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Nutrition Chapter 13 Lecture 1 (Responsibility for Nutrition Care…
Nutrition Chapter 13 Lecture 1
Nutrition in Health Care
Correcting nutritional problems may improve short term and long-term outcomes of medical treatments and help to prevent complications
Malnutrition is frequently reported in pts with acute illness
Estimated of malnutrition in hospital pts range from 38-62%
Health problems
Alter nutrition needs
Can lead to malnutrition
Poor nutrition status
Poor nutritional status weakens the immune function and compromises a person’s ability to heal, which has an ultimate influence over the course of the disease & the body's response to treatment
Longer hospital stays and an increase in the overall cost of pt care
Affect of Illness on Nutrition
Illness along with its s/s, and tx can lead to malnutrition by reducing food intake, interfering with digestion and absorption
Can reduce food intake d/t
Nausea- decrease appetite
Inflammation of mouth- uncomfortable to eat
Medications can cause GI upset and can interferes with digestion & absorption
Alters metabolism & excretion
Prolonged bed rest could result in pressure sores, which increase metabolic stress and raise protein and energy needs
Illness
Dietary restrictions are needed for some surgeries or chronic illnesses which may require a lifetime of change - diabetes
It’s a drain on financial resources
May be unable to prepare food
Causes emotional upset
As a healthcare worker this is our challenge which is to help our pts appreciate the potential benefits of nutrition therapy and accept those dietary changes
Responsibility for Nutrition Care
The members of the health care team work together to make sure that the nutritional needs of the patient are met.
Sometimes the nutrition care of a pt is included in the medical care plan that is developed by the whole team- these plans are critical pathways which is a coordinated plan of care for a specific medical dx, tx, or procedures
Registered Dietitians- food and nutrition experts
Provide medical nutrition therapy
Assess, diagnose, develop, implement & evaluate nutrition care plans
Plan & approve menus
Provide education
Registered Dietetic Technician
Assist the Registered Dietitians in the implementation and monitoring, education and screen pts.
Physicians
Prescribe diet orders and other orders r/t nutrition
Nurses
Screen patients
Participate in nutrition assessments
Provide direct nutrition care- we encourage them to eat, find solutions record I&O and answer questions
Other team members such as pharmacists, & speech therapists consult
Identifying Risk for Malnutrition
Nutrition screening
Identifies persons at risk for nutrition problems
Must be done 24 hours after admission
Should be completed in 10-15 minutes
The assessment data is used to develop a plan of action to prevent or correct energy or nutrient imbalances or to determine whether a care plan is working.
Screening- collect health related data
Medical diagnosis
Medical record
Physical measurements
Lab reports
Diet history
Interview with pt or caregiver
Planning Care
The Nutrition Care Process is what Registered Dieticians use as systematic approach to medical nutrition therapy
Nutrition assessment
Nutrition diagnosis- like nursing dx
Specific nutritional problem, etiology, s/s,
“Unintentional wght loss r/t insufficient kcalorie intake aeb a 10 pound wght loss in the past few months”
Nutrition intervention
May include counseling, or education
Goals are stated in terms of measurable outcomes
DM pt who is overweight would have goals measurable by wght loss and changes in blood glucose levels.
Nutrition monitoring & evaluation
Nursing care plan will include a nursing diagnoses
That will suggest the need for nutritional interventions.
If you look at the nrsg dx of “impaired swallowing”
It alerts others for potential problems with food intake and suggests the need for a modified diet-
This type of nrsg dx can go along with medical disorders Like developmental disabilities, diseases that involve the Esophagus, and neurological conditions
Historical Information
Historical info gives valuable includes about nutritional status and nutrient requirements- also gives us an insight to personal preferences
Medical history
Age
Current complaint
Surgical history
Family medical history
Allergies
Chronic disease risk
Mental status
Social history
Cultural heritage
Socioeconomic status
Cognitive ability
Living situation
Educational level
Employment status
Religious beliefs