requirements average 2,200 to 2,800 calorie/day for a 12 to 18-year- old male.
o Average U.S. adolescent consumes a diet deficient in folate, vitamin A and E, iron, zinc, mag, calcium, and fiber.
• Adulthood and older adulthood
o Need a balanced diet that consists of 40% to 55% carbs, and 10-20% fat (with
no more than 30% fat).
o A 24 hr dietary intake is helpful in determining the need for dietary education.
- Use whole grains, select orange and dark green leafy vegetables, avoid fruits with added sugar (make half your plate vegetables and fruits), use vegetable oils, 132-362 discretionary calories are permitted per day.
MEN CALORIE INTAKE WOMEN CALORIE INTAKE
19 to 30 years old: 2,400 calories 19 to 30 years old: 2,000 calories
31 to 50 years old: 2,200 calories 31 to 50 years old: 1,800 calories
51+ years old: 2,000 calories 51+ years old: 1,600 calories
Teaching about High-Fiber Food Sources
• Beans
• Vegetables
• Oats
• Whole grains
• Cereals
• Nuts, seeds
• Raw or dried fruits
• Barley
• Flaxseed
• Avocado
• Chickpea
• Brown Rice
• Sweet Potato/Reg. Potato
• Quinoa
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