Nutritional Needs & Supplements Fluids Electrolytes Total Parenteral Nutrition Natural Supplements

1. Nutritional Supplements
Fluids, Electrolytes
Vitamins, Minerals
Total Parenteral Nutrition
Natural Supplements, Herbs

3. Basic Nutrition Categories
 Macronutrients
 Carbohydrates
 Proteins
 Fats
 Micronutrients
 Vitamins
 Minerals
 Water

4. Carbohydrates (fruit/veg/grains)
 Simple
 Sugars containing no energy yielding calories
 Empty calories (candy)
 Complex Carbohydrates
 Starches take longer to break down in digestive
tract and have more nutritional value than sugars
 Food energy (whole grain bread)
 All carbs are broken down in to glucose

5. Glucose
 Stored in the liver and muscle tissue as
glycogen
 Carbohydrate rich diet needed to
maintain muscle glycogen, preferred fuel
 55% of daily calories complex carb
 10% or less of daily calories from simple
carbs

6. FATS
 Only source for fatty acid linoleic acid that is
essential for growth and skin maintaince
 Provides lubrication & shock absorber, insulates and
protects the body’s organs against trauma & cold
 Energy reserve
 Helps metabolize carbohydrates & proteins
 Manufacture needed cortisol, sex hormones and cholesterol
 Carrier for fat soluble vitamins D,E,A,K
 No more than 30% diet from fat and preferably
monosaturated fat

7.  Saturated
 Solid at room temp/Raise blood cholesterol & LDL
 Animal source and dairy products
 Palm & coconut oils increase cholesterol
 Trans-fatty acids (margarine & packaged foods)
 Unsaturated (monounsaturated & polyunsaturated)
 Liquid at room temp/Lower blood cholesterol
 Mono-unsaturated
 Olive oil, canola oil
 Poly-unsaturated
 Veg oils, nuts, deep water cold fish

8. PROTEIN
 Breaks down into amino acids
 Meat, dairy, fish, beef, chicken and pork
 Incomplete proteins
 Plant based (soy, tofu, beans, peanuts)
 Building Blocks
 For hormones, enzymes, blood-plasma transport
system, repair body cells, tissue and muscle
 Hi protein diets excrete extra Nitrogen, increase
fluid requirements.

9. Vitamins and Minerals
 Solubility
 Water-Carried in blood
stream & excreted
 CB
 Fat-Stored liver &
adipose
 DEAK
 Diseases
 Scurvy (C)
 Ricketts (D)
 Beriberi (B)

10. Minerals
Calcium Iron
 Acetate, carbonate, * keeps O2 in blood
chloride, gluconate * females 18mg
* males 8mg
Others: Na, Zn, K,
Mg, Phosphorus,
Selenium

11. Fluids
 Average water
percentage
 Can we drink too much
water?
 Body weight X 0.6
divided by 12 equals
number of 8 oz. glasses
of H20 per day

12. Electrolytes (mEq)
 Sodium (Na+)
 Retains body fluid &
enzyme activities
 Generate/transmit nerve
impulses & acid/base
balance
 Potassium (K+)
 Cardiac rhythm &
glycogen, enzymes,
conduct nerve impulses
 Chloride (Cl-)
 Transport CO2, form
HCl, retain K,
 Hydrogen (H+)

13. Malnutrition Consequences
 20% reduction in body mass –
moderate
 40% reduction in body mass –
severe
 Marasmus
 Growth retardation due to
imbalance of protein-calorie,
patients thin develops over
months to years
 Kwashiorkor
 Lack of dietary protein
 Poor wound healing
 Immune system suffers
and infection rate rises
 Organ failure
 CV, Renal, GIT,
respiratory,

14. Total Parenteral Nutrition (TPN)
 Food and calories
given intravenously
 Indications- Patients
who
 Cannot eat or eat
enough
 Have severe burns,
pancreatitis, gallbladder
& inflammatory bowel
disease, diarrhea
 Central Line attached
via superior vena cava
to the heart
 Peripheral Line
attached to an
extremity usually the
arm at the wrist or back
of the knee.

15. Special TPN Issues
 Renal Failure
 Catabolic patient
 Compatibility
 Stability
 Thrombosis
 Non-tunneled catheters
 Tunneled catheters
 Implanted ports
 Complications of TPN
 Dehydration
 Liver toxicity
 Elevated
 TG, glucose, lipids,
albumin
 Reduced
 Glucose, albumin
 Imbalance
 Acid-Base
 Electrolytes

16. Nutrition

17. The TRAPEZOID !

18. The REAL Thing – Coca-Cola
 Active ingredient is
phosphoric acid.
 pH of 2.8
 Dissolves a nail in 4
days.
 Dissolves a tooth in 24-
48 hours.
 Trucks carrying Coca
Cola syrup (the
concentrate) must use
Hazardous Material
placards.
 The distributor of Coke
use it to clean the
engines of their trucks.

19. Diets?
 Atkins
 SouthBeach
 Somersizing

20.  Zone
 Mediterranean
 Blood Type
 Weightwatchers

21. Labels !
Read
them.

22. Natural Supplements

23. Selected Natural Supplements
 Camomile
 Anti-inflammatory,
spasmotic, infective
 Chondroitin
 Interferes with enzymes
that break down
cartilage
 Chromium picolate
 Weight loss
 Glucose
 CV toxicity

24. Common Herbal Supplements
 Feverfew
 Migraine headaches
 Ginger
 Antiemetic
 Ginkgo, ginseng
 Oxygen and energy
 Glucosamine
 Cartilage
 Melatonin
 Hormone
 St. Johns’s wort
 Natures Prozac

25. Let the Sunshine In !
 Summer surgeries with improved recovery
times
 High levels Vit D
 Mood

26. Summary Slide
 Fluids
 Electrolytes (mEq)
 Vitamins and Minerals
 Calcium
 Malnutrition
 Total Parenteral Nutrition (TPN)
 Common Herbal Supplements