Nutritional Needs of A Client: by Mr. Manasseh Mvula 4 Year BSC Student

Nutritional
Needs
of a client
By
Mr. Manasse
h Mvula
4 year BSc
th
student
General objective
At the end of this lecture, a student

should have knowledge on meeting
basic client nutritional needs.
Specific Objectives
At the end of this lecture, a student should be
able to;
• Define nutrition and nutritional status

• State four (4) methods that can be used in
assessment of nutritional status
• Describe in detail the four (4) approaches
used to assess the nutritional status
Cont’d
• Outline factors influencing diet

requirements and intake
• Explain general guidelines on food
preparation and serving
Introduction
0Nutrition (also called nourishment) is

the provision, to cells and organisms of
the materials necessary in the form of
food to support life (Williams S.R.,
1995).
0Nutrition concerns the food people eat
and how their bodies use it.
Cont’d
0Nutritional status is the balance
between the intake of nutrients by an
organism and the expenditure of these
in the processes of growth,
reproduction, and health maintenance
(Williams S.R., 1995).
Assessment of Nutritional
status
0 Nutritional assessment of the client is an integral part
of the total health assessment because food and fluid
are the basic biologic needs (Wilson and Giddens,
2005).
0 Commonly summarized by the mnemonic "ABCD,"
which stands for Anthropometric measurement,
Biochemical or laboratory tests, Clinical indicators, and
Dietary assessment.
Anthropometric method
0 Anthropometry is a measurement system of
size and makeup of the body (Potter and
Perry, 2005).
0 Approaches are usually non-invasive and
generally assess the size or body composition
of an individual.
0 For adults, body wt and ht are used to evaluate
overall nutritional status and to classify
individuals as at healthy or non-healthy
weights
Cont’d
0 The most recent classification is to use Body
Mass Index (BMI, in kg/m2).
0 BMI, regardless of population, is normal at
18.5 to 25.0 kg/m2, overweight at 25.0 to 29.9
kg/m2, and obese at over 30.0 kg/m2.
0 In general BMI greater than 30 is assumed to
be due to excessive adiposity.
Cont’d
0 In children, growth charts, have been developed to allow
clinicians to assess weight-and height-for-age, as well as
weight-for-height.
0 For children, low height-for-age is considered stunting,
while low weight-for-height indicates wasting.
0 In addition to wt and ht, measures of Mid Upper Arm
Circumference (MUAC)and skin fold measured over the
triceps muscle at the mid-arm are used to estimate fat and
muscle mass.
0 Anthropometric measures of nutritional status can be
compromised by other health conditions eg oedema
characteristic of some forms of malnutrition can conceal
wasting by increasing body weight.
Stretch time…
Biochemical or laboratory
tests
0 No single biochemical and laboratory test is
diagnostic for malnutrition (Potter and Perry,
2005).
0 The tests provide objective data to nutritional
assessment
Cont’d
0 The tests most commonly used are:

Serum proteins- tests include Hb which
provide information regarding red blood
cells and can provide information on iron
and Vit B12 deficiency. Others are blood
glucose which reflect carbohydrate
metabolism.
Cont’d
Urine tests- urinary Cr reflects a persons’

total muscle mass. The greater the muscle
mass the greater the excretion of Cr.
Total lymphocyte count- certain nutrient
deficiencies and forms of protein-calorie
malnutrition can depress the immune
system.
Clinical indicators
0 A nurse performs a nutritional screen
An assessment performed to identify clients
at risk for malnutrition or those
undernourished.
0 This is a quick physical examination that
assesses body systems because effects of
improper nutrition affect all body systems and
can give clues to malnutrition.
Cont’d
0A nurse can assess the general

appearance for cachexia and apathy, CVS
for heart rate and BP, GI system for
anorexia, indigestion and constipation.
0 The nurse can also assess the hair, skin,
face and neck, lips, gums, teeth, eyes and
nails.
Dietary Assessment
0 This is a more specific diet history used to

