# Nutrition --- **Nutrition** is the study of [[nutrients]], and how that food effects our bodies and our [[nursing|health]]. Food contains the [[energy]] and [[nutrients]] that supports [[biology|life]]. The field of nutrition also studies our eating patterns, what influences them, and what an ideal health diet would be. [[nutrients|Nutrients]] are the chemicals—some organic and some inorganic—that are found in food that are essential to human growth and function. [[nutrients#Macronutrients: Energy & Water|Macronutrients]] are the majority of what we eat in order to gain [[biological energy|energy]] (typically measured in *calories*), such as carbs, proteins and fats. >[!quote] >Let food be thy medicine and medicine be thy food >— Hippocrates Gaining energy is fundamental to staying alive. There are two mechanisms that drive us to eat food: our [[hunger]] and our [[appetite]]. Hunger is a non-specific psychological drive, and appetite is a specific, psychological drive. ## Nutritional Status Someone's **nutritional status** refers to how well nourished or how [[malnutrition|malnourished]] someone is. One's nutritional state has a big effect on how the body responds to illness and treatment for that illness. Lab values that can be used to assess nutritional status: - [[labs|basic or complete metabolic panel]] - [[complete blood count|CBC]] - [[plasma#Total Protein|total protein]], testing for albumin and pre-albumin ### NPO **NPO** stands for the Latin "nil per os" meaning "nothing by mouth". It's an [[orders|order]] that means the patient is unable to eat or drink anything, even water (but sometimes things like ice chips are allowed). Most of the time this is done as a precaution prior to [[surgery]] or as a treatment. Nurses actually do have the power to make someone NPO as long as they follow it up with a physician. The reason that this is important before surgery is because undergoing [[general anesthesia]] has a risk of vomiting, which has a high risk of aspirating the stomach contents into the lungs. This is a good way to get a bed in the ICU. ## Enteral & Parenteral Feeding {probably needs it's own note} **Enteral feeding** and **parenteral feeding** are two ways of getting someone the nutrition that they need that basically bypasses eating **Enteral feeding** involves skipping the mouth and getting contents straight into the stomach: - Through the nose: - A **nasogastric** or **NG tube** is a tube that is inserted into the nose and goes all the way to the stomach. - A **nasojejunal** or **NJ** tube is just like the NG tube, but it has a weighted tip so it'll go into the jejunum - Some tubes can have multiple ports that can deliver material to the right spot - Very salty, and you must give water because they're at risk for [[hypernatremia]]. - You don't need to hold feeding for repositioning, there is no increased aspiration risk. - A **percutaneous endoscopic gastrostomy** or **PEG** tube is installed directly into the stomach wall, bypassing the throat entirely - Associated with less aspiration risk, because it kind of wedges open the [[stomach|cardiac sphincter]]. - A **percutaneous endoscopic jejunotomy** or **PEJ** tube is installed directly into the [[small intestine#The Jejunum & Ileum|jejunum]], bypassing the stomach entirely. - **Parental feeding** or [[total parental feeding]] (**TPN**) is when we can give all the nutrients someone needs straight into the [[blood|bloodstream]] via an IV. ___