Collecting Clinical Data

Question 1

Clinical data / nutrition impact symptoms

Answer 1

Factors or symptoms impacting on nutrition
If patient has all of these symptoms have to work out a systematic plan through prioritisation. Eg how to give them confidence to eat the right thing to reduce the problem

Appetite/ satiety 
Nausea
Vomiting
Bowel habits 
Medications
Pain 
Fatigue/ energy levels
Sleepiness 
Hair loss/ nails/ skin 
Mental state

Question 2

Ways of collecting data

Answer 2

Conversation
Build report - body language, sit next to patient, cultural personnel in room
Questionnaire- pre assessment tool
Other interventions already in place- trash magazine advice, could be bettering or worsening symptoms
Prioritising symptoms that they most want to fix- eg providing a scale of pain to suggest the worst problem

Question 3

Challenges

Answer 3

Cultural barriers- interpreter, friend etc.
Uncomfortable conversations- vowel movements periods etc, try to make them feel as comfortable as possible
Dementia, confusion, mental state. Try to talk to the patient first to assess how severe it is
Trauma- other methods of communication that are non verbal eg using whiteboard, iPad, technology

Question 4

Poor appetite

Answer 4

What is causing this decreased appetite and what is their baseline?
Small frequent meals, not overloading plate
Blood tests
Talking about medications already on- is it a side effect?
Shifting feeding to periods of hunger- when they have least loss of appetite?
Can I use liquids instead of solids
Exploring patients favourite foods, how can I incorporate this?
Food fortification- making every mouthful count

Question 5

Bowel habits

Answer 5

Using correct jargon depending on patient
Bristol stool chart to collect data
Process of elimination- foods, liquids

Question 6

Fatigue

Answer 6

Lack of concentration, cannot remember decreases in appetite
Referral to an OT
Exercise physiologist
Blood tests- thyroid, mineral deficiencies, gut problem etc. holistic- could occur as a result of many things

Question 7

Pain

Answer 7

Varies on type of pain
Determine severity of pain
If acknowledge max degree of pain, go in and assess them on that particular day, are they feeling better? Are they on pain medication
Fish oil tablets, turmeric etc. magnesium- muscle relaxant

Question 8

PPI medication side effects

Answer 8

Used to inhibit gastric acid secretion causing reflux

Inability to break down fats and protein
Low pH required for gastric emptying, hence heavy gut feeling
Inability to kill off bacteria hence leading to diarrhoea and infection.
When good exits stomach it is required to be a specific pH. Cells in the duodenum are not triggered if pH is not low enough- hence lack of release of bile and pancreatic enzymes, hence diarrhoea. Ie digestion occurring too quickly and large bowel doesn’t know how to digest. Leads to distension and flatulence.
Acid require to break down protein, B12 attached hence deficiency
Acid required to increase solubility of many minerals - hence may be due to lack of calcium absorption, which may be due to lack of B12 absorption assisting calcium