ATI Nutrition Proctored

Part 1: General Notes

Part 2: Focused Review Notes

Part 3: ATI Rational with Additional/Supported Information

PART 1: GENERAL NOTES (Important Facts)

• Be wary of questions regarding children drinking too much milk i.e. more than 3-4 cups of milk

each day. Too much milk intake reduces intake of other essential nutrients, especially iron.

Watch for anemia with milk-aholics.

• Vitamin D’s presence is required by the parathyroid gland, in order for it to function.

• If the patient is taking digoxin or K-supplements, avoid salt substitutes because many are

potassium based

• Potassium Sources: bananas, potatoes, citrus fruits

• No milk (as well as fresh fruit or veggies) on neutropenic precautions.

• Nondairy sources of calcium include RHUBARB, SARDINES, COLLARD GREENS 24

• Nonfat milk reduces reflux by increasing lower esophageal sphincter pressure

• Yogurt has live cultures, so do not give to immunosuppressed patients

• No phenylalanine with a kid positive for PKU (no meat, no dairy, no aspartame).

• Acid Ash diet: cheese, corn, cranberries, plums, prunes, meat, poultry, pastry, bread

• Alk Ash diet: milk, veggies, rhubarb, salmon

PART 2: Focused Review Notes

Manifestations of Vitamin A Toxicity

 Can cause teratogenic effects on fetuses

 Blurred vision

 Bone pain or swelling

 Hypercalcemia

 ICP

 Liver damage

 Skin peeling, itching

 Nausea and vomiting

 Abnormal softening of the skull bone (children) and bulging fontanels

Planning Care for a Client Who Follows Seventh-Day Adventist Dietary Laws

 Vegetarianism

o Do not consume animal products of any type INCLUDING eggs and milk

products.

o Vitamin B12 and Vitamin D supplements may be needed with a pure vegan diet.

 Vegan diets are adequate in protein due to intake of nuts and legumes (dried peas and

cooked beans).

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Initiating Continuous Enteral Feeding

 This is recommended for critically ill patients because it is associated with small residual

volumes, and a lower risk of aspiration and diarrhea.

 Residual volumes should be measures q4-6hrs.

 Feeding tubes should be flushed with water q4hr to maintain patency and hydration.

 If patient’s gastric volume exceeds 500ml, the continuous feeding should be HELD and

tolerance reassessed.

o In children, residual volumes should be measured and held if the amount is equal

to or greater than ¼ the prescribed feeding amount.

 Residual should be returned and the amount rechecked in 30min to 1hr.

Recommendations for Nutritional Supplement

 Add skim milk to powder milk (double strength milk)

 Use whole milk instead of water recipes

 Add cheese, peanut butter, chopped hard-boiled eggs, yogurt.

 Dip meats in eggs or milk and coat with bread crumbs before cooking.

 Nuts and dried beans are significant sources of protein  great alternatives to dairy

allergy or lactose intolerance!

Assessing Caloric Intake

 Toddlers: 1 to 3 years old

o Limit 100% juice 4 to 6oz a day

o The 1 to 2-year-old requires whole cow’s milk to provide adequate fat.

o Food serving size is 1 tablespoon for each year of age.

 Preschoolers: 3 to 6 years old

o Preschoolers need 13 to 19 g/day of complete protein.

o 1 tablespoon per year of age for size of foods.

o May switch to skin or 1% low-fat milk after 2 years.

 School-Age Children: 6 to 12 years old

o Weight loss program is directed for children 40% overweight.

 Adolescence

o Energy requirements average 2,000 calorie/day for a 12 to 18-year-old female.

o Energy requirements average 2,200 to 2,800 calorie/day for a 12 to 18-yearold male.

o Average U.S. adolescent consumes a diet deficient in folate, vitamin A and E,

iron, zinc, mag, calcium, and fiber.

 Adulthood and older adulthood

o Need a balanced diet that consists of 40% to 55% carbs, and 10-20% fat (with

no more than 30% fat).

o A 24 hr dietary intake is helpful in determining the need for dietary education.

- Use whole grains, select orange and dark green leafy vegetables, avoid fruits with added

sugar (make half your plate vegetables and fruits), use vegetable oils, 132-362

discretionary calories are permitted per day.

MEN CALORIE INTAKE WOMEN CALORIE INTAKE

19 to 30 years old: 2,400 calories 19 to 30 years old: 2,000 calories

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