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Nutrition Care
and
Assessment
Poor nutrition
status
Can influence the
course of disease
& bodys response
to treatment
Hospitalized
patients
40-60% with
acute illness are
malnourished
Others decline in
nutrition status
within 3 weeks
Interferes with
digestion &
absorption
Alters metabolism &
excretion
Dietary restrictions
for some surgeries or
chronic illnesses
Drain on financial
resources
Unable to prepare
food
Emotional upset
Responsibility for
Nutrition Care
Registered Dietitians
Provide medical
nutrition therapy
Assess, diagnose,
develop,implement &
evaluate nutrition care
plans
Plan & approve menus
Provide education
Registered Dietetic
Technician
Assist the Registered
Dietitians
Physicians
Prescribe diet orders
Nurses
Screen patients
Participate in nutrition
assessments
Provide direct nutrition
care
Screening
Medical diagnosis
Medical record
Physical
measurements
Lab reports
Diet history
Planning Care
The Nutrition Care The Nursing
Process
Process
Nutrition
assessment
Nutrition diagnosis
Nutrition
intervention
Nutrition
monitoring &
evaluation
Assessment
Nursing diagnosis
Outcome
identification &
planning
Implementation
Evaluation
Intervention
Diagnosis
Actual or potential
Problem, etiology,
signs & symptoms
Dietary changes
Nutrition education
Medication changes
Monitoring &
evaluation
May need to
modify the plan
Must be flexible
Historical Information
Medical history
Age
Gender
Weight
Prescription drugs
OTC medications
Dietary
supplements
Type of illness
Social history
Cultural heritage
Financial concerns
Who prepares and
shops for food
Living situation
Diet history
Food intake
Meal patterns
Physical problems
Dietary Assessment
Methods
24-hour recall
Food record
Food frequency
questionnaire
Recorded over
several days
Recorded as
consumed
Does not rely on
memory
Direct observation
Calorie counting
Time consuming
2007 Thomson - Wadsworth
Anthropometric Data
Height: Adults
Length
Head
circumference
Assesses brain
development
< 3 years of age
Infants
< 24 months
Weight
BMI
% Usual body
weight
% Ideal body
weight
Circumference of
waist & limbs
Evaluates body fat
Evaluates muscle
mass
Biochemical Analysis
Provides information about
Protein-energy nutrition
Vitamin & mineral status
Fluid & electrolyte balance
Organ functioning
Plasma Proteins
Albumin
Most abundant
Slow to reflect
changes in status
Transferrin
Transports iron
Indicates PEM &
iron status
Slow to detect
changes in status
Prealbumin &
retinol-binding
protein
Also called
transthyretin
Responds quickly
to changes in
protein status
Expensive test
Fluid Imbalance
Edema
Dehydration
Weight gain
Facial puffiness
Swelling limbs
Abdominal
distention
Tight-fitting shoes
Diseases of heart,
kidney, liver, lungs
Thirst
Dry skin or mouth
Reduced skin tension
Dark yellow or
amber urine with low
volume
Fever, sweating,
vomiting, diarrhea,
burns
Assessment of
Nutrition Status
Functional
Assessment
Integrating
assessment data
Exercise tolerance
Respiratory
muscle strength
Immunity
Subjective Global
Assessment (SGA)
Combines
historical
information with
results of physical
examination