Nutrition - PowerPoint PPT Presentation

Loading...

PPT – Nutrition PowerPoint presentation | free to download - id: 42314a-MjA5Y



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

Nutrition

Description:

Nutrition Developed by D. Ann Currie, R.N,M.S.N. Potassium Macro mineral Requirements-Adults-2 grams Serum levels- 3.5-5.0 mEq/L Necessary for transmission and ... – PowerPoint PPT presentation

Number of Views:235
Avg rating:3.0/5.0
Slides: 150
Provided by: AnnC150
Learn more at: http://www.epcc.edu
Category:
Tags: nutrition

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: Nutrition


1
Nutrition
  • Developed
  • by D. Ann Currie, R.N,M.S.N.

2
Nutrition
  • Proper nutrition is needed for maintaining
    health and preventing illness. It also helps with
    wound healing. A well balance diet helps in the
    care and treatment of many diseases and
    conditions. The nurse needs to understand how a
    diet can help the client to achieve a healthy
    lifestyle, and help in the healing process.

3
Recommended Dietary Allowances
  • RDA- Amount of a nutrient need by a healthy
    individual.
  • Requirements for nutrients may be increased
    during illness and other times such as periods of
    growth, pregnancy, and physical demands or stress.

4
Nutrients
  • Nutrients are substances that are needed for
  • Cell growth,
  • Cellular function,
  • Enzyme activity,
  • Carbohydrate/ fat/protein synthesis,
  • Muscle contractions,
  • Wound healing,
  • Immune competence,
  • and LIFE.

5
WATER
  • H2O
  • Water is not a nutrient but is needed for life.
  • A human can only live 3-5 days without water, but
    10-14 days without food.
  • Calories 0

6
Water -Sources
  • Tap water- Bottle water
  • Fruits
  • Vegetables
  • Juices
  • Some in meats, fish, gravies.
  • IV fluids
  • Tea ,coffee and soda may have caffeine not good
    sources.

7
Water- Function in Body
  • It is part of body fluids
  • Cellular fluids, blood, hormones, sweat, urine,
    tears, lymph.
  • Lubricant.
  • Adult body fluid volume 60
  • Infant (newborn) body fluid volume 77
  • Embryo 90

8
Adult Body Fluid Volume
  • Intracellular ( cellular) fluid- ICF 40
  • Extra cellular fluid-ECF 20
  • Interstitial fluid (tissue spaces)- 15
  • Intravascular fluid (vascular fluid)-5

9
Water- Requirements
  • Depends on
  • Age
  • Activity
  • Temperature-both internal and external.
  • Losses

10
Water -Requirements
  • Adult- 30ml/Kg/day
  • Adult of 70Kg X 30 ml. 2100 ml/day.
  • Or 15 ml/lb/day.
  • Adult weighing 150 lbs. X 15 ml. 2250ml /day.
  • 6-8 glasses of water to 8-10 glasses of water per
    day.
  • Hot climates 2-3liters per day.

11
Medications/Supplements
  • Tap water.
  • Gatorade- Sport drinks.
  • IV fluids
  • Pedialyte
  • Enteral feedings
  • TPN

12
Water-Deficit (not enough)
  • FVD- Fluid Volume Deficit
  • Dehydration
  • Clinical manifestations
  • Weight loss
  • Dry skin
  • Dry mucous membranes
  • Poor skin turgor- tenting.
  • Decrease urine output

13
Normal Body Fluids Loses per day
  • Urine 1000-1200 ml/day
  • Sweat 400-500 ml/day
  • Respirations 400-550 ml/day
  • Stool 100-200 ml/day.
  • Tears small amount.

14
Increase Loses of Fluid
  • Burns
  • Sweating
  • Fever
  • Diarrhea
  • Inadequate intake
  • Diabetes-( Increased blood sugar)
  • Caffeine
  • EOTH- Alcohol
  • Drugs- Diuretics

15
Water- Excess (Too much)Toxicity
  • Fluid Volume Excess-
  • FVE
  • Edema
  • Causes
  • Excess intake usually
  • because of IV fluids.
  • Renal failure
  • Clinical manifestations
  • Weight gain.
  • Hypertension-High B/P
  • Edema- pitting vs
  • Non-pitting
  • Moist lung sounds
  • ( crackles/ rales)

16
Nursing Interventions
  • Monitor intake and output ( I0)
  • What goes IN( I)
  • Oral
  • IV Fluids
  • N/G Tubes.
  • What goes OUT( I)
  • Emesis
  • Urine
  • Stool
  • Drainage
  • Bleeding

17
NSG. Interventions
  • Diaper weight 1 gram wt.1 ml.
  • This would go for dressings or pads too
  • A dressings weighing 10 grams10 ml.of drainage
    or blood.
  • Assess weight daily.
  • Assess skin turgor.
  • Listen to lung sounds.
  • Check for edema.
  • Provide fresh pitcher of water several times a
    day, for the client with no restrictions of
    fluid.
  • Check the doctors order for IV rate.
  • Monitor IV fluids carefully.

