Chapter 2: Diagnosis and Intervention Flashcards
second step of the NCP, which is defined as the “identification and labeling of nutritional problems that dietetics practitioners are responsible for treating independently” (Lacey and Pritchett 2003). In 2005, the ADA approved a specialized terminology for dietetics practice, the International Dietetics and Nutrition Terminology (IDNT). IDNT contains four sets of terms and definitions, one for each step of the NCP.
Nutrition Diagnosis
practiced by many religions. It has been identified as a mechanism that allows one to improve one’s body, to earn approval (as with Allah or Buddha), or to understand and appreciate the sufferings of others.
Fasting
defined as “purposely planned actions intended to positively change a nutrition-related behavior, environmental condition or aspect of health for an individual (and his/her family or caregivers), target group or the community at large” (ADA, 2009).
Nutrition Intervention
Two Types of NI
Direct nutrition interventions
Indirect interventions
might include nutrition education, insertion of an enteral feeding tube, or providing recipes for modified diets.
Direct nutrition interventions
might include referrals to outside agencies, collaborating with colleagues in pharmacy for medication management, or requesting orders for nutrition education.
Indirect interventions
the format closely reflects the steps of the nutrition care process. The letters represent the different steps: Assessment, Diagnosis, Intervention, Monitoring and Evaluation.
ADIME format
the oldest method for documenting nutrition care and is
still in popular use.
SOAP format
information obtained in an interview with the patient or caregiver and includes chief medical problem and relevant symptoms
Subjective
information includes nutrition screening or assessment data, such as the results of anthropometric and laboratory tests and the physical examination.
Objective
information includes nutrition screening or assessment data, such as the results of anthropometric and laboratory tests and the physical examination.
Objective
section contains brief evaluation of the subjective and objective data and provide concise diagnoses of the nutrition problems.
Assessment
recommendations that can help solve the problem, including the nutrition prescription, plan for nutrition education and counseling, and referrals to other professionals or agencies.
Plan
approach for food/nutrient provision.
Food and/or Nutrient Delivery
A formal process to instruct or train a patient/client in a skill or to impart knowledge to help patients/clients voluntarily manage or modify food, nutrition and physical activity choices and behavior to maintain or improve health
Nutrition Education
A supportive process, characterized by a collaborative counselor-patient relationship, to establish food, nutrition and physical activity priorities, goals, and individualized action plans that acknowledge and foster responsibility for self-care to treat an existing condition and promote health
Nutrition Counseling
Consultation with, referral to, or coordination of nutrition care with other health care providers, institutions, or agencies that can assist in treating or managing nutrition related problems
Coordination of Nutrition Care
This includes all aspects of an “individualized approach to food/nutrient provision” (ADA, 2009). These interventions include the amount of foods served, type of foods, meal timing, mealtime environment, and alternate methods for feeding
Food Nutrient and Delivery
provides nutrients using the gastrointestinal tract (GI) tract. Enteral nutrition includes oral diets or supplements, but the term more often refers to the use of tube feedings, which supply nutrients directly to the stomach or intestine via a thin, flexible tube.
Enteral feeding
tube is placed into the stomach via the nose
Nasogastric
tube is placed into the GI tract via the nose. (nasoenteric feeding usually refer to nasoduodenal and nasojejunal feedings.)
Nasoenteric
tube is placed into the duodenum via the nose
Nasoduodenal
tube is placed into the jejunum via the nose
Nasojejunal
tube is inserted into the stomach through the mouth. This method is often used to feed infants because a nasogastric tube may hinder the infant’s breathing.
Orogastric tube
an opening into the GI tract through the abdominal wall.
Enterostomy
an opening into the stomach through which a feeding tube can be passed. A nonsurgical technique for creating a gastrostomy under local anesthesia is called percutaneous endoscopic gastrostomy (PEG).
Gastrostomy
an opening into the jejunum through which a feeding tube can be passed. A nonsurgical technique for creating a jejunostomy is called percutaneous endoscopic jejunostomy (PEJ). The tube can either be guided into the jejunum via a gastrostomy or passed directly into the jejunum (direct PEJ).
Jejunostomy
Types of Enteral Formulas
• Standardized/ Intact formulas
• Elemental formulas
• Modular formulas
• Specialized formulas
• nutrients are delivered using only the peripheral veins
• the infusion of nutrient solutions into peripheral veins, usually a vein in the
arm or back of the hand
• most often used in patients who require short-term nutrition support (about 7 to 10 days) and who do not have high nutrient needs or fluid restrictions
Peripheral Parental Nutrition (PPN)
• the infusion of nutrient solutions into a central vein
• preferred for patients who require long-term parenteral nutrition
Total Parenteral Nutrition (TPN)
