NR 324 Week 5 EDAPT_Altered Nutrition and Altered GI Function

For example, some types of vegetarian diets exclude red meat, placing a client at higher risk of developing vitamin, iron, or protein deficiencies. Certain variations of vegetarianism, such as a client who excludes all meat and animal products, are at risk for developing cobalamin (vitamin B12) deficiencies as this vitamin is fortified or found in higher amounts in animal proteins. Nutritional Assessment Cultural preferences are important factors to consider when conducting a nutritional assessment. People have unique cultural values and beliefs regarding food and unique times to eat, which may affect eating habits. Culture and religion may also influence what foods are considered acceptable, how they are prepared, and how and who prepares them. For example: • A client who follows the Hindu faith may follow vegetarian practices and require avoidance of certain meats and meat preparations. • A client with ulcerative colitis who follows Jewish dietary practice may find comfort in knowing that enteral feeding preparations will be prepared kosher. A thorough nutrition assessment can help clients trust in the care being provided and feel supported in their beliefs while they heal. Obesity and Weight Classifications In discussions about altered nutrition, it is important to discuss the concept of obesity or an excessively high amount of body fat or tissue. Obesity is a major risk factor for multiple disease processes and healing issues, including heart disease, stroke, diabetes mellitus, and more. Attitudes about obesity can create a bias or discrimination toward clients who are obese. Obesity must be viewed and treated as a chronic disease. The most common measure of obesity is the body mass index (BMI). BMI is calculated by dividing a client’s weight (in kilograms) by the square of their height (in meters). While the BMI calculation is easy, cost-effective, and reliable, other factors must be taken into consideration, such as the client’s age, gender, and body build. For example, a bodybuilder may have a BMI that is technically classified as obese but, because of their high muscle mass, the BMI may not be an accurate indicator. Other measures, such as waist circumference, are another tool to assess obesity. Health risks increase if a client has a waist circumference of greater than 40 inches in men or 35 inches in women. With obesity, the client is at risk of developing metabolic syndrome. Metabolic syndrome is a group of risk factors that increase a client’s chance of developing cardiovascular disease, stroke, and diabetes mellitus. Obesity is one of those risk factors, along with hypertension, abnormal lipid levels, and high blood glucose levels. Goals Like assessing a client who smokes, it is important to see if clients who are obese are ready to make a change in their lifestyle. Understanding any barriers to compliance with dietary, exercise, or medication changes will help the client be successful long-term. It can be an incredibly challenging healthcare problem to manage and overcome, but with thoughtful planning, implementation, and resources, clients can be prosperous. Overall goals for plans of care are that the