Basic care and comfort

•    All individuals require the same nutrients, but the amounts vary according to factors such as age, weight, activity level, and health state.
•    The energy value of foods is defined in calories; only proteins, fats and carbohydrates provide calories.
•    The average adult drinks 2 to 3 liters of water per day.
•    The normal thirst mechanism in the elderly may be diminished and they may need encouragement to drink sufficient water to prevent dehydration.
•    Discontinue ROM exercises at point of pain.
•    Use rubber suction tips on crutches and canes to prevent slipping.
•    Prevent deformities and complications such as contractures, thrombophlebitis, and pressure ulcers by turning and positioning the client in good alignment.
•    There should be at least two inches between axilla and top of arm piece of crutch to prevent pressure on the brachial plexus.
•    The majority of residents in nursing homes are incontinent.
•    Incontinence is not a normal sequela of aging.
•    Initiate pain relief before the pain becomes unbearable.
•    Essential amino acids cannot be synthesized. They must be ingested daily
•    Weight is maintained when daily food intake equals energy expenditure.
•    Age affects daily requirements: young, old, pregnancy, lactation.
•    Weight loss is a long-term process and patients need long-term support.
•    Reconstructive surgery may be required after large amount of weight loss.
•    Support groups are available for patients losing weight.
•    Increased fiber in the diet may cause flatulence.
•    In constipation, increase fluid to 3000 cc/day (unless contraindicated).
•    Small frequent loose stools or seepage of stool are often indicative of a fecal impaction.
•    Use transparent drainage bag initially for assessment of stoma and drainage.
•    Avoid foods that cause odor, gas, diarrhea, or may block ileostomy.
•    Allow the client to rate his degree of pain and the degree of relief from pain relief measures.
•    Self-control methods to manage pain: distraction, massage, guided imagery, relaxation, biofeedback, hypnosis.
•    Change ostomy appliance as needed.


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