Cues

Nursing Diagnosis/ Scientific Basis Altered Nutrition: Less than body requirements related to decreased oral intake

Planning After 8 hours of nursing care the patient will be able to: Progressively gains weight toward desired goal Weight is within normal range for height and age Recognizes factors contributing to underweight Identifies nutritional requirements Consumes adequate nourishment

Subjective: Dili man ni siya mukao as verbalized by her grandmother

Objective: Lack of interest in food Reported inadequate food intake less than RDA(Recommended Dieatary Allowance) Aversion to eating

Scientific Basis: Inability to ingest or digest food or absorb nutrients because of biological, psychological, or economic factors

Nursing Intervention >Determine healthy body weight for age and height. Refer to dietitian for complete nutrition assessment if 10% under healthy body weight or if rapidly losing weight. Legal intervention may be necessary. >Observe client's ability to eat (time involved, motor skills, visual acuity, ability to swallow various textures).

Rationale Early diagnosis and a holistic team treatment of eating disorders are desirable.

Evaluation GOAL PARTIALLY MET! After 8 hours of nursing care the patient was able to: Recognizes factors contributing to underweight Identifies nutritional requirements

Poor vision was associated with lower protein and energy (calorie) intakes in home care clients independent of other medical conditions Nursing assistance with activities of daily living (ADLs) will conserve the client's energy for activities the client values. Clients who take longer than 1 hour to complete a meal may require

>If client lacks endurance, schedule rest periods before meals and open packages and cut up food for client.

assistance An abnormal value in a single diagnostic study may have many possible causes, but serum albumin less than 3.2 g/dl was shown to be highly predictive of mortality in hospitals, and serum cholesterol of less than 156 mg/dl was the best predictor of mortality in nursing homes The consequences of malnutrition can lead to a further decline in the patient's condition that then becomes self-perpetuating if not recognized and treated. Extreme cases of malnutrition can lead to septicemia, organ failure, and death (Arrowsmith,

>Evaluate client's laboratory studies (serum albumin, serum total protein, serum ferritin, transferrin, hemoglobin, hematocrit, vitamins, and minerals).

>Assess for recent changes in physiological status that may interfere with nutrition.

1997). Diarrhea in patients receiving warfarin has been suggested as possibly causing lower intake and/or malabsorption of vitamin K It may be difficult to tell if the problem is physical or psychological. Refusing to eat may be the only way the client can express some control, and it may also be a symptom of depression Mealtime usually is a time for social interaction; often clients will eat more food if other people are present at mealtimes. Good oral hygiene enhances appetite; the condition of the oral mucosa is critical to the ability

>Observe client's relationship to food. Attempt to separate physical from psychological causes for eating difficulty.

>Provide companionship at mealtime to encourage nutritional intake.

>Provide good oral hygiene before and after meals.

to eat. The oral mucosa must be moist, with adequate saliva production to facilitate and aid in the digestion of food