18
Calories- Requirements
  • Adult calorie requirements are based are age,
    sex, activity level and need.
  • Base adult calorie needs are
  • 30-35 Calories per IBW ( Ideal body weight) Kg.
    (Kilograms)
  • example Adult who IBW is 58 Kg.
  • 58kgx 30 calories/Kg 1740 calories/day.
  • 58Kgx 35 calories/Kg2030 calories/day.
  • So the range would be 1740-2030 calories per day.

19
Protein(Amino Acids)
  • Calories 4 calories per 1 gram

20
Protein-Food Sources
  • Complete proteins come from animal sources
  • Diary Products- Cheese, Milk, Yogurt, Ice Cream.
  • Meat.
  • Fish.
  • Poultry.
  • Eggs.

21
Protein- Food Sources
  • Incomplete proteins from plants sources
  • Beans
  • Legumes
  • Nuts
  • Brown rice
  • Whole grains and cereals.
  • Soy products- Tofu

22
Protein- Food Sources
  • Complementary Proteins
  • Beans and Rice.
  • Whole grain macaroni and Cheese.
  • Peanut butter and Whole grain bread.

23
Protein- Function in The Body
  • Amino acids help to build and maintain all body
    tissues.
  • Part of
  • Hormones.
  • Blood.
  • Antibodies.
  • Albumin.

24
Protein- Function in the body
  • Provides energy after carbohydrate and fat
    supplies are exhausted.
  • Needed for growth and development of tissues.
  • Wound healing.

25
Protein- Requirements
  • Men 50-60 grams per day.
  • Women 40-50 grams per day.
  • Pregnant women 60 grams per day.
  • Increase requirements of protein are needed with
    illness and healing process.
  • 10-20 of total daily calories should be from
    protein.

26
Protein- Medication/Supplements
  • Nutrition supplements
  • Ensure
  • Protein shakes
  • Whey products
  • Protein bars.
  • TPN (Total Parental Nutrition)-IV Central Line.
    (Place TPN on an infusion device.)
  • Albumin.
  • Enteral Feedings. Feeding Tubes.

27
Protein-Deficit ( not enough)
  • The lack of enough protein intake can lead to
  • In children effects growth.
  • Anemia.
  • Increase infections.
  • Delayed wound healing.

28
Protein- Excess
  • Increase weight gain.
  • Renal/Kidney damage.

29
Nursing Interventions.
  • Monitor Protein intake- Do 24-48 hours dietary
    intake history.
  • Monitor Lab tests
  • BUN- Low BUN can indicate low protein intake.
  • Albumin- Low Albumin can also indicate low
    protein intake.
  • Total Protein- Low Total Proteins can indicate
    low protein intake.

30
Carbohydrates
  • Calories
  • Food-4 calories per 1 gram.
  • IVs- 3.4 calories per 1 gram

31
Carbohydrates- Food Sources
  • Refine sugars- White sugars, cane sugar, candy,
    etc.
  • Fruits.
  • Vegetables- Starchy vegetables.
  • Beans.
  • Nuts.
  • Legumes.
  • Whole grains.
  • Rice.
  • Oysters and clams.
  • Some meats.
  • Fiber is indigestible carbohydrates.

32
Carbohydrates-Function in the Body
  • Carbohydrates are the main source of energy for
    the body.
  • Maintains protein and fat balance.

33
Carbohydrates-Requirements
  • Depends on
  • Size.
  • Activity level.
  • Age.
  • Sex.
  • If couch potato a person needs less .
  • A client on bedrest needs less.
  • 50-60 of total calories should come from
    carbohydrates.

34
Carbohydrates- Requirements
  • Carbohydrates should come from
  • 2-4 servings of fruits.
  • 3-5 servings of vegetables.
  • 6-11 servings of whole grains.
  • Only a small amount from refined sugars.

35
Medications/ Supplements
  • Dietary supplements- Ensure.
  • IV Fluids- D5W
  • TPN- Total Parental Nutrition.
  • D5W- 5 Dextrose solution5gramof glucose per
    100ml. So a 1000ml bag of D5W 50 grams of
    glucose.
  • 50gramsx 3.4 calories/1 gram 170 calories per
    bag.

36
Carbohydrate- Deficit
  • A deficiency of carbohydrates in the diet can
    lead to
  • Weight loss.
  • Hypoglycemia
  • Headache, confusion, tired, irritability, hungry,
    muscle wasting, ketoacidosis, and ketones in the
    urine.

37
Carbohydrate-Excess
  • Too many carbohydrates in the diet can lead to
  • Weight gain.
  • Hyperglycemia
  • Increase thirst, hungry, increase urination, dry
    skin, fruity breathe.
  • Diabetes mellitus- increase blood sugar due to
    problem with insulin.

