Lecture 1 - NCP

Question 1

List important anthropometric questions to ask your client;

Answer 1

Weight
Height
Weight change over time
Usual weight
Goal weight

Question 2

List relevant food/nutrition related questions you would ask your client;

Answer 2

Diet hx
FFQ relevant to case (e.g. T2DM and grains)
Level of knowledge
Previous diets/nutrition interventions

Question 3

How do you analyse and interpret step 1 of the NCP?

Answer 3

Using comparative standards;
Estimate dietary requirements (Schofield, Griffith handbook) and compare to EER, EPR, EFR.
Aghe food groups

Question 4

What are the three domains of a nutritional diagnosis?

Answer 4

Intake*
Clinical
Behavioural/Environmental

*try to pick from this domain first

Question 5

What is important to consider when writing up the aetiology of the PES?

Answer 5

Is it the root cause, and is this something we can fix as dietitians

Question 6

What is important to consider when writing up the signs and symptoms of the PES?

Answer 6

Is it quantifiable data?

It must be the basis for monitoring and evaluating progress.

Question 7

What is important to consider when establishing goals and strategies as part of the nutrition intervention?

Answer 7

They must address the etiology and reduce the signs and symptoms

Question 8

What is a goal, and what is a strategy?

Answer 8

A goal is the outcome you want to achieve to change the patients practise.

A strategy assists the patient achieve their goal. Be SMART.

Question 9

What 4 domains should strategies be focused?

Answer 9

Food and nutrition delivery (e.g. Meals , EN, add nutrients).
Nutrition education (e.g. Provide resources, explain conditions in relation to nutrition).
Nutrition counselling (e.g. Goal setting, cognitive behaviour).
Co-ordination of nutrition care (e.g. Dr, biochem; Nurse, food charts, bowels; OT, feeding equipment; SP, swallow).

E.G. EDUCATE; NEGOTIATE; REFER

Question 10

What is important to consider when developing goals and strategies?

Answer 10

They must be SMART.
They consider long term and short term.
Plan them using available resources, Best Practise Guidelines, identifying ways to meet clients nutritional requirements.
Implement them using a ‘patient centred’ approach; what will patient do to meet goals?
Individualise them; they must be acceptable to patient.

Question 11

What is important to consider when writing up the monitoring and evaluation part of the NCP?

Answer 11

Link it to the assessment; e.g. Food/nutrition related hx (diet hx, food diary), anthroptric measurements (wt loss/gain/stable, SGA, NOT ht), biochemistry (r/v lab values, blood pressure), NFPF (swallow), patient centred outcomes (self/efficacy, knowlegde, behaviour changes, QoL)

Include reminder for next appointment.

Include outcome measures for initial and long term monitoring.

Include frequency of monitoring and time frame.

Relate to goals.