Clinical Nutrition and Dietetics Manual for Nurses V Supriya
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ge1Clinical Nutrition and Dietetics Manual for Nursesge2
ge3Clinical Nutrition and Dietetics Manual for Nurses
Author Dr. V Supriya MSc MPhil RD PhD Lecturer Department of Clinical Nutrition Sri Ramachandra University Porur, Chennai, Tamil Nadu, India Foreword Dr. Lalitha Ramaswamy MSc PhD
ge4
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Clinical Nutrition and Dietetics Manual for Nurses
First Edition: 2017
9789386150332
Printed at
ge5Dedicated to
My family members and friends for their continued love and supportge6
ge7Foreword
Nutrition is important for the well-being of all people. Basic knowledge of nutrition helps individuals select foods that are required to provide adequate nutrients to maintain health. Changes in lifestyle pattern and the flooding of the market with commercial foods have resulted in faulty food habits and increase in the incidence of noncommunicable diseases.
The author has dealt with the subject of nutrition in a simple, yet comprehensive, manner, which enables the reader understand the basic concepts of nutrition. The chapters on food preservation and safe handling of foods will go a long way in promoting the consumption of nutritious and safe foods. Basic concepts of food groups, recommended dietary allowance, making healthy food choices for various age groups, food budgeting, and menu planning are summarized well. The objectives and functions of the various national and international programs are outlined and will serve to understand the role of the organizations in combating malnutrition. The book creates new avenues for nutrition counseling of the patients and the public. The reader will be able to impart the knowledge gained from the facts presented in the book to the society as well as apply it in his/her own life.
The book authored by Ms V Supriya of the Department of Clinical Nutrition, Sri Ramachandra University, who has a long-standing academic and practical experience on clinical nutrition practices provides all the information required by the nurses to tackle the nutrition problems of patients. The book is a valuable guide for the nursing students and practitioners. It communicates effectively the factors related to the role of food, nutrients and diet. The book will help meet the syllabus of nursing course and overcome the challenges of the nursing field. It can be recommended as a textbook for the nursing students for their nursing course.
Dr. Lalitha Ramaswamy MSc PhD
Associate Professor and Head
Department of Nutrition and Dietetics
PSG College of Arts & Science
Coimbatore, Tamil Nadu, Indiage8
ge9Preface
Clinical Nutrition and Dietetics is an emerging field of biological sciences. It is a health-related career that actually transforms the nutrition and food science into the promotion of health. We exist in a modern civilization, where many do not bother about the foods they consume on a day-to-day basis. Many noncommunicable diseases were proved to be preventable through diet. “Let food be thy medicine and medicine be thy food”—as said by Hippocrates forms the basis for a lot of therapeutic conditions. By this means, understanding of clinical nutrition becomes essential for a health practitioner, who handles patients.
Clinical Nutrition and Dietetics Manual for Nurses is written for the nursing students who are not majoring in nutrition, but would like to gain knowledge about the essential features of nutrition and how it applies to their own lives. This book will not only serve as a standalone text for nursing students, it might also provide as a practical up-to-date resource for the practicing dietitians and a good supplementary text for the nutrition students as well.
The topics dealt cover the syllabus of Indian Nursing Council (INC). The entire syllabus is segregated into 13 chapters. Each chapter has an abstract and chapter objectives to present the students with a brief understanding of the contents. Every chapter ends with activities or exercises that help in the revision of the chapter learnt and could be utilized as homework or assignment. Also, a question bank prepared, based on the university pattern, would really benefit the students from examination point of view. Menu plans for life cycle and therapeutic conditions would be particularly of great help to the nursing students as they carry on with their clinical postings and manage the patients in the wards. The glossary of terms have been highlighted within each chapter for effortless understanding of the biological terms used in this text.
