UNIT 4 Flashcards by siomai a

is a systematic method to provide high-quality nutrition care.

NUTRITION CARE PROCESS

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it was published as part of the Nutrition Care Model
the process provides a framework for the Registered Nutritionist/Registered Nurse to customize care
use of the NCP can lead to more efficient and effective care, nutrition research

NUTRITION CARE PROCESS

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Its purpose is to obtain adequate information to identify nutrition-related problems.

NUTRITION ASSESSMENT

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is a systematic process of obtaining, verifying, and interpreting data to make decisions about the nature and cause of nutrition-related problems.

Nutrition assessment

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It is an accurate method for assessing the nutritional statues

Dietary history

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The information should be collected by a trained interviewer

Dietary history

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Details about usaul intake, types, amount, frequency & timing needs to be obtained

Dietary history

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Cross checking to verify data is important

Dietary historry

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Advantage: easily done
diasdvantage: patients may hoard food which is recorded as eaten

Plate diagram

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Advante: easily done
disadvante: people can remember snack but often forget snacks

24-HOUR RECALL

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Advantage: qualitative
Disadvantage: Inaccurate estimates of actual quantity of food consumed

1 to 3 day record

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Advantage: Easily done
Disadvantage: May significantly underestimate usual intakes

Food frequency questionnaires

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Amount, frequency, type of food consumed
-period of collection 1-7 days
-reliable, but difficult to maintain

Food Diary

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CDC guidelines define a height for age values less than 5th percentile as short stature

Stature

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Measured at the nipple midway between inspiration and expiration

Chest circumference

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30cm at birth
50cm by yrs

Head circumference

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Low weight for-age is a marker of failure to thrive

Rayner and Rudolf

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Anthropometric Parameters
BASIC MEASUREMENTS

-height, weight, circumference eg OFC( infant up to age 2 years only)
-skin-fold thickness

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Some measurements used for nutritional assessment include:

Height, Mass, BMI, Triceps skin-fold, Waist, hip and mid arm circumference, and derived measurements/ratios

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-It is a measure of body fat based on your weight in relation to your height
-It is more of an indicator than a direct measurement of a person’s total body fat
-

BMI

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BMI CALCULATION

Weigh in kg/ (height in m)^2

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Under weight

<18.5

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Normal range

18.5-24.9

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Over weight

25.0-29.9

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Obese

>=30

Obese class 1

30.0-34.9

Obese class 2

35.0-39.9

obese class 3

>=40

A defect in the gene that synthesizes leptin, which is a crucial hormonal substance produced by fat and released into the bloodstream that acts on hypothalamus to regulate body weight

Genetic factor

-congenital absence of leptin produces continual hunger and marked obesity in childrens - the second genetic defect observed is the body's response to the signal leptin provided -this signal largely determines how much one eats, how much energy one expends and ultimately one's body weight

Genetic Factor

Studies have shown that __ people are about 25 percent more likely to experience a mood disorder like depression compared with those who are not obese

obese

Sedentary lifestyle can lead to obesity and so active lifestyle can overcome such problems

Level of physical activity

A large consumption of foods high in sugar and fat increases the likelihood of weight gain. Consequently, the total energy intake rises, which causes problems of overweight and vice versa

Dietary habits

Insomnia or lack of sleep can cause hormonal imbalance that increase your appetite or craving for foods high in calories and carbohydrates

Sleeping hours

- economic constraints contribute to unhealthy food choices

economical factor

The act of identifying a disease or condition from its signs and symptoms. Investigation or analysis of the cause or nature of a condition, situation, or problem.

STEP 2. NUTRITION DIAGNOSIS

Is summarized into structured sentence called PES Statement

The Nutrition Diagnosis

PES

Problem, Etiology, Signs and symptoms

consider the intake, More specific to the role of RDN

(P) Problem

the root cause

(E) Etiology

that is needed to monitor and document

(S) Signs and symptoms

leads to selection of the nutrition intervention aimed at resolving the underlying cause of the nutrition problem

Identifying the etiology

three general domains

Intake, Clinical, behavioral-environmental

Excessive or inadequate intake compared to requirements

Intake

Medical or physical conditions that are outside normal

Clinical

Relate to knowledge, attitudes, beliefs, physical environment, access to food, or food safety

Behavioral-Environmental

Is purposely planned actions intended to positively change a nutrition related behavior, environmental condition, or aspect of health status

Nutrition intervention

- directed to the etiology or cause of the problem identified in the PES statement.. -sometimes the intervention must be directed toward the signs and symptoms if the RDN cannot impact the etiology

Nutrition intervention

Two interrelated components of nutrition intervention

Planning, implementation

Prioritize the nutrition diagnosis Set goals and determine expected outcome Define specific nutrition intervention strategy Define time and frequency of care

PLANNING

Communicate and carry out the plan of care Continue data collection

IMPLEMENTATION

Four domains

-food and/or nutrient delivery -nutrition education -nutrition counseling -coordination of nutrition care

Determines whether the patient is meeting the nutrition intervention goals or desired outcomes

STEP 4. NUTRITION MONITORING AND EVALUATION

is needed to identify whether the nutrition-related problem still exists and evaluate the progress made toward resolving the problem

NUTRITION REASSESSMENT

progress toward the nutrition intervention or goal

Monitor

The appropriate nutrition care indicators

Measure

The nutrition care indicators against appropriate standards selected during the nutrition care planning

Evaluater

Quality documentation for nutrition monitoring and evaluation includes the ff:

-date and time -indicators measured, results, and the mthod for obtaining the measurement -criteria to which the indicator is compared -factors facilitating or hampering progress -other positive or negative outcomes -future plans for nutrition care, nutrition monitoring, and follow-up discharge

Following tools may be used to evaluate patient/client's progress

-patient/client questionnaires -suirveys -pretests and posttests -patient/client/family member intervers -anthropometric measuremtns -biochemical and medical test results -food and nutrition intake tools

Method for collecting the outcome

diet record and recall

Data source

patient, family/caregiver, chart

Intervention components

type, duration, and intensity

Describes the patient's progress through consistent terms that are evaluated based on carefully selected indicators and criteria

Nutrition Monitoring and Evaluation.