Nutrition

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Vitamin D

by Nancy Munoz, DCN, MHA, RDN, FAND

Vitamin D is a fat-soluble vitamin that is not commonly found in foods. Good sources of vitamin D include fortified cereal, fortified milk, and fish with high fat content such as salmon. This nutrient is also produced endogenously through skin exposure to the ultraviolet rays from the sun. Vitamin D made available to the body through sun exposure, food, and supplements is organically inactive and must go through a chemical process that introduces a hydroxyl group (-OH) into an organic compound (hydroxylation). This chemical process converts vitamin D to calcidiol and calcitriol, which the body can absorb.

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Nutrition Management

by Dr. Nancy Munoz, DCN, MHA, RDN, FAND

The presence of diabetes can contribute to a decreased wound healing rate. Increased glucose levels can stiffen the arteries and contribute to narrowing of the blood vessels. This can contribute to pressure injury development and is a risk factor for impaired wound healing.

Diabetes is an illness in which the individual’s blood glucose level is above the established range. Glucose is present in the foods we eat. Most foods contain a blend of carbohydrates, proteins, and fats. The amount of each of these nutrients in the foods we consume determines how quickly the body transforms food into glucose. For instance, consuming carbohydrates affects blood glucose levels one to two hours after the meal. Ingesting protein has very little influence on blood glucose levels, and the glucose from the fat in foods is slowly absorbed and does not contribute to increase glucose levels.

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Nutrition and Protein

by Nancy Munoz, DCN, MHA, RDN, FAND

The National Pressure Ulcer Advisory Panel (NPUAP) defines a pressure injury as localized damage to the skin and/or underlying soft tissue, usually over a bony prominence or related to a medical or other device. The injury can manifest as intact skin or an open ulcer and may be painful. The injury occurs as a result of intense and/or prolonged pressure, occasionally in combination with shear. The tolerance of soft tissue for pressure and shear may also be affected by microclimate, nutrition, perfusion, comorbidities, and the condition of the soft tissue.

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patient mobility and activity

By Holly Hovan MSN, APRN, CWOCN-AP

The Braden category of activity focuses on how much (or how little) the resident can move independently. A resident can score from 1 to 4 in this category, 1 being bedfast and 4 being no real limitations. It is important to keep in mind that residents who are chairfast or bedfast are almost always at risk for skin breakdown.

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enteral nutrition feeding

By Holly Hovan MSN, APRN, CWOCN-AP

A common misconception by nurses is sometimes predicting nutritional status based on a resident's weight. Weight is not always a good predictor of nutritional status. Nutritional status is determined by many factors and by looking at the big picture.