Chapter 1 highlights on the basic nutrition and its concepts of health, wellness and disease. Essential classification of foods, and National Health Policy are introduced in this unit. Chapters 2, 3, 4 and 5 cover the macronutrients, such as carbohydrates, proteins, fats and energy respectively. Their functions, sources, digestion, absorption and their importance in human health are effectively brought out with appropriate illustrations and examples. Chapters 6 and 7 highlight the micronutrients, such as vitamins and minerals. Micronutrient deficiencies, highly prevalent in India among vulnerable population, have to be understood clearly by the health care professionals. Water, the elixir of life, is predominantly covered in chapter 8. Electrolyte imbalances, and their management from a nurse's perspective are clearly spelled out in chapter 8. Safe food handling, food adulteration, preservation of foods, different methods of cooking form the vital components of chapter 9. Nutrition therapy for special circumstances is proved by evidence-based practice. Appropriate menu planning, budgeting menus for diversified age groups and their recommendations are compiled in chapter 10.
Nutritional status assessment through four techniques, such as anthropometry, biochemical, clinical and diet history are explained in detail with color images emphasizing their essenge10tialities. Chapter 11, therefore, would not fail to grab the attention of health care practitioners to understand the basic techniques of nutrition care process involved. Therapeutic cases and their medical nutrition therapy highlighted in a brief manner would be a cakewalk for the beginners of nutrition. Sample Menus provided would create curiosity even for a layman to go through chapter 12. Specialized nutrition support, such as enteral and parenteral nutrition, a vital part of nurse's profession, is explained in a comprehensive manner with good illustrations. The final chapter covers the actual role of a nurse in nutrition education programs both in health care setting as well as a community, thus highlighting the significance of food, nutrition and health.
I wish the reader of this book a very good learning experience!!
Dr. V Supriya
ge11Acknowledgments
“Every individual matters, every individual has a role to play, every individual makes a difference.” As the saying goes, there are a number of people whom I would like to thank for their efforts in making this valuable book.
First of all, I am grateful to the Almighty for giving me courage and patience to successfully compile this book.
I wish to express my sincere thanks to the Chancellor, Shri V.R. Venkataachalam, and Dean of Faculties, Professor K.V. Somasundaram and entire management team of Sri Ramachandra University, Chennai, India for being instrumental in bringing out innovative ideas into action.
I am deeply indebted to my mentors Ms. Bhavani Pazhani, and Dr. T.R. Gopalan for being such a great inspiration and constant encouragement to my professional achievements.
I owe my heartfelt gratitude to Dr. Lalitha Ramaswamy, my guide and well-wisher for providing me with an excellent foreword for this textbook.
Sincere appreciation goes to my beloved Head of the Department, Dr. A.J. Hemamalini and my colleagues for their generous support and valuable suggestions.
I express my sincere thanks to my beloved friends Ms. Aarifa Nisar, and Ms. Kezia Nithiyan for all their love, support and motivation throughout the project.
Thanks are due to many of my students, past and present, who have helped in the contribution of images and menu plans.
I bestow all my respect to my parents, Shri C. Velraja, and Smt. V. Saroja, and my sister Ms. Selvarani for their everlasting love, continued support, and constant prayers for all my accomplishments.
I owe a lot to my husband, Mr. Ayyakannan, my little bundle of joy, Baby Ribuvanth, and my niece and nephew for their understanding, and continuous encouragements in all my endeavors.
I convey my sincere thanks to Jaypee Brothers Medical Publishers, New Delhi, India for their efforts and suggestions, especially Shri Jitendar P. Vij (Group Chairman), Mr. Ankit Vij (Group President), Ms. Chetna Malhotra Vohra (Associate Director–Content Strategy) and Ms. Ruby Sharma (Project Manager) for helping me through my idea.
Lastly, my deepest gratitude to one and all who, directly or indirectly, have lent their helping hands in this venture.ge12
ge13INC Syllabus
Placement: First Year
Time: Theory 60 hours
Course Description: The course is designed to assist the students to acquire knowledge of nutrition for maintenance of optimum health at different of life and its application for practice of nursing.
Unit
Time (Hrs)
Learning objectives
Content
Chapters
Th.
Pr.
I
4
 
