Summary ATI NUTRITION PROCTORED FOCUSED REVIEW-LATEST

- ATI Rationale with Additional/Supported Information PART 1: GENERAL NOTES (Important Facts) Vitamin B12 is for pernicious anemia Ferrous sulfate for iron deficiency 18.5-24.9 bmi is healthy weight Below 18.5 BMI is underweight 25-29.9 is overweight 30 BMI or greater is obese rangea 10-20 is normal BUN level 200 is ok for blood glucose Celiac disease remove any gluten from diet, wheat rye and barley Pregnant woman increase iron to be able to promote RBC growth to fetus Stomatitis you want to avoid spicy, acidic foods and salty foods • 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). 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! ................................................................................................CONTINUE.