38
Carbohydrates Nursing Interventions
  • Assess dietary intake of carbohydrates with a
    24-48 hours dietary history.
  • Weight the client.
  • IV- Check order for type of fluids. and
  • Check rate. Place IV on infusion device.
  • TPN- Total Parental Nutrition- Check order with
    two nurses. Check rate. Follow Protocol for TPN.
    Check blood sugars level as ordered. Place IV on
    infusion device.
  • NPO- Nothing by mouth. Are calories coming from
    IVs or TPN?

39
Fats
  • Calories
  • Food- 9 calories per 1 gram of fat.
  • IV fluids- Intralipids
  • 10 solution1.1calories per 1 ml.
  • 20 solution 2.2calories per 1 ml.

40
Fats- Food Sources
  • Dietary-
  • Butter.
  • Oils- Animal sources and plant sources.
  • Diary Products- Milk, Cheese, etc.
  • Meats.
  • Bacon- 1 slice 1fat serving.
  • Nuts.
  • Avocados.
  • IVs- Intralipids.
  • TPN-Total Parental Nutrition.

41
Fats- Function in the Body
  • Fat makes up part of the cell membranes.
  • The lining around nerves.
  • Steroid Hormones- Estrogen and testosterone.
  • If womens body fat decreases below 18 they will
    stop menstruation and have fertility problems.
  • Fat for padding for warmth in cold climates.
  • Secondary source for energy.

42
Fats- Requirements
  • Less than 30 of total calories should come from
    fats. (US government).
  • According to AHA ADA
  • No more than 30 grams of fat per day.
  • People with Gall Bladder problems should have
    less than 20 grams of fat per day.
  • No one under 4 years of age should be placed on a
    low fat diet.

43
Fats- Medications/Supplements
  • IVs- Intralipids.
  • TPN-Total Parental Nutrition.
  • Dietary supplements.

44
Fat-Deficit
  • Lack of fat in the diet can lead to
  • Weight loss.
  • Decrease in hormone production.
  • In children- neurological problems.
  • Labs- decrease in cholesterol levels.

45
Fats- Excess
  • Too much fat in the diet can lead to
  • Increase weight.
  • High cholesterol levels and high triglycerides
    levels.
  • CAD- Heart Disease-MIs or CVA-Strokes.

46
Fats- Nursing Interventions
  • Assess dietary intake of fats with a 24-48 hour
    diet history.
  • Monitor cholesterol levels- LDH HDH, Total
    cholesterol level and triglyceride levels.
  • Monitor IV fats- Check order, rate, site, and
    IO. Place Iv of infusion device.
  • Weigh client.

47
Vitamins
  • Vitamins are organic compounds required by the
    body in small amounts for growth and normal
    metabolic processes.
  • Vitamins- 13
  • Types
  • Water soluble-Vitamin C and B complex.
  • Fat soluble-Vitamins A, D, E, and K .

48
Vitamin A
  • Fat soluble vitamin.
  • Retinol
  • Required for normal vision, growth, bone
    development, skin, and mucous membranes. Repair
    tissue especially epithelial cells.
  • Requirements-Men-600-900mcg.
  • Women750-770mcg. Pregnancy-up to 800mcg.
    Lactation-1200-1300mcg.

49
Vitamin A- Food Sources
  • Liver-Beef, Meat, butter, Fortified Margarine,
    egg yolks, cheeses, Whole milk, kidneys and fish
    oil.
  • Dark green vegetables-spinach, kale, turnip
    greens, asparagus, and broccoli.
  • Bright orange vegetables and fruits-carrots,
    sweet potatoes, pumpkin, cantaloupes, apricots,
    and peaches.

50
Vitamin A-Medication and Supplements
  • Isotretinon (Accutane)-Acne, skin problems.
  • Increase Vitamin A- Skin healing, Macro
    degeneration, Reversing Vitamin A deficiency ,and
    some forms of leukemia.
  • Vitamin A supplements should not be taken in
    megadoses.

51
Vitamin A-Deficiency
  • A lack of Vitamin A can lead to vision problems-
    Night blindness, xerophthalmia, corneal
    ulcerations and blindness.
  • Skin lesions and infections.
  • Respiratory tract infections.
  • Urinary calculi.

52
Vitamin A- Excess
  • Hypervitamintosis A
  • Clinical manifestations Anorexia, vomiting,
    irritability, skin changes, yellow-orange color
    of skin, Pain in muscle, joints and bones,
    enlargement of spleen and liver, Increased
    intracranial pressure and other neurological
    signs, weakness, decreased B/P, low WBC count,
    weight loss and Teratogenic effect in the fetus.

53
Nursing Interventions
  • Assess dietary intake of Vitamin A.
  • Teach clients to never take excess amounts of
    Vitamin A especially in children and pregnant
    women.
  • Monitor amount of Vitamin A in supplements.
  • Observe for signs of toxicity.