  • Describe the relationship between Nutrition and Health
Introduction
  • Nutrition:
    • History
    • Concepts
  • Role of nutrition in maintaining health
  • Nutritional problems in India
  • National nutritional policy
  • Factors affecting food and nutrition: socio-economic, cultural, tradition, production, system of distribution, life style and food habits, etc.
  • Role of food and its medicinal value
  • Classification of foods
  • Food standards
  • Elements of nutrition: macro and micro
  • Calorie, BMR.
1
II
2
 
  • Describe the classification, functions, sources and recommended daily allowances (RDA) of carbohydrates
Carbohydrates
  • Classification
  • Caloric value
  • Recommended daily allowances
  • Dietary sources
  • Functions
  • Digestion, absorption and storage, metabolism of carbohydrates
  • Malnutrition: Deficiencies and over consumption
3
ge14
III
2
 
  • Describe the classification, functions, sources and recommended daily allowances (RDA) of fats
Fats
  • Classification
  • Caloric value
  • Recommended daily allowances
  • Dietary sources
  • Functions
  • Digestion, absorption and storage, metabolism
  • Malnutrition: Deficiencies and over consumption
5
IV
2
 
  • Describe the classification, functions, sources and recommended daily allowances (RDA) of proteins
Proteins
  • Classification
  • Caloric value
  • Recommended daily allowances
  • Dietary sources
  • Functions
  • Digestion, absorption metabolism and storage
  • Malnutrition: Deficiencies and over consumption
4
V
3
 
  • Describe the daily calorie requirement for different categories of people
Energy
  • Unit of energy–Kcal
  • Energy requirements of different categories of people
  • Measurements of energy
  • Body mass index (BMI) and basic metabolism
  • Basal metabolic rate (BMR)
    • Determination and factors affecting
2
VI
4
 
  • Describe the classification, functions, sources and recommended daily allowances (RDA) of vitamins
Vitamins
  • Classification
  • Recommended daily allowances
  • Dietary sources
  • Functions
  • Absorption synthesis, metabolism storage and excretion
  • Deficiencies
  • Hypervitaminosis
6
ge15
VII
4
 
  • Describe the classification, functions, sources and recommended daily allowances (RDA) of minerals
Minerals
  • Classification
  • Recommended daily allowances
  • Dietary sources
  • Functions
  • Absorption synthesis, metabolism storage and excretion
  • Deficiencies
  • Over consumption and toxicity
7
VIII
3
 
  • Describe the sources, functions and requirements of water & electrolytes
Water and electrolytes
  • Water: Daily requirement, regulation of water metabolism, distribution of body water
  • Electrolytes: Types, sources, composition of body fluids
  • Maintenance of fluid & electrolyte balance
  • Over hydration, dehydration and water intoxication
  • Electrolyte imbalances
8
IX
5
15
  • Describe the Cookery rules and preservation of nutrients
  • Prepare and serve simple beverages and different types of foods
Cookery rules and preservation of nutrients
  • Principles, methods of cooking and serving
    • Preservation of nutrients
  • Safe Food handling-toxicity
  • Storage of food
  • Food preservation, food additives and its principles
  • Prevention of food adulteration Act (PFA)
  • Food standards
  • Preparation of simple beverages and different types of food
9
X
7
5
  • Describe and plan balanced diet for different categories of people
Balanced diet
  • Elements
  • Food groups
  • Recommended daily
10 and 12
ge16
 
 
 
 
Allowance
  • Nutritive value of foods
  • Calculation of balanced diet for different categories of people
  • Planning menu
  • Budgeting of food
  • Introduction to therapeutic diets: Naturopathy—Diet
 
XI
4
 
  • Describe various national programmes related to nutrition
  • Describe the role of nurse in assessment of nutritional status and nutrition education
Role of nurse in nutritional programmes
  • National programmes related to nutrition
    • Vitamin A deficiency programme
    • National iodine deficiency disorders (IDD) programme
    • Mid-day meal programme
    • Integrated child development scheme (ICDS)
  • National and International agencies working towards food/nutrition
    • NIPCCD, CARE, FAO, NIN, CFTRI (Central food technology and research institute) etc.
  • Assessment of nutritional status
  • Nutrition education and role of nurse
11 and 13