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Nutrition Care & Assessment

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Veronica Leman

on 21 October 2013

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Transcript of Nutrition Care & Assessment

Nutrition Care & Assessment
Veronica Leman

Nutrition in Health Care
Nutrition is #1 in preventing and treating disease
Poor nutrition:
weakens immune system
affects healing process
can alter disease in the body and how it responds to treatment
38-62% of hospitalized patients with acute illness are malnourished
Risk for Inadequate Nutrition
Biophysical:
medical disease or conditions
genetic predisposition
age
Psychological:
mental illness
too much stress
poor self-image
Socioeconomic
poverty
drugs or alcohol
fad diets
food preferences
Nutrition Care Process: Assessment, Diagnosis, Intervention, Monitoring and Evaluation
#1: Assessment (subjective)
Medical, social, dietary histories
Registered dieticians: provide comprehensive nutritional assessments (nutrition therapy & care plans, provide education)
Registered dietetic technician: assist registered dietician
Physician: prescribe diet orders
Nurses: monitor & evaluate interventions, give nutrition assessments, provide direct nutrition care
Nutrition Care Process: Assessment, Diagnosis, Intervention, Monitoring and Evaluation
History
Medical history: age, current problem, surgical history, family history, allergies, mental status

Social history: culture, socioeconomic status, education, style of living, employment, religion

Medications and supplements: prescription, over-the-counter, herbal
Diet History & Assessment
History includes:
Food intake
Dietary restrictions
Exercise
Alcohol use
Food allergies/intolerances
Nutrition knowledge
Availability of food
Methods of Assessing:
24-hour recall
Food frequency questionnaire
Food record (journal)
Direct observation
#1: Assessment (physical)
Symptoms:
Hair that is dry or brittle, or skin that has dry patches.
Poor wound healing or sores.
Lack of subcutaneous fat or muscle wasting.
Abnormal cardiovascular measurements
(heart rate and rhythm, blood pressure).
General weakness or impaired coordination

Functional Assessment
Exercise tolerance (treadmill)
Muscle strength (hand-grip device)
Immune system (skin's response to antigens)

Nutrition Care Process: Assessment, Diagnosis, Intervention, Monitoring and Evaluation
#2: Diagnosis
Problem, etiology, signs & symptoms

"Disturbed body image r/t..."

"Imbalanced nutrition: more than body requirements r/t..."

"Readiness for enhanced nutrition r/t..."
Nutrition Care Process: Assessment, Diagnosis, Intervention, Monitoring and Evaluation
#3: Intervention
Dietary & lifestyle changes
Nutrition education
Medication changes
Nutrition Care Process: Assessment, Diagnosis, Intervention, Monitoring and Evaluation
#4: Monitoring and Evaluation
Watch physical signs
Look at I&O
May have to change plan

Weight
Weigh at same time every day
Percentage weight change calculation
1-2% change in a week or 7.5% change in 3 months indicates significant weight loss
Lab values
I&O: 2-3 L/day
Protein-measured by serum albumin levels
Transferrin
Pre-albumin & retinol-binding protein
BMI: Body Mass Index
Normal/healthy weight
18.5-24.9

Overweight
25-29.9

Obese
30+


Whitney, E., DeBruyne, L.K., Pinna, K., Rolfes, S.K. (2011). Nutrition for health and health care. Belmont, CA: Wadsworth, Cengage Learning

Nutrition for nursing. (2013). Assessment Technologies Institute.
Full transcript