54
Vitamin D
  • Fat soluble vitamin.
  • Ergocalciferol -obtained from food.
  • Cholecalciferol -formed by exposure of skin to
    sunlight.
  • Necessary for the absorption of calcium. Helps to
    maintain healthy bone and teeth.
  • Requirements-Men and women 5-15 mg.

55
Vitamin D- Food Sources
  • Milk and some milk fat products
  • Irradiated foods
  • Liver
  • Egg yolks
  • Salmon
  • Tuna fish
  • Sardines
  • Certain cereals.
  • Also Sunshine.

56
Vitamin D Medication and Supplements
  • Vitamin D supplements-
  • Calcitriol( Rocaltrol, calcijex).
  • Cholecalciferol (Delta-D)
  • Multivitamins.
  • Clients should not take mega doses of Vitamin D.

57
Vitamin D- Deficiency
  • Lack of Vitamin D can lead to changes in serum
    calcium levels, rickets in children and
    osteomalacia in adults.

58
Vitamin D - Excess
  • Too much Vitamin D can lead to hypercalcemia,
    calcification of soft tissues, cessation of
    life, and teratogenic effects in the fetus.

59
Nursing Interventions
  • Monitor dietary intake of Vitamin D.
  • Teach client not to take excess Vitamin D. No
    mega doses.

60
Vitamin E
  • Fat soluble vitamin.
  • Tocopherol
  • Antioxidant.
  • Maintains integrity of muscles and nerves.
  • Protect other nutrients-especially Vitamins A
    C.
  • Helps with the formation of RBCs.
  • Prevents the destruction of certain fats
    including the lipid portions of cell membranes.

61
Vitamin E- Requirements
  • Men and Women- 15mg.
  • Lactation-19mg.

62
Vitamin E- Food Sources
  • Green leafy vegetables,
  • Plant/Vegetable oils- seeds
  • Butter
  • Eggs
  • Wheat germ
  • Milk fat
  • Cereals

63
Vitamin E- medication and Supplements
  • Tocopherol (Aquasol E, Vita-Plus)
  • PO/IM 60-70 units/day

64
Vitamin E- Deficiency
  • Vitamin E deficiency is rare.
  • In adults only seen in severe malabsorption
    disorders.
  • In premature neonates may lead to hemolytic
    anemia.

65
Vitamin E- Excess
  • High doses- nausea, vomiting, fatigue, headaches
    blurred vision, diarrhea,
  • In preterm infants- excess Vitamin E can cause
    respiratory distress, liver failure,
    thrombocytopenia, and ascites.

66
Nursing Interventions
  • Assess dietary intake of Vitamin E.
  • Check dose of supplements.
  • Teach clients not to take mega doses of Vitamin E.

67
Vitamin K
  • Fat soluble vitamin.
  • Phytonadione.
  • Essential for normal blood clotting.
  • Activates precursor proteins found in the liver
    into clotting factors ll, Vll, lX, and X.
  • Requirements- Men Women-65-70mcg. 1mcg/Kg.

68
Vitamin K- Food Sources
  • Green Leafy Vegetables- Spinach, kale, turnip
    greens, broccoli, and green tea.
  • Liver
  • Oatmeal
  • Soy beans
  • Moderate amount in coffee.

69
Vitamin K-Medication and Supplements
  • Phytonadione (AquaMEPHYTON )
  • PO/IM/Subcutaneous
  • 1mcg/Kg
  • Use to Treat-Clients with clotting disorders,
    antidote for overdose of warfarin (coumadin), and
    prevent hemorrhagic disease in the newborn infant.

70
Vitamin K -Deficiency
  • A deficit of Vitamin K can lead to Abnormal
    bleeding( melena, hematemesis, hetaturia,
    epistaxis, petechiae, ecchymoses, hypovolemic
    shock)

71
Vitamin K- Excess
  • Too much Vitamin K can lead to excessive
    clotting.
  • Antidote for an overdose of Vitamin K is Heparin.
  • Clients on warfarin (Coumadin) Should not take
    Vitamin K supplements or eat too much Vitamin K
    high foods.

72
Nursing Interventions
  • Assess dietary intake of Vitamin K.
  • Check Vitamin K doses.
  • Teach client on warfarin (Coumadin) not to eat
    excessive amounts of food high in Vitamin K.
  • Know the antidote for overdose of Vitamin K is
    Heparin.

73
Vitamin C
  • Water soluble vitamin.
  • Ascorbic acid.
  • Essential for the formation of skin, ligaments,
    cartilage, bone, and teeth.
  • Required for wound healing and tissue repair.
  • Metabolism of Iron and Folic acid. RBC formation.
  • Synthesis of fats and proteins
  • Preservation of blood vessel integrity.
  • Resistance to infection.
  • Collagen formation

74
Vitamin C- Requirements
  • Men and Women-65-90mg/day.
  • Lactation-115-120 mg./day

75
Vitamin C Medications and Supplements
  • Ascorbic acid
  • PO/IM/IV
  • Vitamin deficiency-100-500mg/day
  • Burns-500-2000mg/day.

