Chapter 17: Nutrition Intervention

1
Chapter 17 Nutrition Intervention

• Estimation of Nutrition Needs
• Estimating Energy Needs
• Gold StandardIndirect calorimetry
• MED Gem Handheld
• Harris Benedict Equation
• Basal Energy Needs
• Additional energy needs for activities and
  stress
  
• Normal weight25 -30 kcal/kg/d
• Obese21 kcal/kg/d
• Increased needs 35 kcal/kg/d

2
Review

• Test 1 results
• Chapter 16 Review
• HAMWI Method for determining IBW
• IBW
• Weight Change
• BMI

3
Nutrition Needs cntd.

• Protein Needs
• Healthy adult0.8 gm/kg/day
• Increased needs for surgery, sepsis, burns
  1-2.5 gm/kg/day
  
• Decreased for Pre-Renal - .6 gm/kg/day
• Nitrogen Balance
• Micronutrientsspecific health problems identify
  additional micronutrient support

4
Medical Nutrition Therapy

• Problems identified
• Goals and InterventionsNutrition Care Plan
• Resolve immediate and long-term nutritional
  problems
  
• Outcome measures-indicators of change that help
  evaluate intervention effectiveness includes
  education
  
• Nutrition therapy should be based on cost benefit
  considerations

5
Standard and Modified Diets

• Standard Dietsincludes all foods
• Modified or Therapeutic Dietadjusted according
  to symptoms or conditions
  
• Diet Modifications
• Therapeutic Diets Low Na, Diabetic Diet, Renal
  Diet, Supplement w/meal
  
• Mechanically Altered Diets Puree, Mechanical
  Soft, full clear liquid.

6
Diet Modifications, cntd.

• Dietary Treatments
• Symptoms or conditions prevented or relieved
• Diet Orders
• Diet prescribed by physician
• Dietician or nurse suggest diet prescription
• Awareness of inappropriate diet orders
• Diet Manuals
• Identifies modifications to standard diets
• Guidelines for dietary department
• Should be approved available at nursesstation

7
Diet Modifications, cntd.

• Feeding Routes
• Enteral nutrition
• By mouth
• Tube feedings
• Parenteral nutrition
• Peripheral parenteral nutrition
• Total parenteral nutrition

8
Feeding Routes, cntd.

• Tube Feedings
• Utilizes digestive tract
• Requires functioning digestive tract
• Intravenous Feedings
• Malnourished
• Limited use of GI tract

9
The Medical Record

• Medical Record
• Legal document that records a clients health
  history
  
• Measures taken to treat problems
• Results of tests and therapy
• Goal-oriented to meet specific objectives
• Includes nutrition-related information