Technical center for higher education

Coclé Regional University Center

Nursing Technician
A-22 group D

nutrition
summary
NUTRITIONAL MANAGEMENT IN PATIENT DISEASES

teacher;

Prepared by

Maria Victoria Ramos Gonzalez

2-752-2134
Summary

NUTRITIONAL MANAGEMENT IN PATIENT DISEASES

 Nutritional management of obesity, hypertension and metabolic syndrome

Throughout human history, gaining weight and storing fat have been seen as signs of health and
prosperity. However, today's lifestyles have changed and food production and quality of life have
increased, which has significantly increased weight gain and obesity has become a threat to health.

 Obesity
Obesity is a condition of abnormal fat accumulation in adipose tissue, to a degree that affects
health.
It is a chronic disease with high prevalence, affecting both adults and children.
For a useful diagnosis, it is necessary to differentiate the type of abdominal fat distribution
or android obesity, which is known as gynoid distribution or inferior type.
The body mass index (BMI) is used to measure obesity in the population, using body
weight (kg) and height (m).
BMI = weight (kg) / height (m2)

The health consequences of obesity are diverse and range from an increased risk of
premature death to a range of disorders that significantly affect quality of life. It is a risk
because it can cause cancer, cardiovascular diseases, and have consequences such as
diabetes.

Obesity treatment is based on 4 strategies:

Preventing weight gain
Maintaining proper weight
Management of associated diseases
Reducing body weight

For dietary intervention to be effective, a well-structured, balanced and varied dietary plan
must be created with the aim of reducing calories and modifying alterations in the eating
pattern.

Diet therapy for the obese patient:

It is necessary to study eating habits before dietary treatment. Carbohydrates should

be complex and have a low glycemic index.
In children and adolescents, it is about containing the gain and not letting it reduce;
during growth and development it is necessary to consume energy and nutrients to
achieve normal development.
It is always good to promote physical activity,

 High blood pressure

 Arterial hypertension (HTN) is a risk factor for cardiovascular diseases in general and in
itself. It is associated with weight gain and insulin resistance.
The treatment of hypertension is adapted to the patient according to the blood pressure
levels they present.
Caffeine intake increases blood pressure levels sharply.

 The ingestion of foods with high tyramine content should be limited.

 Reducing sodium in the diet
 Weight reduction
 Increase the intake of foods rich in potassium, magnesium and calcium

 Metabolic syndrome
Metabolic syndrome (MS) is a risk factor for cardiovascular diseases.
The most frequent combination of symptoms of MS is obesity with hypertension or
dyslipidemia. Treatment involves therapeutic changes in lifestyle, diet and exercise.
Individuals with MS have a higher risk of presenting an acute vascular event.

Dietary management of patients with MS is based on the identified risk factors.

 For the treatment of MS dyslipidemia, a diet low in saturated fats is recommended,
with a higher proportion of mono and polyunsaturated fats.
 If it is an increase in triglycerides, the type of treatment to be performed must be
evaluated.

 Adult-onset diabetes
Diabetes mellitus (DM) is currently a serious problem for global public health. DM is a chronic
disease, with different causes, characterized by hyperglycemia, as a result of a deficit in insulin
secretion.

Type 1 diabetes is less common and is associated with an absolute insulin deficiency, generally
due to autoimmune destruction of the beta cells of the pancreas. There is no evidence that
lifestyle factors can reduce the risk.

Type 2 diabetes is responsible for the majority of diabetes cases in the world. It occurs when
insulin production is not sufficient to compensate for the underlying abnormality, creating
increased resistance to its action.

Children born to people with type 2 diabetes tend to be large and have a large birth weight, which
makes them more likely to develop obesity and be exposed to suffering from type 2 diabetes at an
early age.

Dietary treatments for DM:

Minimize blood sugar fluctuations
Provide a balanced diet
Promote a healthy weight
 Avoid vascular complications
Achieving a good quality of life
Normalize blood pressure and plasma lipids

Although dietary treatment should be individualized, the diet should depend on the
socioeconomic situation and especially on physical and work activity.

It is important to note that we should not talk about a diabetic diet, but rather a group of
recommendations, so that the team that cares for the patient can better plan the diet and
physical activity program, accompanied by drug treatment.

