Nutrition Care Process

Nutrition Care Process
Introduction: Healthcare
Terminology
Clinical pathways
● coordinated programs of treatment that merge the care plans of different

health practitioners; also called care pathways, care maps, or critical pathways.
Diet orders
► specific instructions regarding dietary management; also called nutrition

prescriptions.
Medical nutrition therapy
► nutrition care provided by a registered dietitian; includes assessing nutrition

status, diagnosing nutrition problems, and providing nutrition care.
Nutrition care plans
► strategies for meeting an individual’s nutritional needs.

Nutrition support teams
► health care professionals responsible for the provision of nutrients by tube

feeding or intravenous infusion.
P-E-S
► a statement that describes a nutrition problem in a format that includes the

problem
(P), the etiology or cause (e), and the signs and symptoms (s).
Half-life
► in blood tests, refers to the time it takes for the concentration of a

substance to be reduced by half. albumin has a half-life of 14 to 20 days,
meaning that half of the amount circulating in plasma is degraded in this time
period.
Fluid retention ( also called edema )
► may be caused by malnutrition, infection, injury, and some medications. It

can also result from impaired blood circulation or disorders of the kidneys,
liver, and lungs. Physical signs of fluid retention include weight gain, facial
puffiness, swelling of limbs, abdominal distention, and tight-fitting shoes.
Dehydration
► may be caused by vomiting, diarrhea, sweating, fever, excessive urination,

blood loss, and burns (due to fluid loss through skin lesions). Risk of
dehydration is especially high in older adults, who have a reduced thirst
response and various other impairments in fluid regulation. Signs or symptoms
include thirst, weight loss, dry skin or mouth, reduced skin tension, dark
yellow or amber urine, and low urine volume.
Functional assessment
► Nutrient deficiencies sometimes impair physiological functions, so clinicians

may conduct tests or procedures to evaluate some aspects of malnutrition.
For example, both PEM and zinc deficiency can depress immunity, which can
be evaluated by testing the skin response to antigens that cause redness and
swelling when immune function is adequate. Muscle weakness due to wasting
(loss of muscle tissue) may be assessed by testing hand grip strength. Exercise
tolerance, which is reduced in heart and lung disorders, may be evaluated
using a treadmill or cycle ergometer.
Diet progression
► a change in diet as a patient’s tolerances permit

Diet Manual
► When designing menus for modified diets, the dietary and foodservice
personnel
Nothing by Mouth (Npo)
► An order to not give a patient anything at all—food, beverages, or

medications—is indicated by NPO, an abbreviation for non per os, meaning
“nothing by mouth.” For example, an order may read “NPO for 24 hours” or
“NPO until after X-ray.” The NPO order is commonly used during certain acute
illnesses or diagnostic tests involving the GI tract.
Dietary reference intake (DRI)
► a set of nutrient intake values for healthy people in the United States and
Canada. These values are used for planning and assessing diets and include:
► • Estimated Average Requirements (EAR)
• Recommended Dietary Allowances (RDA)
• Adequate Intakes (AI)
• Tolerable Upper Intake Levels (UL)
Estimated average requirement (EAR)
► the average daily amount of a nutrient that will maintain a specific

biochemical or physiological function in half the healthy people of a given age
and gender group.
Recommended Dietary allowance (RDA)
► the average daily amount of a nutrient considered adequate to meet the

known nutrient needs of practically all healthy people; a goal for dietary
intake by individuals.
Deficient
► inadequate; a nutrient amount that fails to meet the body’s needs and
eventually results in deficiency symptoms.
Adequate intake (AI)
► the average daily amount of a nutrient that appears sufficient to maintain a

specified criterion; a value used as a guide for nutrient intake when an RDA
cannot be determined.
Total Upper Intake Level (UL)
► the maximum daily amount of a nutrient that appears safe for most healthy
people and beyond which there is an increased risk of adverse health effects.
Estimated Energy Requirement (EER)
► the average dietary energy intake that maintains energy balance and good
health in a person of a given age, gender, weight, height, and level of
physical activity.
Acceptable Macronutrient Distribution
ranges (aMDr)
► ranges of intakes for the energy nutrients that provide adequate energy and
nutrients and reduce the risk of chronic diseases.
► Comparing nutrient recommendations At least 40 different nations and
international organizations have published nutrient standards similar to those
used in the United States and Canada. Slight differences may be apparent,
reflecting differences both in the interpretation of the data from which the
standards were derived and in the food habits and physical activities of the
popula- tions they serve.
► Many countries use the recommendations developed by two international

