HAP TER 1 Nutrition in Nursing Nutrition montonng diagnosis FIGURE 1.2 The nutrition care process. ke the nursing process, the nutrition care ocess is a problem-solving method used to problems. nutrition-related aluate and treat may also integrate nutrition, the nutritional plan of care devised by dietitians is specific for nutrition problems. Some obvious differences in focus are described below. information about the patient from the Dictitans may obtain much of ther preliminary nursing history and physical examination, such as height and weight, skin integrity over-the-counter swallowing, or self-feeding. chief com- usual diet prior to admission; difficulty chewing, drugs used prior to admission supplements, and plaint, medications, and living situation. Dietitians may request laboratory tests to assess vitamin levels when deficiencies are suspected. micronutrient Dietitians interview patients and / or families to obtain a nutrition history, which may include information on current dictary habits; recent changes in intake or appetite; intake of snacks alcohol consumption; food allergies and intolerances; ethnic, cultura, or religious dict infu- ences; nutrition knowledge and belies, and use of supplements. A nutrition history can help differentiate numtion problems caused by inadequate intake from those caused by discase. Dietitians usually calculate estimated calorie and protein requirements based on the assessment data and determine whether the diet ordered is adequate and appropriate for the individual Dietitians determine nutrition diagnoses that define the nutntional problem, etiology and signs and symptoms. While a nursing diagnosis statement may begin with "Altered nutrition: eating less than the body needs," a nutrition diagnosis would be more specific such as "Inadequate protein energy intake.". Dietitians may also determine the appropriate malnutntion diagnosis code for the patient for hospital interventions may include requesting a dict order change, requesting additiona reimbursement purposes. Nutrition laboratory tests to monitor nutritional repletion, and performing nutrition counseling education.