CHAPTER 1 Nutrition in Nursing ased on Maslow's hierarchy of needs, food and nutrition rank on the same level as air in the basic necessities of life. Obviously, death eventually occurs without food. But unlike air, food does so much more than simply sustain life, Food is loaded with person al, social, and cultural meanings that define our food values belich, and customs. That food our ishes the mind as well as the body broadens nutrition to an art as well as a science. Nutrition is not simply a matter of food or no food but rather a question of what kind, how much, how often, and why. Merging want with need and pleasure with health are keys to feeding the body, mind, and soul. Although the dietitian is the nutrition and food expert, nurses pla a vital role in nutri- tion care Nurses may responsible for screening hospitalized patients to identity patients at nutritional risk. They often serve as the liaison between the dietitian and physician as well as with other members of the health-care team. Nurses have far more contact with the patient and family and are often available as a nutrition resource when dietitians are not instructions. In home care such as during the evening, on weekends, and dunng discharge and wellness settings, dietitians may be available only on a consultative basis. Nurses may reinforce nutrition counseling provided by the dietitian and may be responsible for basi nutrition education in hospitalized clients with low to mild nutritional risk. Nurses are inti mately nvolved in all aspects of nutritional care This chapter discusses nutrition within the context of nursing, including nutrition screening and how nutrition can be integrated into the nursing care process. SCREENING NUTRITION g is a quick look at a few variables to identify individuals who are mal Nutritional Screen. Nutrition a quck look at a few nourished or who are at risk for malnutrition so that an in-depth nutrition assessment variablas to judge a can follow. Screening tools should be simple, reliable, valid, applicable to most patients clients relative risk for nutr tonal problems. or clients in the group, and use data that is readily available Academy of Nutrition and senior center may use a nutrition Can be custam de Dietetics. 2012). For instance, a community-based Big ed for a particular screen that focuses mostly on intake risks common to that population, such as whe cr has physical limitations that impair the abil the client eats alone most of the time an population leg. preg women or for ity to buy or cook food (Fig. 1.1). In contrast, common screening parameters in acute a specific disorder e.g., cardiac disease! care settings include unintentional we ght loss, appetite, body mass index (BM disease severity. Advanced age, dementia, and other factors may be considered. There is Malnutrition: literally no univer ally agreed upon tool that is valid and reliable at identifying risk of malnutrition bad nutrition" or any nutritional imbalarce in all populations at all times rganization that sets health-care standards and including overnurition The Joint Commission, a nonprofit In practice, malnutrition accredits health-care facilities that meet those standards, specifies that nutrition screening be usually means undemu conducted within 24 hours after admission to a hospital or other health-care facility even tntion or an inadequate intake at protein and/or on weekends and holidays. The Joint Commission allows facilities to determine sereening criteria and how risk is defined. For instance, a hospital may use serum creatinine level as a calories that causes criterion with a level greater than 2.5 m/dL defined as "high risk because the ls fat sewandel screening muscle wasting majority of their patients are elderly and the prevalence of chronic renal problems is high The Joint Commission also leaves the decision of who performs the screening up to indi vidual facilities. Because the standard applies 24 hours a day, 7 days a week, staff nurses are often responsible for completing the screen as part of the admission process. Clients who ass" the initial screen are rescreened after a specified amount of time to determine if their status has changed