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Nutrition Terminology #1. Nutrition Fats Hyperalimentation Minerals Gastrostomy tube Fluids Full liquid diet. Terminology #2. Mechanical soft diet ADA (American Diet Association) diet Pureed diet Clothes protector (i.e., towel, bib) Cellulose or fiber Diaphoresis Diuresis.
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NutritionTerminology #1 • Nutrition • Fats • Hyperalimentation • Minerals • Gastrostomy tube • Fluids • Full liquid diet
Terminology #2 • Mechanical soft diet • ADA (American Diet Association) diet • Pureed diet • Clothes protector (i.e., towel, bib) • Cellulose or fiber • Diaphoresis • Diuresis
Terminology #3 • Emesis • Essential nutrients • Expectorate • Forcing fluids • Intake and output (I & O) • Therapeutic diets
Terminology #4 • Carbohydrates • Proteins • Intravenous infusion • Vitamins • Nasogastric tube • Clear liquid diet • Soft diet
Terminology #5 • Low sodium diet • Low fat diet • Bland diet • Amino acids • Dehydration • Digestion • Edema
Terminology #6 • Enteral feeding • Exchange list • Fats • Gavage • Nutrients • Total parenteral nutrition (TPN)
Body’s need for food and fluids • Provide energy for daily living • Promote growth and repair of tissue • Provide the necessary substances for regulation of bodily functions • A balanced diet is essential to good health • A balanced diet is composed of sufficient nutrients
Common nutrients and their food sources • Carbohydrates • Proteins • Fats • Vitamins • Minerals • Dietary fiber • Water
Basic four food groups • Meat group • Dairy group • Vegetable and fruit group • Bread and cereal group
Vegan basic four food groups • Whole grains • Vegetables • Fruits • legumes
Special nutritional needs of the elderly • Fewer calories if they are less active • Additional vitamins and minerals due to digestive disturbances • Medications may interfere with digestion and nutrient use • Poor oral hygiene or ill-fitting dentures
Special nutritional needs of the elderly #2 • Ability to taste foods could be diminished • Many common diseases interfere with eating • Social isolation may interfere with appetite
Diets commonly ordered in diet therapy for residents • Low sodium • Diabetic (ADA) • Low fat • Bland • Mechanical soft • Pureed
Diets commonly ordered in diet therapy for residents #2 • Full liquid diet • Clear liquid • Soft
Liquids and foods allowed for the “special” hospital diets-Role of NA • See that the residents received the diets ordered • Report any problems • Assist the doctors and nurses in evaluating a resident’s fluid balance • Calculate and record resident’s food intake
Proper technique for feeding residents • Provide a comfortable and enjoyable atmosphere • Providing feeding assistance • Serving resident’s in their room • Serving resident’s in dining room
Prevention of choking • Close supervision when eating • Follow resident’s individual feeding plan • Cut food into small pieces • Proceed at the resident’s pace • Sit down while feeding the helpless resident
Recognition of signs of choking • Inability to speak • coughing
Dietary modifications affiliated with religious cultures • No pork-Jews • No coffee, tea, alcohol-Mormon, Seventh Day Adventist • No milk products-Asian • No beef-East Indian • No alcohol, pork-Muslim
Alternative ways to administer nutrition • Tube feedings • Intravenous infusion
Terminology #2 • Integumentary • Dermis • Epidermis • Abrasion • Cyanosis • Excoriation • Decubitus ulcer
Terminology #3 • Necrosis • Urine • Prosthesis • Urinal • Urination • Catheter
Terminology #4 • Feces • Elimination • Fecal impaction • Anal incontinence • Flatulence • Constipation • Diarrhea
Terminology #5 • Ostomy • Colostomy • ileostomy • Stool • Stoma • Defecation
Daily routine care/Early Morning • Offer bedpan/urinal or assist to bathroom • Wash face and hands • Offer oral hygiene • Straighten bed and unit • Position resident for breakfast
Morning care after breakfast • Oral hygiene • Offer bedpan/urinal or assist to bathroom • Bathing • Shaving • Skin care • Dressing • Hair care • Change bed linens
Prepare for mealsLunch and dinner • Offer bedpan/urinal or assist to bathroom • Wash hands/face • Straighten bed/unit • Position for meal
Afternoon care • Offer bedpan/urinal or assist to bathroom • Wash face and hands • Oral hygiene • Grooming as necessary • Change soiled linen • Straighten unit
Evening (HS) care • Offer bedpan/urinal or assist to bathroom • Wash face and hands • Oral hygiene • Change soiled linen • Dress for bed • Back massage • Straighten unit
Benefits of bathing • Cleanliness • Reduce bacteria and germs • Promote skin integrity • Stimulate circulation • Provide movement and exercise • Relaxation • Sense of well-being • Opportunity for communication and observation
Body areas that require bathing • Face • Underarms (axilla) • Hands • Perineal area • Any area where skin folds or creases
Types of baths • Shower • Tub/whirlpool, medicinal • Complete bed bath • Partial bed bath
General guidelines for bathing residents • Check with nurse regarding type of bath • Refer to procedure manual for special baths • Identify skin care products to be used • Check resident’s personal choices • Collect necessary equipment • Provide privacy
General guidelines for bathing residents #2 • Assure adequate comfort • Use comfortably warm water, change it when it becomes soapy, dirty or cold • Bathe areas soiled by fecal material or urine • Wash from cleanest to dirtiest area • Rinse off all soap • Pat skin dry
Safety Guidelines for bathing • Monitor correct water temperature • Use safety equipment • Stay with resident • Use correct body mechanics
Privacy during bathing • Close door • Pull curtain around resident • Only uncover area being washed
Observations to be made during bathing/skin • Color • Rashes • Dryness • Bruises • Odors • Swelling
Observations/Fingernails,toenails,hair,eyes and Mental Status #2 • Presence of nits • Color of sclera • Orientation/alertness • Mood • Attitude
Observations that require reportingskin • Color • New rashes • New bruises, broken skin, bleeding • Unusual odors • Complaints of pain
Observations that required reporting/ Fingernails, hair • New Yellow, thickened nails • New significant hair loss • Flaking • Sore scalp • Nits
Observations that require reportingEyes and Mental status • Redness • Yellowing of sclera • Disorientation • Depression • Development of unresponsiveness
Types of medicinal baths • Bran • Oatmeal • Starch • Sodium bicarbonate • Epsom salts • Pine products • Sulfur • Salt
Purposes of medicinal baths • Soothing sedation • Relief of pruritis • Relief of skin disorder (dry skin, irritation, rash)
Oral hygiene / Purpose • Cleanliness of mouth and teeth • Prevent mouth odor and infection • Prevent tooth loss • Comfort • Pleasant taste • Improve taste of food
Oral hygiene / When to perform • On awakening • After each meal • Bed time
Oral hygiene / Special circumstances • Unconscious • Mouth breather • O2 • NG tube • Elevated temperature
Steps of oral hygiene • Carry out procedure using standard precautions • Examine oral cavity and report findings
Steps in cleaning and care of dentures • Use standard precautions • Examine oral cavity and report findings
Nurse assistant role for resident nail care • Easier to clean after soaking in warm, soapy water • Be cautious to prevent damage to tissues • Report unusual conditions to nurse • Follow facility procedure
Nurse assistant role / caring for hair • Part of daily care • Important for identity and self-esteem • Accommodate resident preferences for style, hair products