RLE 10

• Nutritional status is a key element for overall health.
• Good nutrition is important for everybody system.
• The responses are collected as students file out of the classroom.
• At the end of the class, students are asked to use index cards or half-sheets of paper to provide written feedback on the most useful or meaningful thing they have learned and any questions they have as the class ends.
• The responses are responded to during the next class meeting or as soon as possible.
• Poor nutrition may be a problem in itself, for example, lack of vitamin D can cause rickets.
• Poor nutrition may also exacerbate an underlying disease, for example, diabetes mellitus or cardiovascular disease.
• Low protein reserves will impede healing, for example, from a surgery.
• Poor nutrition children may contribute to daily growth and cognitive issues in school.
• Hydration status is critical to every patient's health.
• Under- or over- hydration can accompany disease, medical treatment, and environmental conditions.
• The patients can die or suffer serious complications if alterations in hydration are not recognized immediately.
• Assessment of Dehydration and Overhydration is done through a health assessment which includes physical examination and history taking.
• Heat stress or sustained vigorous physical activity can lead to dehydration, which can be prevented by free water consumption or purposeful drinking.
• Patient’s BMI is a factor in determining health risks.
• For adults older than the age of 50, increasing foods rich in vitamin B6 and iron is recommended.
• Obesity-related risk factors include infertility, hypermenorrhea, polycystic ovarian syndrome, type 1 diabetes, and androgenicity.
• Anorexia nervosa can lead to severe cognitive disorder, increased corticotrophin-releasing factor, tachycardia, and decreased BUN.
• The recommended daily allowance for sodium is 2400 mg/day.
• Maintaining a healthy weight can be achieved through 15 minutes per day of physical activity at a moderate intensity, 30 minutes per day of physical activity at a moderate intensity, 45 minutes per day of physical activity at a moderate intensity, or 60 minutes per day of physical activity at a moderate intensity.
• Dietary changes can be appropriate to recommend for patients with hypertension.
• Weight gain occurs when caloric intake exceeds caloric expenditure over time and typically appears as increased body fat.
• Hypothyroidism can cause fluid accumulation.
• Weight loss can be due to decreased intake of food for reasons such as anorexia, dysphagia, vomiting, diarrhea, malabsorption of nutrients, allergic reaction to food, problem with mastication, food aversion, peer pressure, poor food choices, inability to cook, poor cooking habits, inability to access food stores, lack of financial resources.
• Dehydration is defined as deficient fluid volume (DFV) and its symptoms include thirst, diaphoresis, vomiting/diarrhea.
• Overhydration is defined as excess fluid volume (EFV) and its signs include short term weight gain, edema, increased BP, decreased or bounding pulse.
• In the general assessment, the nurse assesses nutrition during the Review of Systems (ROS) and Health Patterns.
• Common or concerning symptoms of dehydration include changes in weight, usually unintended, anorexia, changes in the sense of taste or smell, difficulty of chewing or swallowing.
• Short-term weight loss, dry mucous membranes, sunken eyes, decreased skin turgor, fever, decreased blood pressure and pulse pressure, increased pulse rate in decreased pulse amplitude, decreased urine output and increased specific gravity, decreased venous filling, alteration in mental status, and weakness are signs of dehydration.
• The patient's body mass index (BMI) can be calculated from the height and weight.
• This must be taken into account before assuming the patient is obese or overweight.
• Individuals with large muscle mass may have falsely high calculated BMI.
• The proportion of height to weight can indicate whether the patient is over or underweight.
• Skin, hair, and nails are examined in the head, ears, eyes, nose, and throat (HEENT) examination.
• Eating disorders, obesity-related risk factors and diseases, nutrition counselling, and patients with hypertension are discussed on page 166-169.
• Respiratory, cardiovascular and peripheral vascular, gastrointestinal, neurologic examinations are also conducted.
• Conditions that contribute to dehydration include exposure to excessive heat, excessive exercise in heat, decreased mobility ability to drink, medications (diuretics), vomiting and diarrhea, burn injuries, hemorrhage, jugular vein distention, S3 heart sound, fine crackles in the lungs, dyspnea, alteration in mental status, and urine output and urine specific gravity may be decreased or increased depending on diagnosis.
• Conditions that contribute to overhydration include heart failure, kidney failure, liver disease, increased sodium intake, and excessive intravenous fluid.
• Signs of poor nutrition may occur in any body system and usually by the time a sign appears the condition is fairly severe.
• The nurse looks for signs of nutritional problems and hydration problems during the general head-to-toe physical examination.