Assessment and Care
Nutritional Risk
• Primary: Inadequate intake of nutrients
• Secondary
o Illness/Disease
o Iatrogenic effects
Malnutrition -- Pay attention to signs and symptoms
Dietary History
• assess dietary history through the use of food diary
Food Selection
• Attitudes toward nutrition and dietary
• Food preferences
• Food choice
• Food liking
Assessment Tools
• Physical assessment
o BMI calculation to gather objective data on nutritional status
o Pay attention to BMI parameters
• Biceps/triceps skin-fold measurement
, Clinical Values
• Fluid intake and output
• Calorie count
o record foods and amount of calories
o Record actual percentages of what the patient has eaten
• Hemoglobin level
o may be low due to iron deficiency
Visceral Protein Status
• Albumin Level
o late indicator of malnutrition
o stored in muscles (somatic) and blood/organs (visceral)
▪ most abundant in blood
• half-life is 20 days
o Good index for patient who are otherwise healthy
▪ elderly live alone and scheduled elective surgery
o Normal: 3.5-5.0
Prealbumin Level
• Normal: 16-40 mg/dL
• Half-life in serum for 2 days
• More sensitive indicator
o Changes in protein levels for shorter timeframes
o Recent dietary intake
• Best indicator for malnutrition
o Trauma, Stress, Infection
• Low level
o Protein Malnutrition
o Protein deficiency
Diet Modification
• Clear Liquid Diet
o chicken broth, tea, coffee, cranberry juice, and water
• Full Liquid Diet
o Careful planning provides adequate nutrients
o strained soup, cereals, juice, water, puddings
o Advantage: carefully planned it can add adequate nutrition
Nutritional Risk
• Primary: Inadequate intake of nutrients
• Secondary
o Illness/Disease
o Iatrogenic effects
Malnutrition -- Pay attention to signs and symptoms
Dietary History
• assess dietary history through the use of food diary
Food Selection
• Attitudes toward nutrition and dietary
• Food preferences
• Food choice
• Food liking
Assessment Tools
• Physical assessment
o BMI calculation to gather objective data on nutritional status
o Pay attention to BMI parameters
• Biceps/triceps skin-fold measurement
, Clinical Values
• Fluid intake and output
• Calorie count
o record foods and amount of calories
o Record actual percentages of what the patient has eaten
• Hemoglobin level
o may be low due to iron deficiency
Visceral Protein Status
• Albumin Level
o late indicator of malnutrition
o stored in muscles (somatic) and blood/organs (visceral)
▪ most abundant in blood
• half-life is 20 days
o Good index for patient who are otherwise healthy
▪ elderly live alone and scheduled elective surgery
o Normal: 3.5-5.0
Prealbumin Level
• Normal: 16-40 mg/dL
• Half-life in serum for 2 days
• More sensitive indicator
o Changes in protein levels for shorter timeframes
o Recent dietary intake
• Best indicator for malnutrition
o Trauma, Stress, Infection
• Low level
o Protein Malnutrition
o Protein deficiency
Diet Modification
• Clear Liquid Diet
o chicken broth, tea, coffee, cranberry juice, and water
• Full Liquid Diet
o Careful planning provides adequate nutrients
o strained soup, cereals, juice, water, puddings
o Advantage: carefully planned it can add adequate nutrition
