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  2. 3/29/2023
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  5. MINERALS MINERALS FUNCTION FOOD SOURCES DEFICIENCY CONDITION SIDE/ADVERSE EFFECTS OTHER CONSIDERATIONS Iron Fe SO4 Fe fumarate Hgb regeneration Liver, lean meats, egg yolk, green vegetable spinach IDA S/Sx: Fatigue, pallor, weakness Iron Toxicity 10 tab (3g) fatal in children – hemorrhage – ulcerogenic effect of unbound iron Food & antacid slow absorption Vit C ↑ absorption 1st Trimester avoid teratogenic use in 2nd & 3rd Trimester Physiologic anemia ↑OFI, activity – constipating stools turn black or dark green, liquid iron use straw discolor teeth enamel
  6. MINERALS MINERALS FUNCTIONS FOOD SOURCES DEFICIENCY CONDITION SIDE/ADVERSE EFFECTS OTHER CONSIDERATIONS Zinc oral Plays a crucial role in the enzymatic metabolic reactions of both proteins and carbohydrates. Tissue growth and repair. Beef, lamb, eggs leafy & root vegetables Large doses 150mg/d – deficiency ↓ HDL & a weakened immune response hypersensitivity Believed to alleviate common cold
  7. NURSING PROCESS: PATIENT CENTERED COLLABORATIVE CARE 3/29/2023  Vitamins  Assessment  Check the patient for vitamin deficiency before the start of therapy and regularly thereafter.  Explore such areas as inadequate nutrient intake, debilitating disease, and gastrointestinal (GI) disorders.  Obtain a 24- and 48-hour diet history analysis.  When possible, obtain levels to assess serum blood levels.
  8. NURSING PROCESS: PATIENT CENTERED COLLABORATIVE CARE 3/29/2023  Nursing Diagnoses  Nutrition, Imbalanced related to inadequate intake of food sources of vitamins  Knowledge, Deficient related to food sources of vitamins  Decision Making, Readiness for Enhanced related to food choices and vitamin supplementation  Planning  The patient will eat a well-balanced diet.  The patient with vitamin deficiency will take vitamin supplements as prescribed.  The patient will demonstrate knowledge of vitamins contained in food sources.
  9. NURSING PROCESS: PATIENT CENTERED COLLABORATIVE CARE 3/29/2023  Nursing Interventions  Administer vitamins with food to promote absorption.  Store vitamins in light-resistant containers.  Use the supplied calibrated dropper for accurate dosing when administering vitamins in drop form. Solutions may be administered mixed with food or drink.  Administer vitamins intramuscularly for patients who are unable to take vitamins by the oral route (e.g., those with GI malabsorption syndrome).  Recognize the need for vitamin E supplements for infants receiving vitamin A to avoid the risk of hemolytic anemia.  Monitor serum blood levels of any suspected vitamin or mineral deficiency.
  10. NURSING PROCESS: PATIENT CENTERED COLLABORATIVE CARE 3/29/2023  Advise patients to take the prescribed amount of vitamins.  Counsel patients to read vitamin labels carefully and discuss with a health care provider prior to taking any vitamin or supplement.  Advise patients to consult with a health care provider or pharmacist regarding interactions with prescription and over-the-counter medications.  Discourage patients from taking a large dose of vitamins over a long period unless prescribed for a specific purpose by a health care provider. To discontinue long-term use of high-dose vitamin therapy, a gradual decrease in vitamin intake is advised to avoid vitamin deficiency.
  11. NURSING PROCESS: PATIENT CENTERED COLLABORATIVE CARE 3/29/2023  Inform patients that missing vitamins for 1 or 2 days is not a cause for concern because deficiencies do not occur for some time.  Advise patients to check expiration dates on vitamin containers before purchasing them.  Potency of vitamins is reduced after the expiration date.
  12. NURSING PROCESS: PATIENT CENTERED COLLABORATIVE CARE 3/29/2023  Counsel patients to avoid taking mineral oil with vitamin A on a regular basis because it interferes with absorption of the vitamin; mineral oil also interferes with vitamin K absorption.  If needed, take mineral oil at bedtime.  Explain to patients that there is no scientific evidence that large doses of vitamin C will cure a cold.  Alert patients not to take large doses of vitamin C with aspirin or sulfonamides because crystals may form in the kidneys and urine.  Alert patients to avoid excessive intake of alcoholic beverages. Alcohol can cause vitamin B–complex deficiencies.
  13. NURSING PROCESS: PATIENT CENTERED COLLABORATIVE CARE 3/29/2023  Advise patients to eat a well-balanced diet. Vitamin supplements are not necessary if the person is healthy and receives proper nutrition on a regular basis.  Educate patients about foods rich in vitamin A, including milk, butter, eggs, and leafy green and yellow vegetables.  Advise patients that nausea, vomiting, headache, loss of hair, and cracked lips (symptoms of hypervitaminosis A) should be reported to the health care provider. Early symptoms of hypervitaminosis D are anorexia, nausea, and vomiting.
  14. NURSING PROCESS: PATIENT CENTERED COLLABORATIVE CARE 3/29/2023  Cultural Considerations  Food and food choices have strong cultural roots. Determine the patient’s preferred and culturally meaningful foods, and incorporate them into the food and supplement plan.  Use interpreters as appropriate.  Glucose-6-phosphate dehydrogenase (G-6-PD) deficiency is common among people of Arabic and Chinese heritage.  Evaluation  Evaluate the patient’s understanding of the purpose of vitamins and their correct use.  Evaluate the effectiveness of the patient’s diet for inclusion of appropriate amounts and types of food. Have the patient periodically keep a diet chart for a full week to determine typical nutrition.  Determine whether the patient with malnutrition is receiving appropriate vitamin therapy.