Nursing Assistant Nutrition. Bodys need for food & fluids Provide energy for daily living & bodily...
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Transcript of Nursing Assistant Nutrition. Bodys need for food & fluids Provide energy for daily living & bodily...
Nursing Assistant
Nutrition
Body’s need for food & fluids
Provide energy for daily living & bodily functions
Promote growth & repair of tissue Provide necessary substances for
regulation of bodily fluids
Nutrition
Science of foods & their relationship to health– Essential to good health– Composed of sufficient nutrients to meet
the body’s requirements
Common Nutrients
Carbohydrates– Grains– Pastas– Breads– Cereals– Fruits – Vegetables
Proteins
Eggs Milk Meat Fish Nuts Poultry
Fats
Oils Cream Cheese Meat fats Butter
Vitamins
Vegetables Fruits Milk
Minerals
Eggs Dried fruit Potatoes Fish Milk
Dietary fiber
Raw fruits Raw vegetables Whole grains
Fluids
Water Juices Other beverages
Food Pyramid
www.mypyramid.gov Serving sizes based on age, gender, &
activity level
Vegan
Vegetarian AND no animal by products Check www.mypyramid.gov for
specifics
Special nutrient needs of elderly
Age related changes– Fewer calories needed, decreased activity– Digestive disturbances = add vitamins & minerals– Meds may interfere with digestion & nutrient use– Poor oral hygiene, ill-fitting dentures– Ability to taste decreased– Many common diseases interfere with eating & or the
ability to use nutrients– Social isolation = interference with appetite
Food allergies – know status & check for additives (peanuts, shellfish, wheat)
Therapeutic diets
Low sodium Diabetic Low fat Liquid
– Full liquid– Clear liquid– Thickened liquids– Nectar thick– Honey thick
Special consistency diets
Mechanical soft Pureed Soft
Responsibilities of nursing assistant Check that residents receive diets ordered,
check arm bands with tray Report any diet related problems –
preferences, difficulties, N & V, anorexia Assist drs & nurses to evaluate fluid balance,
accurate I & O Calculate food intake according to facility, if
eats all, eats 100% Offer alternate menu with refusal If alternate refused, report to licensed nurse
Technique for feeding
Provide comfortable & enjoyable atmosphere– Sit at eye level– Maintain a positive attitude when feeding
Provide assistance if needed Serve residents in room if unable to join
others in dining area (best choice is dining area)
Alternate liquid & solid food
Steps
Wash hands Check diet card for name, diet order, special
instructions, & allergies Make sure food matches info on card Remove tray from food cart, see that all items are
there Knock & pause before entering room Introduce self Check armband Explain procedure
Steps cont.
Lower side rail Place tray on overbed table If in dining room, remove food items & place
on table – remove tray Place a towel or clothing protector Remove plate cover Seat yourself at eye level Arrange food, butter bread, season food
Steps cont Describe or show food before giving it to resident Use adaptive devices as indicated Use straws & thickeners as indicated Offer small portions of solids ( no more than ½
spoonful) Alternate solids & liquids Ask what they would like Put food on unaffected side of mouth Monitor for pocketing & swallowing difficulties Remove tray when resident is finished
Prevention of choking
High risk residents– CVA– Neurological disease– Trauma to head, neck, or throat– Dementia
Close supervision when eating Follow individual feeding plan Cut food into small pieces, offer in small
amounts, wait until each portion is chewed & swallowed before more is given
Choking cont.
Notify licensed nurse if dysphagia– Long time before swallowing– Swallows several times with each bite– Frequent throat clearing– Difficulty handling foods/fluids in mouth– Wet gurgling voice– Pocketing food– Unintentional weight loss– Feeling by resident that food is sticking
Choking cont
Proceed at resident’s pace – don’t rush Portion should be chewed & swallowed
before more is given Sit down while feeding helpless resident Use adaptive equipment as indicated
Recognition of signs of choking
Universal sign Inability to speak, cough, breathe Cyanosis Loss of consciousness HEIMLICH MANEUVER
DIETARY MODIFICATIONS
Affiliated with religions and/or cultures Ask if there are any preferences Ask family of residents who cannot
communicate
Alternate ways to offer nutrition
Tube feedings– Ordered by doctor when resident unable to eat– Started by a licensed nurse– Your responsibility
• Monitor for tubing kinking or pressure• Monitor level of feeding• KEEP HOB AT 20 – 30 DEGREES AT ALL TIMES• DO NOT LOWER HOB EVEN WHEN REPOSITIONING• Never turn off pump – notify nurse of alarm• Notify nurse if signs of aspiration
Intravenous infusion Ordered by physician Started by licensed nurse Your responsibility
– Monitor IV for kinks, twisting, pressure, or obstruction– Report
• Alarms• C/o pain or burning at site• Swelling or redness at site• Fever• SOB• Bleeding of fluid leakage at IV site• Disconnected IV tubing• Empty IV container