76
Vitamin C- Food Sources
  • Citrus fruits-oranges, lemons, limes,
    grapefruits.
  • Tomatoes
  • Strawberries
  • Cantaloupes
  • Green peppers
  • Chili peppers
  • Raw Potatoes

77
Vitamin C-Deficiency
  • Mild deficiency irritability, malaise,
    arthralagia, increased tendency to bleed.
  • Severe deficiency Scury gingivitis, bleeding
    gums, Problems with skin, joints, and other
    areas.
  • Poor wound healing
  • Anemia
  • Coma
  • Death

78
Causes of Vitamin C Deficiency
  • Diet devoid of Fruits and Vegetables.
  • Excess alcohol (ETOH) intake
  • Elderly with limited diets.
  • Chronic illness.
  • Constance Stress.

79
Vitamin C- Excess
  • Dirrhea
  • Renal calculi
  • In African Americans-retention of iron
    stores-iron toxicity.

80
Nursing Interventions
  • Assess dietary intake of Vitamin C.
  • Check dose of vitamin supplements.
  • Caution overdoses of Vitamin C with
    African-Americans.
  • Suggest Multivitamins for clients with poor
    diets- such as college students.

81
Vitamin B-1
  • Water soluble vitamin
  • Thiamine
  • Essential for maintaining of circulatory,
    digestion and nervous systems.
  • A coenzyme in carbohydrate metabolism.
  • Essential for energy production.
  • Requirements- 1-1.2 mg/day for adults.
  • Pregnancy and lactation-1.4mg/day

82
Vitamin B-1-Food Sources
  • Meat, liver, poultry, fish, egg yolks, dried
    beans, whole grains, cereal products, and peanuts.

83
Vitamin B-1- Medications and Supplements
  • Thiamine-(B-1)
  • PO/IM/IV
  • Deficiency- PO 10-30 mg/day.
  • IV-50-100mg/day until able to take orally.
  • Deficiency is common in alcoholics.

84
Vitamin B-1- Deficiency
  • Mild deficiency fatigue, anorexia, retarded
    growth, mental depression, irritability, apathy,
    and lethargy.
  • Severe deficiency Beriberi (wet or dry)-
    peripheral neuritis, personality disturbances,
    confusion, tachycardia, enlarged heart, heart
    failure, muscle wasting edema, Wernicke-Korsakoff
    syndrome in alcoholics.

85
Vitamin B-1- Excess
  • Rare
  • Diarrhea
  • Nausea/vomiting
  • Increase urination.

86
Nursing Interventions
  • Assess dietary intake of Vitamin B-1.
  • Check IV dose. Infuse with IV pump.

87
Vitamin B-2
  • Water soluble vitamin.
  • Riboflavin
  • Essential for RBC and antibodies formation.
  • A coenzyme in metabolism.
  • Necessary for growth.
  • Aids in building nerve structures. Helps cells to
    utilize oxygen.

88
Vitamin B-2- Requirements
  • Women- 1-1.1 mg/day,prenancy-1.4mg/day,
    lactation-1.6 mg/day.
  • Men1.3mg/day.
  • Vitamin deficiency-30-60mg/day.

89
Vitamin B-2-Food Sources
  • Milk and milk products-cheddar and cottage
    cheeses.
  • Meats- steak, beef liver
  • Eggs
  • Green leafy vegetables.
  • Enriched breads and cereals.
  • Brewers yeast.
  • Salmon.
  • Turkey.

90
VitaminB-2-Medication and Supplements
  • Riboflavin(B-2)
  • PO/IV
  • Deficiency-5-10mg/day-PO
  • Used to treat migraine headaches

91
Vitamin B-2-Deficiency
  • Eye disorders-burning, itching, lacrimation,
    photophobia, and vascularization of the corneal.
  • Glossitis
  • Stomatitis
  • Seborrheic dermatitis

92
Vitamin B-2-Excess
  • Rare
  • Nausea/vomiting
  • Diarrhea
  • Increase urination.

93
Nursing Interventions
  • Assess dietary intake of Vitamin B-2.
  • Check dose on supplement.

94
Vitamin B-3
  • Water soluble vitamin.
  • Niacin
  • Essential for glycolysis, fat synthesis, and
    tissue respiration.
  • A coenzyme in many metabolic processes.
  • Aids in circulation, growth of body tissues.
  • Requirements-Women-14mg/day,pregnancy-18mg/day,lac
    tation-17-20mg/day.
  • Men-16mg/day.

95
Vitamin-B-3-Food Sources
  • Meat, poultry, fish, seafood, eggs.
  • Whole grains, peanuts, legumes.
  • Enriched cereals and breads.

