c. Anxiety about his illness.
d. Loneliness.
e. Diet restrictions. In many disease conditions, a special diet is an important part
of therapy. In addition to educating the patient about the diet, you should help him to
adapt to the diet and enjoy the food that he can have.
f. Changes in usual activity level. Exercise has been reported to increase,
decrease, or have no effect on food intake. Although food intake is decreased
immediately after exercise, habitual moderate exercise over a long period of time
promotes increased food intake.
5-7.
REASONS FOR HOSPITALIZED PATIENTS BEING AT RISK OF
MALNUTRITION
a. The effect of the disease on metabolism. Most illnesses and diseases increase
the need for nutrients. For example, one of the first symptoms of an infectious disease is
loss of appetite and decreased tolerances for food. But, the infection and possible fever
increase the metabolic rate and the actual nutrient requirements.
b. The disease may cause problems with absorption. An abnormality in either
secretion or motility affects not only digestion but also optimal absorption. Motility is the
movement of food through the digestive tract.
(1) Alterations in motility in the esophagus or stomach may result in symptoms
of indigestion and vomiting. Increased motility of the gastric contents through the small
and large intestines results in decreased absorption and diarrhea.
(2)
Conditions that increase motility of the small intestine primarily affect
absorption.
c. The anxiety and stress of being ill may reduce the patient's appetite.
d. The treatment may cause problems with intake, digestion, or absorption. The
decreased desire to eat may be caused by impaired ability to taste food because of
medication, bloating resulting from decreased peristalsis in the gastrointestinal tract
following surgery, or nausea resulting from chemotherapy. Withholding food for various
tests and procedures, or restricting the patient's intake may affect his appetite.
5.8.
NURSING INTERVENTIONS WHICH HELP THE PATIENT MEET
NUTRITIONAL NEEDS
Mealtime is an important event in the patient's long day and the patient's diet is an
integral part of the total treatment plan. Certain nursing interventions may help the patient
meet his or her nutritional needs.
MD0906
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