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NUTRITION (营养)
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PYRAMID POINTS

• Dietary (饮食) measures required for basic needs and for particular body system alterations

• Client diagnosis and the particular requirement or restriction necessary for treatment of the disorder

• Common types of therapeutic diets, nutrients contained in food items, and enteral (肠) feedings

• Diabetic exchange system

• Lifestyle choices

• Food preferences

• Sociocultural or religious considerations

• Religious or cultural influences on health

CARBOHYDRATES (碳水化合物)

• The preferred source of energy

• Promote normal fat metabolism, spares protein, and enhance lower gastrointestinal (GI) function

• Major food sources include milk, grains, fruits, and vegetables

• Inadequate carbohydrate intake affects metabolism

FATS (脂肪)

• Provide a concentrated source and a stored form of energy

• Protect internal organs and maintain body temperature

• Enhance absorption of the fat-soluble vitamins

• Inadequate fat intake leads to clinical manifestations of sensitivity to cold, skin lesions, increased risk of infection, and amenorrhea (闭经) in women

• Diets high in fat can lead to obesity and increase the risk of cardiac disease and some cancers

PROTEINS (蛋白质)

• Made from amino acids and are critical to all aspects of growth and development of body tissues

• Build and repair body tissues, regulate fluid balance, maintain acid-base balance, produce antibodies, provide energy, and produce enzymes and hormones

• Essential amino acids (EAAs) are required in the diet because the body cannot manufacture them

• High-quality proteins or complete proteins such as eggs, dairy products, meat, fish, and poultry contain adequate amounts of EAAs

• Foods that do not contain the EAAs in sufficient amounts are lower quality or incomplete proteins

• Inadequate protein can cause protein energy malnutrition (营养不良) , and severe wasting of fat and muscle tissue

VITAMINS (维生素)

• Facilitate metabolism of proteins, fats, and carbohydrates; act as a catalyst for metabolic functions; promote life and growth processes; and maintain and regulate body functions

• Fat-soluble vitamins (脂溶性维生素) A, D, E, and K can be stored in the body, so an excess can cause toxicity

• The B vitamins and vitamin C are water-soluble, are not stored in the body, and can be excreted in the urine

• Vitamin K acts as a catalyst for facilitating blood-clotting factors, especially prothrombin (凝血素)

• Vitamin C produces collagen (胶原质) , a vital component in wound healing

• Vitamin A maintains eyesight and epithelial (上皮) linings

FOOD SOURCES OF VITAMINS

WATER SOLUBLE

• Vitamin C (ascorbic acid): Citrus fruits, tomatoes, broccoli, cabbage

• Vitamin B 1 (thiamine): Pork and nuts, whole-grain cereals, and legumes

• Vitamin B 2 (riboflavin): Milk, lean meats, fish, grains

• Niacin: Meats, poultry, fish, beans, peanuts, grains

• Vitamin B 6 (pyridoxine): Yeast, corn, meat, poultry, fish

• Vitamin B 12 (cobalamin): Meat, liver

• Folic acid: Green leafy vegetables, liver, beef, fish, legumes, grapefruit, and oranges

FOOD SOURCES OF VITAMINS

FAT SOLUBLE

• Vitamin A: Liver, egg yolk, whole milk, green or orange vegetables, fruits

• Vitamin D: Fortified milk, fish oils, cereals

• Vitamin E: Vegetable oils, green leafy vegetables, cereals, apricots, apples, and peaches

• Vitamin K: Green leafy vegetables, cauliflower, and cabbage

MINERALS (无机盐)

• Components of hormones( 激素 ), cells, tissues, and bones

• Act as catalysts (矿物质) for chemical reactions and enhancers of cell function

• Almost all foods contain some form of minerals

• A deficiency of minerals can occur in chronically ill clients or in clients who are hospitalized

FOOD SOURCES OF MINERALS

CALCIUM (钙)

• Yogurt, low-fat

• Milk

• Rhubarb

• Collard greens

• Cheese

• Tofu

• Spinach, broccoli, green beans, carrots

MAGNESIUM (镁)

