CHAPTER 1 Nutrition in Nursing Screening Nutrition monitoring Nutrition and evaluation FIGURE 1.2 The nutrition care process. Like the nursing process, the nutrition care evaluate and treat problem-solving nutrition-related method used to process is a intervention problems 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 Dietitians may obtain much of their preliminary examination, such as height and weight; skin integrity. nursing history and physical usual diet prior to admission; difficulty chewing, swallowing, or self feeding, chief com- supplements, and over the-counter drugs used prior to admission; 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 dietary habits; recent changes in intake or appetite; intake of snacks: alcohol consumption; food allergies and intolerances ethnie, cultural, or religious diet influ- ences; nutrition knowledge and beliefs and use of supplements. A nutrition history can help nutrition problems caused by inadequate intake from those caused by disease. differentiate Dietitians usually calculate estimated calone and protein requirements based on the assessment data and determine whether the dict ordered is adequate and appropriate for the individual. Dietitians determine nutrition diagnoses that define the nutritional problem, etiology, and signs and symptoms, while a nursing diagnosis statement may begin with "Altered nutrition: eating less than the body necds," a mutrition diagnosis would be more specific. intake. protein-energy such as "Inadequate Dietitians may also determine the appropriate malnutrition diagnosis code for the patient reimbursement for hospital purposes. additional interventions may include requesting a diet order change, requesting counseling or .Nutrition nutritional repletion, and performing nutrition laboratory tests to monitor education.