Nutrition Assessment and Care Process

Speaker Information

• Speaker is Dr Nefisa H. El Banna
• Professor of clinical nutrition
• Ph.D. from University of Illinois, USA
• From Home Economics Hellwan University

Assessment of Nutrition Status

• Nutrition status reflects the degree to which physiologic needs for nutrients are met.
• It's the balance between nutrient intake and requirements.
• Optimal nutrition status is a balance between nutrient intake and nutrient requirements.
• Factors affecting nutrition status include disease, socioeconomics, behavior, emotions, cultural pressures, food intake, nutrient intake, absorption, infection, disease, fever, physiologic stress, body maintenance and well-being, growth, and psychological stress.

Screening and Referral System

• Identify risk factors
• Use appropriate tools
• Involve interdisciplinary collaboration

The Nutrition Care Process

• Includes four phases:
  • Assessment of nutrition status
  • Identification of nutritional diagnoses
  • Medical nutrition therapy (MNT) interventions (e.g., dietary changes, supplements, education, counseling)
  • Monitoring and evaluation of interventions

Nutrition Screening

• Goal is to identify individuals at nutritional risk.
• Purpose is to quickly identify the malnourished or at risk and determine whether a more detailed assessment is needed.

Nutrition Assessment

• Comprehensive evaluation by a dietitian
• Uses medical, social, nutritional, and medication histories.
• Includes physical examination, anthropometric measurements, and laboratory data.
• Purpose is to collect adequate information to make a professional judgment about nutrition status.
• First step in the nutrition care process
• Goals include identifying individuals needing aggressive nutrition support, restoring/maintaining nutrition status, identifying appropriate MNT, and monitoring intervention efficacy

Histories

• Medical History: Includes chief complaint, present/past illnesses, current health, allergies, past/recent surgeries, and family history of disease.
• Medication History: Important as drug effects can be altered by specific foods and timing of meals.
• Diet History: Review of individual's usual food intake patterns and food selection variables. Data collection methods include 24-hour recall and food frequency questionnaires.

Daily Food Record or Diary

• Documents dietary intake as it occurs.
• Often used in outpatient clinics.
• Individual intake is calculated and compared to dietary reference intakes.

Food Frequency Questionnaire

• Retrospective review of intake frequency (e.g., food consumed per day, week, or month).

24-Hour Recall

• Individuals recall specific foods and amounts consumed in the past 24 hours.
• Data is analyzed and compared to dietary reference intakes.
• Concurrent use of food frequency and 24-hour recall improves intake estimate accuracy.

Anthropometry

• Involves obtaining physical measurements and relating them to standards reflecting growth and development.
• Useful for evaluating overnutrition or undernutrition.
• Measurements include height, weight, body mass index (BMI), and subcutaneous fat (skin-fold thickness).

Physical Examination

• Nutrition-focused physical examination is an important component of overall nutrition assessment.
• Some nutritional deficiencies may not be identified by other approaches.
• Some signs of deficiencies are not specific and must be distinguished from non-nutritional causes.

Biochemical Analysis

• Biochemical tests are objective and sensitive measures of nutrition status.
• Not all tests are appropriate.
• Results can be affected by disease state and therapy.

Nutrition Diagnosis

• Based on available data, diagnoses are identified, prioritized, and documented in the medical record.
• Many facilities use standardized formats for communication.

Nutrition Intervention

• Relates etiology and assessment data to activities enabling the patient to meet established objectives.
• Can begin once the diagnosis is identified and objectives are determined.
• May include food and nutrition therapies (e.g., changing diet prescriptions, providing supplements, tube feeding).

Monitoring and Evaluation of Nutrition Care

• Last step in the nutrition care process.
• Monitors and evaluates the care provided.
• Makes the nutrition care plan dynamic and responsive to patient needs.

Test your knowledge on the assessment of nutrition status and the nutrition care process as outlined by Dr. Nefisa H. El Banna. This quiz covers the balance between nutrient intake and requirements, factors affecting nutrition, and the interdisciplinary approach in nutrition care. It's essential for understanding optimal nutrition in various contexts.