Nutritional Management

Mary Ellen Posthauer's picture

By Mary Ellen Posthauer RDN, CD, LD, FAND

Today an increasing number of individuals follow a vegetarian diet either by personal choice or for religious or cultural beliefs. Some research indicates that those who follow a plant-based vegetarian diet (50% of all protein in the diet) tend to be healthier than those who do not. There are several variations of the vegetarian diet from a semi-vegetarian or flexitarian to a strictly vegan diet. Years ago, dietitians were taught that it was critical to combine complementary protein sources using an exact pattern within a meal to achieve the required amount of amino acids. However, current research indicates that as long as the daily requirements are met, the body is able to combine amino acids as needed. The challenge is achieving requirements for individuals with wounds who are consuming vegetarian diets.

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By Janis E. Harrison, RN, BSN, CWOCN, CFCN

My Path to Becoming a Wound, Ostomy and Continence Nurse

"What did I get myself into?" There were several times over the first 10 years of my 20 year marriage to a person with an ostomy that I had to ask myself that question. Then came the revelation of the old saying "if you can't beat 'em…. join 'em." I decided that after major problems my spouse had with several surgeries – which included ostomy revisions, fistulae, abscesses, and surgical wounds – I would need to learn much, much more if I was going to spend the rest of my life with my husband, Daryl, and his maladies.

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Mary Ellen Posthauer's picture

by Mary Ellen Posthauer, RDN, CD, LD, FAND

Several years ago when my nutrition blog began, I discussed the issue of relying on laboratory values – in particular albumin, pre-albumin and transthyretin – as markers of nutritional status. Recently, during a discussion of nutrition and wound care, a dietitian expressed her frustration with a surgeon who kept postponing corrective abdominal surgery until a patient's nutritional status improved, as evidenced by the albumin being in the normal range. However, the patient was receiving adequate calories per enteral feeding and had gained weight. The albumin level was not reflective of the nutritional status. This discussion prompted me to revisit the issue of serum proteins as markers of nutritional status.

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Mary Ellen Posthauer's picture

By Mary Ellen Posthauer, RDN, CD, LD, FAND

Lindsay Andronaco's blog, "How Can Wound Care Nurses Provide Culturally Sensitive Care" prompted me to reflect on similar situations that I have encountered in the nutrition arena. In particular, when individuals with non-healing wounds are either not ingesting or unable to ingest adequate calories to promote healing, the interdisciplinary team meets with the individual and/or caregiver or surrogate to discuss the consideration of enteral nutrition. While the burden and benefit of enteral nutrition is discussed, the team is often challenged by both the cultural and religious beliefs that impact the final decision. Consider this case study.

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Karen Zulkowski's picture
Skin Conditions

By Karen Zulkowski DNS, RN, CWS

I previously discussed the need for a complete head-to-toe skin assessment. Certainly this can tell you whether or not the person is dehydrated, has open or discolored areas, and many other things about their overall health. Color, for example, can give you clues to additional problems such as vitamin and mineral deficiencies that can show on the skin.

Mary Ellen Posthauer's picture

By Mary Ellen Posthauer, RDN, CD, LD, FAND

As we watched the bright colored ball drop at midnight in Times Square and listened to John Lennon's classic song, "Imagine", we closed out the past year and now reflect on the future. What is your greater vision of how the world could be for our clients in 2014? We are entering into a new era and in some ways uncharted territory for how health care will be delivered in the United States.

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By Mary Ellen Posthauer, RDN, CD, LD, FAND

Building on the evidence that I have reviewed in the past several blogs concerning diagnosing adult malnutrition, this month we'll discuss some solutions for meeting energy and protein needs for elderly clients with pressure ulcers.

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By Mary Ellen Posthauer, RDN, CD, LD, FAND

The past few months my blog has been devoted to illustrating the value of using an etiology-based approach to diagnosing adult malnutrition in clinical settings. This approach is detailed in The Academy of Nutrition and Dietetics (Academy) and the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.): Characteristics Recommended for the Identification and Documentation of Adult Malnutrition (Undernutrition).

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By Mary Ellen Posthauer RDN, CD, LD, FAND

In last month's blog, I discussed recent research and publication of the consensus statement of the Academy of Nutrition and Dietetics (Academy) and the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.): Characteristics Recommended for the Identification and Documentation of Adult Malnutrition (Undernutrition).

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By Mary Ellen Posthauer, RDN, CD, LD, FAND

Part 2 in a series discussing nutritional status and diabetic foot ulcer risk.
To read Part 1,Click Here

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