Nutritional Assessment

A Presentation

Nurse’s Role in Nutritional Assessment

• Monitoring and intervention to clients needing acute and chronic nutritional care

• Incorporate family nutritional habits into nutritional care

• Active role in community teaching regarding nutrition

COLLABORATIVE MULTIDISCIPLINARY APPROACH

A varied approach to nutritional assessment will provide the best outcomes for the client: physical assessment by nurses/other providers, comprehensive nutritional assessments by registered dieticians/nurses, and follow-up by nurses/dieticians

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Methods of Nursing Nutritional Assessments

• Food Intake Assessment• Physical Assessment• Anthropometric Tools• Clinical Values

Methods to Evaluated Food Intake

1. Comparision with the MyPyramid Model: Asks client what he or she eats Compares this reported food intake with MyPyramid Model

2. Food Frequency: requests client to fill out a questionnaire asking about Usual food intake during specified times, such as

“What do you usually eat for breakfast?”

3. 24 Hour Recall: asks client what he or she has eaten during the previous24 hours.

4. Food records: asks client to record his or her food intake for a specifiedLength of time (1 day, 3 days, 7 days)

5. Diet History: comprehensive interview to obtain thoroughInformation about food intake, medications, allergies, nutrition knowledge,Cultural preferences, weight history, elimination patterns, alcohol andTobacco usage, financial ability, functional ability to chew and swallow, andSpecial dietary needs.

Nutrition Information about YouWhat does your nutrition label say about You?

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Physical Assessment

• Head to Toe Assessment• Focuses on General Appearance and

signs and symptoms of Nutritional Imbalance

Signs and symptoms of Inadequate Nutrition

• Hair: dry, dull, or brittle• Skin: Dry patches• Wounds: poor wound healing or sores• Fat and Muscles: lack of subcutaneous fat

and/or muscle wasting• Vital signs: abnormal cardiovascular

measurements• General: general weakness and/or

impaired condition

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Anthropometric Tools

Weight assessment: same time of day typically daily or weekly (view this video clip to see correct weight demonstration: http://www.youtube.com/watch?v=B_YBgEElm_A)

Height measurement: measured in cm or in

Anthropometric Tools

Body Mass Index (BMI): BMI = weight (kg) /height(m2)

Body Fat Composition Methods: skin fold measurements (usually back of the arm), waist to hip ratio, densitometry (underwater weighing)

Clinical Values to Assess Nutritional Status

1. Fluid Intake and Ouput: otherwise known as I & O; Average adult intake is 2200 to 2700 mL per 24 hours; Average output should be 2200 to 2700 mL Per 24 hours; average hourly output = 30 mL/hr

2. Protein Levels: measured by serum (blood) albumin levels; Normal albumin = 3.5 to 5.5 g/dL

3. Pre-Albumin (thyroxin-binding protein): more sensitive measure for Critically ill clients; reflects acute changes; Normal level = 23 to 43 mg/dL

Risk Factors for Inadequate Nutrition

Biophysical Factors

Psychological Factors

Socioeconomic Factors

Impact of Risk Factors

Risk factors can affect nutritional status

Ask yourself, “What impact would a particular risk factor have on that person’s nutritional status?”

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