96
Vitamin B-3- Medications and Supplements.
  • Niacin (Nicotinic acid)
  • Niacinamide (nicotinamide)
  • PO
  • Deficiency-PO 50-100mg/day
  • Pellagra-PO-up to 500mg/day
  • Hyperlipidemia- PO 2-6 grams /day- divided in 3
    doses.

97
Vitamin B-3-Deficiency
  • Pellagra erythematous skin lesions,
  • GI problems- stomatitis, glossitis, enteritis,
    and diarrhea.
  • Nervous system problems- Headache, dizziness,
    insomnia, depression, and memory loss.
  • Severe deficiency delusions, hallucinations,
    impairment of peripheral motor and sensory nerves.

98
Vitamin B-3- Excess
  • Rare
  • Transient flushing, headaches, cramps,
    nausea/vomiting, increase blood sugar, and
    increase uric acid levels.
  • Increased liver enzymes.

99
Nursing Interventions
  • Assess dietary intake of Vitamin B-3.
  • Monitor for toxicity with high doses.

100
Vitamin B-6
  • Water soluble vitamin
  • Pyridoxine
  • Essential for RNA and DNA synthesis.
  • Critical for hemoglobin production.
  • A coenzyme in metabolism of carbohydrate,
    protein, and fat formation.
  • Helps to release glycogen from the liver and
    muscle tissue.
  • Maintains antibody function.
  • Balances nervous system function.

101
Vitamin-B-6-Requirements
  • Women-1.2-1.5mg/day, pregnancy-1.9mg/day,
    Lactation-2mg/day.
  • Men-1.3-1.7mg/day

102
VitaminB-6-Food Sources
  • Yeast, wheat germ, liver, glandular meats, whole
    grains and cereals, potatoes, legumes, and
    prunes..

103
Vitamin B-6- Medications and Supplements.
  • Pyridoxine(B-6)
  • PO/IM/IV
  • Deficiency-2-5mg/day
  • Anemia, peripheral neuritis-50-200mg/day.
  • INH therapy-25-500mg/day.

104
Vitamin B-6-Deficiency
  • Skin and mucous membrane leisions-seborrheic
    dermatisis, interrigo, glossitis, stomatitis.
  • Neurologic problems-convulsions, peripheral
    neuritis and mental depression.

105
Vitamin B-6-Excess
  • Ataxia
  • Sensory neuropathies

106
Nursing Interventions
  • Assess dietary intake of Vitamin B-6
  • Check dose on Vitamin B-6 supplements.

107
VitaminB-9
  • Water soluble vitamin
  • Folic acid-(Folate)
  • Essential for normal metabolism of all body
    cells.
  • Needed for the formation of RBCs.
  • Needed for nervous system formation.
  • Requirements-Women and Men- 400mcg/day.
    Pregnancy-600-800mcg/day

108
VitaminB-9-Food Sources
  • Liver, kidney and lima beans, dark green leafy
    vegetables( spinach, broccoli, asparagus), orange
    juice, fortified grain products-cereals and
    breads.

109
VitaminB-9- Medication and Supplements
  • Folic acid
  • PO/IM/IV/subcutaneous
  • Deficiency- up to 1mg/day, when blood tests
    normal then 400mcg/day

110
Vitamin B-9-Deficiency
  • Megaloblastic anemia and other blood
    disorders-Folic anemia.
  • Elevated blood levels of homocysterine.
  • Poor growth in children.
  • Glossitis
  • GI tract disturbances.
  • Decrease intake during pregnancy can cause neural
    tube defects.

111
Vitamin B-9-Excess
  • Rare
  • Nausea/vomiting
  • Diarrhea
  • Increase urination
  • Increase Folic acid intake with Dilantin will
    cause decrease effectiveness of the medication.

112
Nursing Intervention
  • Asses dietary intake of Folic acid/Vitamin B-9.
  • All women of childbearing age should take
    supplements of folic acid when pregnant. And Make
    sure they take in enough Folic acid contenting
    foods.

113
Vitamin-B-12
  • Water soluble vitamin
  • Cyanocobalamin
  • Essential for normal metabolism of all body
    cells.
  • For the formation of RBCs.
  • Healthy nervous system
  • Requirements-Women and Men-2.4-3 mcg
  • /day

114
Vitamin B-12-Food Sources
  • Liver, kidneys, milk, eggs, fish, cheese, muscle
    meats, cooked sea vegetables

115
Vitamin B-12-Medications and Supplements
  • Cyanocobalamin
  • PO/IM
  • Nascobal-Intranasal gel,1 spray in one nostril,
    once a week
  • Parental B-12 should be given for Pernicious
    anemia.

116
Vitamin B-12-Deficiency
  • Pernicious anemia megaloblasitc anemia, yellow
    skin, smooth red beefy tongue, neurological
    disorders-peripheral neuropathy.