• Green leafy vegetables

• Avocado

• Canned white tuna

• Milk, low-fat yogurt

• Cooked rolled oats

• Cauliflower, peas, potatoes

• Pork, beef, chicken

• Raisins

• Peanut butter

PHOSPHORUS (磷)

• Fish

• Pork, beef, chicken

• Organ meats

• Nuts

• Whole-grain breads and cereals

POTASSIUM (钾)

• Avocado

• Raisins

• Pork, beef, veal, fish

• Bananas, cantaloupe, oranges, strawberries

• Carrots, mushrooms, potatoes, spinach

• Tomatoes

SODIUM (钠)

• Table salt

• Soy sauce

• Cured pork, bacon, frankfurters, lunch meat

• Cheese, milk, butter

• White and whole-wheat bread

• Ketchup, mustard

• Canned food, processed food

• Snack food

CHLORIDE

Salt

IRON

Liver, meats, egg yolk, dark-green vegetables, breads and cereals

ZINC

Meats, eggs, leafy vegetables, protein-rich foods

FOOD GUIDE PYRAMID

LEVELS OF THE PYRAMID

• Level one (base of the pyramid)

Bread, cereal, rice, and pasta group

Daily recommendation is 6 to 11 servings

• Level two

Vegetables and fruit group

Daily recommendation is 3 to 5 servings of vegetables and 2 to 4 servings of fruit

• Level three

Includes the milk, yogurt, and cheese group and the meats, poultry, fish, dry beans and peas, eggs, and nuts group

Daily recommendation is 2 to 3 servings for each group

The recommendation for the milk group depends on the various life stage of the individual

• Peak of the pyramid

Includes fats, oils, and sweets

Foods that are high in fats, sugar, or alcohol are to be eaten sparingly because they are kilocalorie-dense (高热量) , nutrient-sparse (低营养) foods

CLEAR LIQUID DIET (清流质饮食)

INDICATIONS

• Serves a primary function of providing fluids and electrolytes (电介质) to prevent dehydration (脱水)

• Initial feeding after complete bowel rest

• Used initially to feed a malnourished person or a person that has not had any oral intake for some time

• Bowel preparation for surgery or tests

• Postsurgical (术后) diet

• Diarrhea (腹泻)

NURSING CONSIDERATIONS

• Clear liquid is deficient in energy and most nutrients

• The body digests and absorbs clear liquids easily

• Contributes to little or no residue (残渣) in the GI tract

• Can be unappetizing (引不起食欲) and boring (厌食)

• Client should not stay on a clear liquid diet for more than a day or two

• Consists of foods that are relatively transparent (透明) to light, and are clear and liquid at room and body temperature

• Foods include such items as water, bouillon (肉汤) , clear broth, carbonated beverages (碳酸饮料) , gelatin, hard candy, lemonade (柠檬水) , popsicles (棒冰) , and either regular or decaffeinated (去咖啡因) coffee or tea

• The nurse should limit the amount of caffeine consumed by the client because caffeine can cause an upset stomach and sleeplessness (失眠)

• Client may have salt or sugar

• Dairy products are not allowed

FULL LIQUID DIET (全流质)

INDICATION

May be used as a second diet after clear liquids following surgery or for the client who is unable to chew (咀嚼) or swallow (吞咽)

NURSING CONSIDERATIONS

• Nutritionally deficient in energy and most nutrients

• Includes both clear and opaque liquid foods and those that liquefy at body temperature

• Foods include all clear liquids and such items as plain ice cream, sherbet, breakfast drinks, milk, pudding and custard (奶冻) , soups that are strained (过滤) , and strained vegetable juices

SOFT DIET

INDICATIONS

• Used for clients with dental problems, clients with poorly fitting dentures, and clients who have difficulty chewing or swallowing

• Used for ulcerations (溃疡) of the mouth or gums (齿龈) , oral surgery, broken jaw (颚裂) , plastic surgery (整形手术) of the head or neck, dysphasia (言语障碍) , or for the stroke (休克) client

• Therapeutic for clients with impaired digestion and/or absorption due to conditions such as ulcerative colitis (溃疡性结肠) and Crohn's disease