NSG 3100 Objectives for Unit 9
1. What is included in a nutritional assessment?
a. Includes an evaluation of weight and recent changes in weight, BMI, diet history,
and pertinent laboratory findings (including serum albumin, serum prealbumin,
nitrogen balance, and other measures)
b. Anthropometric Measurements,
i. Triceps skinfold, mid arm circumference, mid arm muscle area
c. Biochemical Data
i. Serum proteins (Albumin), urinary test, total lymphocyte count
d. Clinical Data
i. Skin, hair, nails, mucosa, Elimination pattern
e. Dietary Data
i. 24 hr food recall, food frequency record, food diary and diet history
2. Know different disciplines involved in collaborative efforts for patients with nutritional
problems.
a. A registered dietitian is helpful in providing nutritional education and services that
may address the psychosocial and economic factors that affect patient care.
b. Case managers are responsible for coordinating timely, cost- effective inpatient
and outpatient services (such as provision of durable medical equipment, infusion
therapy, and transportation for patients), and follow- up after discharge to
promote quality care.
c. Collaboration with a speech therapist is needed for patients who have impaired
swallowing and/or require restorative therapy.
d. Collaboration with a board- certified psychologist may be necessary if
psychological factors might have an impact on the patient’s recovery.
e. Nurse Care Manager coordinates services, equipment, and follow up after
discharge
f. Assistance with feeding can be delegated to UAP.
3. Understand dysphagia, signs and symptoms, and how you would treat it (diet, special
precautions for feeding, etc).
a. Difficulty in swallowing
b. S/S: Coughing during/after swallowing, choking on food/drink, throat clearing,
coughing or vomiting food, weak/soft voice, aspirating, excessive
drooling/saliva/chewing, difficulty chewing, trouble moving food back to mouth,
1
, food sticking in throat, incomplete lip closure, poor tongue control, gagging
before swallowing, hold food in pocket, refuse to eat.
c. Diet: Pureed food: food in blender with pulp like texture Thick Liquid
4. Know nursing considerations for patients on special diets.
a. Nurses play an important role in ensuring safety, monitoring intake, and educating patients
i. Assess patient ability to eat: Before feeding a patient, assess: LOC, Ability to swallow, Presence
of nausea or vomiting Dentition (teeth or dentures) Appetite
1. Patients with dysphagia may require: Thickened liquids Pureed foods Speech therapy
evaluation
b. Prevent aspiration
c.
5. Know how to obtain anthropometric measurements (Box 30.8)
a. Measurements include height, weight, length (infant, toddler), head
circumference
b. Height: remove shoes,/stand erect. Use measuring tape to measure 90 degree
angle from top of head to heel of feet
c. Weight: weight measured at the same time everyday, same scale, same clothing
d. Body index= weight (kg)/height (m)^2
i. < 18.5kg underweight
ii. 18.5k-24.9kg normal weight
iii. 25.0kg-29.9kg over weight
iv. 30.0kg-34.9kg obese class 1
v. 35.0kg-39.9k obese Class 2
vi. More than 39.9k extreme obesity class 3
6. Understand significance of BMI and obesity, associated health complications and
nursing interventions for different BMI’s including collaborative efforts.
a. BMI of 30 or higher is considered obese
b. BMI 25-29.9and obesity contribute to an increased incidence of health related
conditions like diabetes, hypertension, heart disease and other chronic disease
c. Nursing interventions: promote balanced nutrition, Encourage physical activity,
Monitor weight trends, Support patient-centered goals, Address psychosocial
factors
7. Examples of foods rich in Vit C and Vit A, and those that aid wound healing.
a. Vitamin C: collagen synthesis, wound healing
2
1. What is included in a nutritional assessment?
a. Includes an evaluation of weight and recent changes in weight, BMI, diet history,
and pertinent laboratory findings (including serum albumin, serum prealbumin,
nitrogen balance, and other measures)
b. Anthropometric Measurements,
i. Triceps skinfold, mid arm circumference, mid arm muscle area
c. Biochemical Data
i. Serum proteins (Albumin), urinary test, total lymphocyte count
d. Clinical Data
i. Skin, hair, nails, mucosa, Elimination pattern
e. Dietary Data
i. 24 hr food recall, food frequency record, food diary and diet history
2. Know different disciplines involved in collaborative efforts for patients with nutritional
problems.
a. A registered dietitian is helpful in providing nutritional education and services that
may address the psychosocial and economic factors that affect patient care.
b. Case managers are responsible for coordinating timely, cost- effective inpatient
and outpatient services (such as provision of durable medical equipment, infusion
therapy, and transportation for patients), and follow- up after discharge to
promote quality care.
c. Collaboration with a speech therapist is needed for patients who have impaired
swallowing and/or require restorative therapy.
d. Collaboration with a board- certified psychologist may be necessary if
psychological factors might have an impact on the patient’s recovery.
e. Nurse Care Manager coordinates services, equipment, and follow up after
discharge
f. Assistance with feeding can be delegated to UAP.
3. Understand dysphagia, signs and symptoms, and how you would treat it (diet, special
precautions for feeding, etc).
a. Difficulty in swallowing
b. S/S: Coughing during/after swallowing, choking on food/drink, throat clearing,
coughing or vomiting food, weak/soft voice, aspirating, excessive
drooling/saliva/chewing, difficulty chewing, trouble moving food back to mouth,
1
, food sticking in throat, incomplete lip closure, poor tongue control, gagging
before swallowing, hold food in pocket, refuse to eat.
c. Diet: Pureed food: food in blender with pulp like texture Thick Liquid
4. Know nursing considerations for patients on special diets.
a. Nurses play an important role in ensuring safety, monitoring intake, and educating patients
i. Assess patient ability to eat: Before feeding a patient, assess: LOC, Ability to swallow, Presence
of nausea or vomiting Dentition (teeth or dentures) Appetite
1. Patients with dysphagia may require: Thickened liquids Pureed foods Speech therapy
evaluation
b. Prevent aspiration
c.
5. Know how to obtain anthropometric measurements (Box 30.8)
a. Measurements include height, weight, length (infant, toddler), head
circumference
b. Height: remove shoes,/stand erect. Use measuring tape to measure 90 degree
angle from top of head to heel of feet
c. Weight: weight measured at the same time everyday, same scale, same clothing
d. Body index= weight (kg)/height (m)^2
i. < 18.5kg underweight
ii. 18.5k-24.9kg normal weight
iii. 25.0kg-29.9kg over weight
iv. 30.0kg-34.9kg obese class 1
v. 35.0kg-39.9k obese Class 2
vi. More than 39.9k extreme obesity class 3
6. Understand significance of BMI and obesity, associated health complications and
nursing interventions for different BMI’s including collaborative efforts.
a. BMI of 30 or higher is considered obese
b. BMI 25-29.9and obesity contribute to an increased incidence of health related
conditions like diabetes, hypertension, heart disease and other chronic disease
c. Nursing interventions: promote balanced nutrition, Encourage physical activity,
Monitor weight trends, Support patient-centered goals, Address psychosocial
factors
7. Examples of foods rich in Vit C and Vit A, and those that aid wound healing.
a. Vitamin C: collagen synthesis, wound healing
2