groups: FAO (Food and Agriculture Organization) and WHO (World Health Or-
ganization). The FAO/WHO nutrient recommendations are considered
sufficient to maintain health in nearly all healthy people worldwide and are
provided in Appendix I.
Risk factor
► a condition or behavior associated with an elevated frequency of a disease

but not proved to be causal. Leading risk factors for chronic diseases include
obesity, cigarette smoking, high blood pressure, high blood cholesterol,
physical inactivity, and a diet high in saturated fats and low in vegetables,
fruits, and whole grains.
II. Medical Nutrition Therapy &
Evidence based nutrition care
A. Developments in health care that support use of a
care process by dietitians
Florence Nightingale
●An English nurse,pioneered in hospital
foodservice during the Crimean War. She was so
efficient in organizing and managing the meals for
patients that she is considered the first hospital
dietitian in the modern sense.
Hospital Foodservice by Irma
P. Florentin
► in Summary
► ❚ Illnesses and their treatments can alter food intake and
nutrient needs, leading to malnutrition. In turn, poor
nutrition status can influence the course of illness and
reduce the effectiveness of medical treatments.
► ❚ The combined efforts of each member of the health care
team ensure that patients receive optimal nutrition care.
► ❚ Nutrition screening identifies individuals who can benefit
from nutrition assessment and follow-up nutrition care.
The nutrition care process includes four inter- related steps:
nutrition assessment, nutrition diagnosis, nutrition
intervention, and nutrition monitoring and evaluation.
B. International Dietetics Nutrition Terminology
► The International Dietetics Nutrition Terminology is a standardized language
used by dietitians to communicate assessment, nutrition diagnosis,
intervention, monitoring and evaluation based on the nutrition care process
model.
► • Nutrition Assessment/Monitoring & Evaluation
– 6 categories: Food/Nutrition Related History, Anthropometric
Measurements, Biochemical Data, Medical Tests, & Procedures, Nutrition-
Focused Physical Findings, Client History, Comparative standards
► Nutrition Diagnosis
– 3 categories: Intake, Clinical, Behavioral-Environmental
► Nutrition Intervention
– 4 categories: Food & Nutrient Delivery, Nutrition Education, Nutrition
Counseling, Coordination of Nutrition Care
► Nutrition Monitoring and Evaluation
-4 categories: Food/Nutrition Related History Outcomes, Anthropometric
Measurement Outcomes, Biochemical Data, Medical tests, & Procedures
Outcomes, Nutrition-Focused Physical Findings Outcomes

Nutrition Care Process

Uploaded by

Copyright:

Available Formats

Nutrition Care Process

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Nutrition Care Process

Uploaded by

Copyright:

Available Formats

Nutrition Care Process

● coordinated programs of treatment that merge the care plans of different

► specific instructions regarding dietary management; also called nutrition

► nutrition care provided by a registered dietitian; includes assessing nutrition

► strategies for meeting an individual’s nutritional needs.

► health care professionals responsible for the provision of nutrients by tube

► a statement that describes a nutrition problem in a format that includes the

► in blood tests, refers to the time it takes for the concentration of a

► may be caused by malnutrition, infection, injury, and some medications. It

► may be caused by vomiting, diarrhea, sweating, fever, excessive urination,

► Nutrient deficiencies sometimes impair physiological functions, so clinicians

► a change in diet as a patient’s tolerances permit

► An order to not give a patient anything at all—food, beverages, or

► the average daily amount of a nutrient that will maintain a specific

► the average daily amount of a nutrient considered adequate to meet the

► the average daily amount of a nutrient that appears sufficient to maintain a

► Many countries use the recommendations developed by two international

► a condition or behavior associated with an elevated frequency of a disease

You might also like