 Macro and micronutrients

 Carbohydrates should be consumed at least 66% slowly, such as in vegetables,
cereals and legumes, which prevent blood sugar levels from rising after ingestion.
 Protein intake should be 10 to 20% of total energy, in order to reduce the morbidity
of nephropathy.
 Fats, saturated fats and cholesterol intake should be limited due to the predisposition
of diabetic patients to dyslipidemia and atherosclerotic vascular disease.
 Dietary fiber, a diet rich in fiber improves glycemic control
 Vitamins and minerals. The way to obtain antioxidants is through foods rich in
vitamins and minerals, especially fruits and vegetables.
 Alcohol is allowed in small or moderate amounts, it should not be consumed on an
empty stomach or in excessive amounts, as it causes severe hypoglycemia.
 Glycemic index of foods
The glycemic index (GI) refers to the increase in blood sugar caused by different foods.
The IG is influenced by various factors, such as the degree of intestinal absorption, which
depends on the composition and susceptibility to enzymatic digestion of carbohydrates in
foods.

 Acute and chronic diarrhea, nutritional management

Diarrhea: is defined as a sudden increase in the number of bowel movements, an increase in the
usual volume. It is a common symptom of several diseases and a frequent reason for medical
consultation.
Diarrhea can be:
 Acute (3-7 days)
 Persistent (15 days)
 Chronicles (more than 15 days)

Classification

 Secretory diarrhea

Diarrhea not associated with an exogenous secretagogue may present secretory components. These
are usually watery and large in volume, and persist even if no food is consumed orally.

 Osmotic diarrhea
Osmotic diarrhea is usually smaller in volume and disappears with fasting.
Treatment
 Acute diarrhea:
 Consumption of the responsible food or drug should be discontinued.
 Provide adequate fluid and electrolyte intake
 Rehydration should be based on the replacement of the amount of water.
 Modify diet for comfort.

 Chronic diarrhea
 Low fat diet
 Diet high in dietary fiber
 Gluten-free diet

 Dietetic care in patients with chronic kidney disease

Patients with chronic kidney disease present some degree of malnutrition, whether due to
restrictive diets, anorexia, gastritis, hypercatabolism, dialysis, etc. For this reason, it is
necessary to receive food and nutritional support.

For the care of chronic kidney patients, it is necessary to have an individual identification
between the diagnosis and the clinical and nutritional status.
Diet should be balanced and varied, providing sufficient amounts of energy and other nutrients
necessary for the body.
The losses that exist due to chronic inflammatory processes and repeated infections require a
high-calorie diet with specific protein intakes depending on the disease and with the necessary
amounts of carbohydrates and fat to satisfy energy needs.
It is preferable to consume fat from plant sources and cholesterol can be consumed without
exceeding 300 mg per day. The administration of vitamins and minerals is according to needs.
The amount of sodium and potassium should be limited.

Most foods can be consumed, taking into account the quantities indicated in the prescribed
diet.
To consume food, the content should be reduced, avoiding the consumption of canned foods,
sausages, very salty fish

Patients on hemodialysis should maintain a nutritional value approximately

Energy 2600 kcal Potassium 2700 mg

Fat 26% (80 g) Sodium 1 to 3 g
Protein 12% (90g) Phosphorus 1200 mg
Cho 60% (390g)

It should be noted that 3 dialysis sessions are performed each week, each one should occupy
up to 2 feeding frequencies, in food consumption during this procedure provides energy and
nutrients that patients need.

 Nutritional impact on cancer patients, dietary management

 Most patients are in need of nutritional support, since there are multiple factors that affect
nutritional status.
Malnutrition is a risk factor that directly affects immunocompetence, alters wound repair
mechanisms, promotes fatigue and respiratory and cardiovascular mechanisms.
Cancer patients who present malnutrition are identified for different factors that contribute to it:
 Effects of the tumor
 Related to treatment
 Psychological and central nervous system
 Other causes

The assessment of nutritional risk in cancer patients is complex since not only nutritional aspects
must be taken into account, but also those related to the tumor.

Carbohydrates, proteins, lipids, trace elements and vitamins are necessary considering the
hypercatabolic state that is presented, and in small children the formation of CNS structures.

To ensure adequate nutrition, it is necessary to control the most frequently occurring symptoms:

 Oral symptoms
 Mucositis/stomatitis
 Xerostamia
 Treatment
 General: An oral hygiene routine is necessary to reduce the incidence and severity of
complications of cancer treatment.
 Treatment of infections: in case of bacterial or viral infection, treatment with antibiotics or
antivirals is necessary.

When a patient cannot eat but the digestive system can still function, tubes are used.

Water or liquids should always be administered to meet the patient's hydration needs and help
maintain hygiene.