117
Vitamin B-12-Excess
  • Rare with dietary intake.

118
Nursing Interventions
  • Assess for dietary intake of Vitamin B-12.
  • Check dose/route with supplements.
  • Folic acid supplements will mask the signs of
    anemia in pernicious anemia.

119
Vitamin Supplements
  • A normal healthy individual who eats a well
    balanced diet does not need to take vitamin
    supplements.
  • Vitamin supplements are required
  • During periods of increased growth, pregnancy,
    lactation, debilitating illnesses, inadequate
    dietary intake, fad diets (crash diets), and
    malabsorption processes.

120
Minerals
  • Macro minerals-Need more than 100mg/day
    intake-Sodium, Potassium, Magnesium, Chloride ,
    Calcium, etc.
  • Micro minerals-Needs less than 100 mg/day
    intake-Iron, Chromium, Copper, Zinc, Iodine,
    Selenium, Fluoride, Cobalt, etc.

121
Calcium
  • Macro mineral
  • Requirements-Adults-800-1200mg/day.
  • Pregnancy-1000-1300mg/day.
  • Lactation-1300mg/day.
  • Needed for proper function of all body cells and
    tissue.
  • Essential for formation of bones and teeth.
  • Maintains blood clotting mechanism.
  • Regulates heart beat.
  • Regulates nerve conduction and muscle
    contractions.
  • Serum level-9-10.5 mg.

122
Calcium-Food Sources
  • Diary products-milk, cheese, yogurt.
  • Fish with bones- Sardines, salmon.
  • Nuts
  • Beans- Soy Products-Tofu.
  • Green Leafy Vegetables.
  • Fortified orange juice, cereals and breads.

123
Calcium- Deficiency
  • Hypocalcemia- Serum level under 9 mg.
  • Tetany,
  • Dysrrhythmias,
  • Pathological fractures of bones,
  • Risk of bleeding,
  • Brittle nails,
  • Insomnia,
  • Periodontal disease,
  • Osteomalcia,
  • Osteoporsis

124
Calcium-Excess
  • Hypercalcemia- serum levels above 10.5 mg.
  • Flaccid paralysis,
  • Anorexia,
  • Nausea/vomiting,
  • Dysrrhythmias,
  • Kidney stones.
  • Polyuria.

125
Nursing Interventions
  • IV calcium-infusion pump. Place client on EKG
    monitor, and Follow hospital policy.

126
Iron
  • Micro mineral
  • Requirements-Men-10-12 mg./day
  • Women-10-15 mg. /day
  • Pregnancy-27-30 mg./day.
  • Needed for formation of RBCs.
  • Food sources-Organ meats-Livers,
  • Red meat,
  • Tuna fish,
  • Beans,
  • Nuts,
  • Shellfish,
  • Dried fruits- raisins,
  • Dark molasses,
  • Whole grains,
  • Egg yolks,
  • Red wine

127
Iron-Deficiency
  • Microcytic anemia.
  • Iron deficiency anemia.
  • Weakness,
  • Fatigue.
  • Dizziness
  • Altered immune response-increase risk of
    infections.

128
Iron-Excess
  • Hemochromocytosis
  • Iron Toxicity.

129
Nursing Interventions
  • PO- dont give with milk or diary products or
    antiacids -Decreases absorption.
  • Liquid-give through a straw-will stain teeth.
  • IM- give deep IM-Z-track.
  • IV- Give with infusion pump slowly. Watch for
    allergic reactions.

130
Potassium
  • Macro mineral
  • Requirements-Adults-2 grams
  • Serum levels- 3.5-5.0 mEq/L
  • Necessary for transmission and conduction of
    nerve impulses and contraction of skeletal,
    cardiac, and smooth muscles.
  • For enzyme action used to change carbohydrates to
    energy and amino acids to protein.

131
Potassium- Food Sources
  • Meat, Bran, Potatoes, Broccoli, Bananas, peanut
    butter, green leafy vegetables, avocadoes, orange
    juice.

132
Potassium-Deficiency
  • Hypokalemia- serum level under 3.5 mEq/L.
  • Muscle weakness
  • Decreased reflexes
  • Flaccid paralysis
  • CNS depression
  • EKG changes
  • hypotension

133
Potassium- Excess
  • Hyperkalemia- Serum levels above 5.0 mEq/L
  • EKG changes, skeletal muscle weakness,
    bradycardia, cardiac arrest, oliguria, intestinal
    colic, diarrhea.
  • Causes Severe burns, crushing injuries,
    Addisons disease, renal failure, acidosis,
  • Excessive intake usually from IV administration
    or oral supplements. Not from foods

134
Potassium- Nursing Interventions
  • Monitor potassium levels (K)
  • IV- monitor rate, place on IV infusion pump.
    Check kidney function.
  • Med/Surg. Units no faster than 10 mEg/hr. For K
    runs-Place client on EKG monitor
  • PO- give with least ½ cup of water or juice
  • Drug interactions-diuretics (Lasix ) Decrease K
    levels and K sparing diuretics will Increase K
    levels.

