1 Betty Sawyer, M Ed RD LD Registered Clinical DietitianClinical Nutrition Betty Sawyer, M Ed RD LD Registered Clinical Dietitian

2 PURPOSE To increase knowledge about the importance of good nutrition and how it affects health and longevity. To understand how disease affects nutrition requirements. To recognize members of the healthcare team.

3 How do you become a registered dietitian? What do they do?Clincial Community Sports Food service Wellness Food science

4 Altered nutrition needsWounds Impaired swallow Diabetes Underweight Heart Disease Obesity Renal dysfunction Liver dysfunction

5 Altered lab data Altered intake Altered height/weightNutrition assessment Altered lab data Altered intake Altered height/weight

6 HYDRATION/DEHYDRATIONSODIUM Na BLOOD UREA NITROGEN BUN CREATININE CR

7 HEPATIC FUNCION AST – aspartate aminotransferaseLDH – lactate dehydrogenase ALT – glutamic pyruvic transaminase ALK PHOS-alkaline phosphotase BILIRUBIN – bili Ammonia – NH3

8 LIPIDS TRIGLYCERIDES CHOLESTEROL HIGH DENSITY LIPIDSHDL’S LOW DENSITY LIPIDS LDL’S

9 HYPERGLYCEMIA SERUM GLUCOSE BLOOD SUGAR HEMAGLOBIN A1C

10 RENAL FUNCTION BLOOD UREA NITROGEN CREATININE MICROALBUMINEMIAPHOSPHORUS POTASSIUM CGFR

11 INFECTION WHITE BLOOD COUNT WBC

12 ANEMIA HEMAGLOBIN HGB HEMATOCRIT HCT

13 NUTRITION RENAL FUNCTION LIVER FUNCTION PREALBUMIN/ALBUMINTOTAL PROTEIN

14 CONGESTIVE HEART FAILUREB TYPE NATRIURETIC PROTEIN BNP

15 ELECTROLYTES POTASSIUM (K) PHOSPHORUS (PO4) MAGNESIUM (Mg)CALCIUM (Ca)

16 BOWEL FUNCTION CLOSTRIDIUM DIFFICILE TOXIN (C. DIFF+)

17 HEART MUSCLE TROPONINS

18 Enteral nutrition Parenteral nutritionTube feedings IV nutrition

19 Wounds Adequate protein/calories Multivitamin Vit C – 500 mg dailyZinc – 50 mg daily (4-6 weeks)

20 Increased frequency Reduced carbohydrate Regular meals and timesDiabetes Increased frequency Reduced carbohydrate Regular meals and times

21 Hospital Nutrition SerivcesNutrition evaluation Nutrition education Room service

22 Ideal body weight calculationWomen: 5” 100# then 5# for every additional inch Men: 5’ – 106# then 6# for every additional inch

23 QUESTIONS?