assess the client’s actual and potential needs
(Potter and Perry, 2005).
0 Components:
Diet
Number of meals per day
Food preferences and preparation practices
Components cont’d
Unpleasant symptoms
Indigestion, heartburn, gas
Allergies
Chewing and swallowing
Appetite
Elimination
Factors influencing Diet
requirements and Intake
Age
 Children normally require a lot of
carbohydrates, proteins and vitamins for
proper growth and repair.
 For infants for example, breast milk is the
ideal food and they require to be fed whenever
necessary.
Cont’d
Religious practices
 Some religious practices like Rastafarians
encourage adoption of vegetarian diets.
Cultural practices
 Some cultural practices forbid intake of
certain foods for example some cultures in
Zambia forbid pregnant women to eat eggs.
Cont’d
Occupation and Physical Activities
 Nutrients give the energy needed to perform the daily
activities of living.
 The amount of energy used by the body is the energy
expenditure and this varies widely from individual to
individual.
 When we do more work, our body requires more
energy to keep our bodies healthy
 Workers like army recruits, builders and athletes need
more food that contains more nutrients such as
carbohydrates, protein and fats.
Cont’d
Environment’s Weather
 For example on the weather, people are
more likely to consume more food
during the cold rather than hot weather.
 People tend to eat more during the cold
season.
Cont’d
Disease
 Disease states like, burns and malnutrition
require a special diet if healing is to take place.
Other factors include social and economic

status.
Preparation and serving of
food to patients
0 Food should be prepared in a hygienic manner
to prevent food poisoning.
0 It is important to always prepare food that a
patient prefers and enjoys although some
patients may require health education on the
type of food to avoid drug interactions and
malnutrition.
Cont’d
0 On serving, food should be attractive in
appearance.
0 Serving food neatly can stimulate the client’s
appetite.
0 It is good practice to ensure that the client
receives and eats their prescribed diet.
0 Cultural and religious aspects of patients
should be taken into consideration as well as
the level of consciousness.
Take home points
0 Nutrition is the provision, to cells and

organisms of the materials necessary in the
form of food to support life whereas
Nutritional status is the balance between the
intake of nutrients by an organism and the
expenditure of these in the processes of
growth, reproduction, and health
maintenance.
Cont’d
0 Nutritional assessment of the client is an
integral part of the total health assessment
because food and fluid are the basic biologic
needs.
0 The purpose of the nutritional assessment is
to identify patients at risk for malnutrition
and those with poor nutritional status.
0 Four main methods exist for nutritional
assessment namely anthropometric,
biochemical, clinical indicators and dietary
assessment abbreviated as ABCD.
Cont’d
0 Nutrition being the basic biologic need, is
affected by many factors some of which
include age and culture.
0 Finally, when preparing food for the patient, it
is best practice to prepare food according to
the patient’s preference and taking into
account factors like culture and religion.
Assignment
0 Read and write brief notes on the importance

of meeting the client basic nutritional need.
References
0 Potter, A,P and Perry, A,G(2005),

Fundamentals of Nursing, 6th Edition, Mosby,
USA.
0 Wilson S.F, Giddens J.F (2005), Health
Assessment for Nursing Practice, 3rd edition,
Elsevier Mosby, USA
0 Williams S.R (1995), Basic Nutrition and Diet
Therapy, 10th edition, Mosby publishers, USA
End of Lectu
re
Have a bles
s ed day

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Nutritional

At the end of this lecture, a student

• Define nutrition and nutritional status

• Outline factors influencing diet

0Nutrition (also called nourishment) is

0 The tests most commonly used are:

Urine tests- urinary Cr reflects a persons’

0A nurse can assess the general

0 This is a more specific diet history used to

Other factors include social and economic

0 Nutrition is the provision, to cells and

0 Read and write brief notes on the importance

0 Potter, A,P and Perry, A,G(2005),

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