135
Sodium
  • Macro mineral
  • Requirements-Adults- 500mg-4000mg-
  • 2-4 grams
  • Serum levels of sodium- 136-145 mEq/L.
  • Necessary for normal nerve conduction and muscle
    contraction.
  • Principal cation in extra cellular fluids.
  • Essential for acid-base balance.
  • Food sources- table salt, process foods ( such as
    can foods), soy sauce, seafood, cured meats, and
    even sodas.

136
Sodium- Deficiency
  • Hyponatremia- Serum level under 136 mEq/L
  • Decreased cerebral function
  • Weakness
  • Nausea/ vomiting
  • Decreased B/P
  • Causes Sodium deficit, GI losses, diuretics,
    burns, water intoxication.

137
Sodium- Excess
  • Hypernatremia-Serum levels above 145 mEq/L
  • Edema, weight gain, increased B/P, fluid volume
    overload, thirst.
  • Causes Too much sodium intake, renal failure,
    cirrhosis, steroid therapy, aldosterone excess.

138
Sodium-Nursing Interventions
  • Monitor sodium levels.
  • Maintain IO.
  • Weight daily.
  • IV fluid- Monitor rate and place IV on infusion
    pump.
  • Listen to lung sounds.

139
Chromium
  • Micro mineral
  • Requirements- Adults-0.5-2.0 mg/day.
  • Necessary for carbohydrate (glucose) metabolism.
    Potentiates insulin.
  • Helpful in controlling (noninsulin dependent
    diabetes) Type II diabetes.
  • Food sources- Brewers yeast, oysters, liver,
    potatoes, seafood, whole grains, cheeses.
    poultry, bran, and lean meat.

140
Chromium-Cont.
  • Deficiency- Impaired glucose tolerance(
    hyperglycemia, glycosuria) , impaired growth and
    reproduction and decreased life span.
  • Excess- not established.

141
Copper
  • Micro mineral
  • Requirement-Adult-1.5-3 mg/day.
  • Cofactor for hemoglobin synthesis.
  • Needed for collagen formation.
  • Food sources- oysters, shellfish, liver, nuts,
    cereals, poultry, dried fruits, and chocolate.
  • Prolonged copper deficiency may lead to anemia
    which is not corrected by taking just iron.
  • Also neutropenia, leukopenia, osteoporosis,
    depigmentation of skin. Menkes disease.
  • Excess- Wilsons disease.

142
Zinc
  • Micro mineral
  • Requirements- Adult-Men- 12-15 mg/day,
    Women-11-13 mg/day , pregnancy- 15 mg/day.
  • Food sources- meat, liver, eggs, seafood, wheat
    germ.
  • A component of many enzymes that are essential
    for normal metabolism
  • Necessary for normal cell growth.
  • Synthesis of RNA and DNA
  • Maintains health skin and mucous membranes, and
    aids in wound healing.
  • Maintains growth of sexual organs . Needed for
    proper protein structures.














143
Chloride
  • Macro mineral
  • Requirements-Adult- 80-110 mEq/day- 750mg/day.
  • Serum levels-90-110 mEq/L
  • Major anion of body fluids
  • Part of gastric acid secretion
  • Helps to maintain osmotic pressure and
    electrolyte, acid-base balance.
  • Food sources-Table salt and foods containing NaCl

144
Chloride-Cont.
  • Chloride deficiency- Hypochloridemia-serum levels
    under 90 mEq/L-Dehydration, Low B/P, low shallow
    respirations, paresthesias of face and
    extremities, muscle spasms and tetany.
  • Chloride excess- Hyperchloridemia- Serum level
    above 110 mEq/L-increased rate and depth of
    respirations, lethargy, stupor, disorientation
    and coma.

145
Phosphorus
  • Macro mineral
  • Requirements-Adults-700mg.
  • Forms bone matrix.
  • Part of ATP and nucleic acids.

146
Iodine
  • Micro mineral
  • Requirements-Adults-150mcg/day
  • Component of thyroid hormones
  • Food sources- sea salt, and seafood.
  • Iodine deficiency-Thyroid gland enlargement,
    goiter, possible hypothyroidism
  • Iodine excess- Iodism with coryza,
  • edema, conjunctivitis, stomatits, and vomiting.

147
OTHER NUTRIENTS
  • Nutrients not discussed in this presentation
    check the text and web.

148
Vegetarians
  • Pure vegetarian- Only eat food from plant
    sources Vegetables, fruits, grains, legumes,
    and nuts. May need Vitamin B12 supplements.
  • Lacto vegetarian- Eats vegetarian diet and milk
    and milk products-cheeses, yogurt, etc.
  • Lacto ova vegetarian- eats vegetarian diet plus
    eggs and milk products.

149
REMEMBER NUTRITION IS AN IMPORTANT PART OF
HEALTH AND LIFE
About PowerShow.com