NCP DIME Flashcards
Diagnoses:
PES statements
Problem related to Etiology as evidenced by signs and symptoms
problem is the_____
nutrition diagnoses
etiology refers to ____
the cause or contributing factor and is linked to the problem/diagnoses
signs and symptoms_____
indicators used to determine nutrition diagnoses; will be used in monitoring and evaluation steps
Etiology tells ____
Signs & Symptoms tells___
- what intervention is needed
- indicators/markers that need to be monitored and evaluated
3 Domains of Nutrition diagnostic terminology:
Intake, Clinical, Behavioral
- Intake (excessive or inadequate) energy balance, oral/nutrition support intake, fluid intake, bioactive substances, nutrients
- Clinical (medical/physical conditions abnormal): functional, biochemical, weight
- Behavioral (problems relating to knowledge, attitude, beliefs, physical environment, access to food/food safety) knowlegde and beliefs, physical activity, food safety and access
When developing PES statements, RDN should focus on:
- inferences
- prioritization
- differential diagnosing
Diagnosing in nutrition education setting:
nutrition problems more likely to be knowledge deficit on food choices or cooking
Diagnosing in MNT setting:
pertains to medical conditions resulting in admisson
Signs are_____
Symtoms are_____
- objective and observable changes in pt health status
- subjective changes that pt feels
?: purposeful planned actions intended to positively change a nutrition related behavior, environment, conditions, or aspect of health status
Intervention
RDN chooses intervention that addresses the:
etiology of the nutrition problem
4 domains for nutrition internvention:
1) Food and/or nutrient delivery
2) Nutrition education
3) Nutrition counseling
4) Coordination of nutrition care
HPDP
Health promotion and Disease prevention
can: improve QOL, length of life, prevent disease in a cost-effective manner, delay health care costs
Goals in the intervention phase should be:
SMART (specific, measurable, achievable, relevant and realistic, and time-defined)
Identifying desired outcomes and actions should be based on:
evidence-based practice
5 factors the affect nutrition status
human biology, lifestyle, food and nutrient, environmental, system
First category of nutrition intervention is:
food and/or nutrient delivery
IDDSI level 0
Thin: flows like water, drink through cup/straw
IDDSI level 1
Slightly Thick: thicker than water, straw and syringe
IDDSI level 2
Mildly thick: flows off spoon, sippable, mild effort with straw
IDDSI level 3
Moderately thick and Liquidized: can be drunk from cup, moderate effort with straw, cant be eaten with fork, can with spoon
CANT be layered or molded on plate
IDDSI level 4
Extremely thick and Pureed: eaten spoon, cant be drunk, no straw, no chewing. CAN be piped, molded or layered. Falls off spoon when tilted, not sticky, liquid doesn’t separate from solid
IDDSI level 5
Minced and Moist: fork/spoon, scooped and shaped on plate, soft and moist without separated thin liquid
IDDSI level 6
Soft Bite Sized: fork, spoon, chopstick, mashable, no knife needed, chewing needed, moist without separated liquid,
IDDSI level 7
Regular Easy to chew: don’t present food with choking hazard
IDDSI food testing methods:
fork drip test, spoon tilt test, fork pressure and spoon pressure test
Fork Drip test used for:
IDDSI 3-5 foods appropriate thickness and cohesiveness
Spoon tilt test for:
Adhesiveness and cohesiveness of foods
Fork/Spoon pressure test used for:
IDDSI 4-7, how hard the food is
Drinks tested using:
gravity flow 10mL syringe test
Nutrition intervention has 2 steps:
planning and implementation
In Planning you:
prioritize nutrition diagnoses
Implementation includes:
communicating the intervention (plan of care), carrying it out, and continuing data collection via M&E
4 Domains of Monitoring and Evaluating:
- food/nutrition related history outcomes
- anthropometric measurement outcomes
- biochemical data, medical tests, and procedure outcomes
- NFPE outcomes
Direct Nutrition Outcomes
food and nutrition related history, anthropometric measurements, biochemical data, medical tests, procedures, NFPE
Healthcare utilization outcomes
nutrition interventions that have a measurable effect on reducing amount of healthcare pt uses
Patient-centered outcomes
QOL, health related QOL, functional status, symptoms, treatment adherence
Nutrition care outcomes
results of nutrition care related to the nutrition diagnoses and intervention plan goals.
Nutrition indicators
markers measures and evaluated to determine how well nutrition care intervention is working
Documentation should be:
transparent (date and time), accurate, objective, thorough, complete
?: recommendations that define appropriate care for a patient with medical issue and promote consistency and quality
Standards of care
?: used to identify critical elements that should occur in course of patient’s treatment and associate a timeframe
Critical pathways
?: feature of patient centered care and involves evaluating pt risk, planning care plans, and coordinating/monitoring care
Case management
?: shown to increase patient satisfaction with care while reducing healthcare spending and achieving positive health outcomes
Case management
?: process of reducing number og unnecessary tests/procedures (completed by manager to ensure pt treatment plans adhere to Standards of care)
Utilization management
Standardized nutrition indicators and nutrition care criteria increase:
validity and reliability of outcome
What can aggregate nutrition care data?
Nutrition care outcome management system
