Nutrition in the nursing prosess
In nursing care plans, nutrition may be part of the assessment data, diagnosis, plan, or evaluation. The remai nder of this chapter is intended to help nurses imple provide quality nursing care that includes basic nutrition, not to help nurses become dietians.
Assessment
It is well recognized that malnutrition ts a major contributor to morbidity, mortality, im paired quality of life, and prolonged. hospital stays (white et al .. 2012). However, there is currently no sin gle. universally agreed upon method to assess or diagnose malnutrition. pproaches vary widely and may lack sensitivity (the ability to diagnose all people who are malnourishe d) and specificity (misdiagnosing a well-nourished penon). For instance, albumin and prealbumin have been used as diagnostie markers of malnutrition. These pro teins are now known to be negative acute phase proteins, which means their levels de. crease in response to inflammanon and physiologe stress. Because are not specific for nutritional status, failure of these levels to increase with nutntion repletion does not mean that nutrition thery is inadequate Fessler, 2008). Although their usefulness malnutrition is limited, thee proteins may help identify patients ar high risk for diagnosing morbidity, mortality, and malnutrition (Banh, 2006). BMI and some or all of the compo- nents of subjective global assessment (Box 1.1) are commonly used to assess nutrition (Fessler, 2008) Medical History and Diagnosis The chief complaint and medical history may reveal disease-related risks for malnutrition inflammation is present. (Fig. 13). Patients with gastrointestinal and whether symptoms or disorders are among those who are most prone to malnutrition, particularly when symptoms such as nausea, vomiting. diarrhea, and anorexia last for more than 2 weeks. Box 1.2 lists psychosocial factors that may impact intake or requirements and help identify nutrition counscling needs.