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Nursing diagnosis: Imbalanced nutrition: less than body requirements related to loss of appetite.

NANDA Definition: Intake of nutrients insufficient to meet metabolic needs. Cause analysis: lack of appetite, is a common symptom of many diseases, brief periods of anorexia are life-threatening but can sause temporary malnutrition, prolonged anorexia may lead to serious glycogen which provides energy throught glycogenolysis, prolonged reduced of food consumption may minimize ,reduce ,consume the stored glycogen thus malnutrition occurs. (Timby and Smith , Medical-surgical . pp.741) Assessment Subjective: NIC: Nutrition monitoring Objective: 1. Obtain nutritional history; include family, significant others, or caregiver in assessment. 2. Determine etiological factors for reduced nutritional intake. 1.Patients perception of actual intake may differ. The patient will be able to increase appetite as evidence by consume more food intake. NOC:Nutritional status : food intake NIC with intervention rationale Expected outcome

2. Proper assessment guides intervention , for example ,patients with dentition problems require referral to a dentist, whereas patients with memory losses may require services such meals on wheels. 3. Many psychological, psychosocial, and cultural factors determine the type ,amount, and appropriateness of food consumed. 4.Fewer families today have a general meal together, many

3. Monitor or explore attitudes toward eating and food.

4. Monitor the environment in which eating occurs.

adults find themselves eating on the run or relying heavily on fast foods with reduced nutritional components. 5. Encourage patient participation in recording food intake using a daily log. 5. Determination of type ,amount and pattern of food fluid intake is facilitated by accurate documentation by the patient or caregiver as the intake occurs, memory is insufficient. 6. Elevating the head of bed 30 degrees aids in swallowing and reduces risk of aspireation.

6. Suggest ways to assist the patient with meals, as needed ensure a pleasant environment, facilitate proper position,and provide good oral hygiene and dentition.

7. Provide companionship during mealtime.

7. Attention to the social aspects of eating si important in both the hospital and home settings. 8. Such supplements can be used to increase calories and protein without interfering with voluntary food intake. 9. These may decrease appetite and lead to early satiety.

8. Suggest liquid drinks for supplemental nutrition.

9. Discourage beverages that are caffeinated or carbonated.

10. Review and reinforce to patient or caregivers : -the basic four food groups, as well as the need for specific minerals or vitamins. -importance of maintaining adequate caloric intake; -foods high in calories and protein that will promote weight gain and nitrogen balance e.g. small reequent meals of foods high in calories and protein)

10. Patients may not understand what is involved in a balanced diet. They also better able to ask questions and seek assistance when they know basic information.

(Gulanick/myers 2007 6TH Ed Nursing Care Plan pp 135-137)

Evaluation :

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