Assesment Of Nutrition Status PDF

Dr. Nefisa H. El Banna Prof. of clinical nutrition Ph D. from UNIV of Illinois USA Home Economics Hellwan university Nutrition Status An individual’s nutrition status reflects the degree to which physiologic needs for nutrients are being met. The balance between nutrient intake and nutrient...

Dr. Nefisa H. El Banna Prof. of clinical nutrition Ph D. from UNIV of Illinois USA Home Economics Hellwan university Nutrition Status An individual’s nutrition status reflects the degree to which physiologic needs for nutrients are being met. The balance between nutrient intake and nutrient requirements is the nutrition status. When adequate nutrients are consumed to support the body’s daily needs and any increased metabolic demands, the person moves into optimal nutrition status Appropriate assement techniques can detect a nutritional deficiency in the early stages Persons at nutritional risk can be identified on the basis of screening information that is routinely obtained at the time of admission to a hospital. Nutrition Imbalance : Several of the leading causes of death, including cardiovascular disease diabetes, and some types of cancer have a strong link with the type and amount of food consumed Nutrition is also significant in major diseases such as obesity , anemia , and osteoporosis States of nutritional deficiency or excess occur when the nutrient intake is not balanced with specific requirements for optimal health Nutrition deficiency may stem from inadequate ingestion , impaired digestion or absorption , dysfunctional metabolic processing , or increased excretion of essential nutrients Over nutrition also presents major nutritional problems manifesting as obesity and related disease , Nutrition screening and assessment are integral parts of the nutrition care process (NCP) which has four phases: 1- assessment of nutrition status, 2- identification of nutritional diagnoses, 3- Medical nutrition therapy (MNT) interventions such as dietary change nutritional supplements, education, counseling, 4- monitoring and evaluation of the effectiveness of the nutritions Nutrition Screening Regardless of the information gathered the goal of screening is to identify individuals who are at nutritional risk The purpose of a nutrition screen is to quickly identify individuals who are malnourished or at nutritional risk and determine whether a more detailed assessment is warranted Nutrition Assessment Nutrition Assessment is a comprehensive evaluation carried out by a dietitian for defining nutrition status using medical , social, nutritional , and medication histories ; physical examination; anthropometric measurements ; and laboratory data. The purpose of assessment is to gather adequate information in which to make a professional judgment about nutrition status. The nutrition assessment is the first step in the nutrition care process The goals of nutrition assessment are to : 1. Identify individuals who require aggressive nutrition support. 2. Restore or maintain an individual’s nutrition status. 3. Identify appropriate MNT 4. Monitor the efficacy of these interventions Histories Medical History The medical history usually includes the following information : Chief complaint , present and past illness, current health, allergies , past or recent surgeries , family history of disease. Medication History A medication history is an important part of eny nutrition assessment. The effects of drug therapy can be altered by specific foods and the timing of food and meal consumption. Diet History : A diet history is perhaps the best means of obtaining dietary intake information , and refers to a review of individual’s usual patterns food intake and the food selection variables that dictate the food intake. Dietary intake data are assessed either by collecting retrospective intake data as with a 24- hour recall or food frequency questionnaire Daily Food Record or Diary A daily food record, or food diary, involves documenting dietary intake as it occurs and is often used in outpatient clinic settings The individual’s nutrition intake is then calculated and compared With dietary reference intakes The Food Frequency Questionnaire is a retrospective review of intake frequency ( i.e., food consumed per day, per week , or per month ) The 24- Hour Recall method of data collection requires individuals to remember the specific foods and amounts of foods they consumed in the past 24- Hour. The information is then analyzed and compared with dietary reference intakes. Concurrent use of food frequency and 24- Hour Recall Questionnaire improves the accuracy of intake estimates Anthropometry : Anthropometry involves obtaining physical measurements of an individual and relating them to standards that reflect the growth and development of the individual. These physical measurements are another component of the nutrition assessment and are useful for evaluating overnutrition or undernutrition LENGTH OR HEIGHT : Height measurements are valuable when used in conjunction with other anthropometric and clinical assessment measurements. Weight Weight measurements are valuable when used in conjunction with other anthropometric and clinical assessment measurements. Body Mass Index The most widely used height- weight index is commonly referred to as the Body Mass Index ( BMI) and is a validated measure of nutrition status Subcutaneous fat ( Skin- Fold Thickness) : (Circumference measurements) : If more complete information on actual body composition is needed , additional anthropometric data can be obtained. These data include additional skin- fold and Circumference measurements. Physical Examination : A nutrition- focused Physical Examination is an important component of overall nutrition assessment because some nutritional deficiencies may not be identified by other assessment approaches. Some signs of nutritional deficiency are not specific and must be distinguished from those with a nonnutritional etiology. Biochemical Analysis : Biochemical tests are the most objective and sensitive measures of nutrition status , but not all are appropriate. Caution must be used when interpreting results because they can be affected by disease state and therapy. Nutrition Diagnosis After assessment of nutrition status using all of available data, nutrition diagnosis are identified, prioritized, and documented in the medical record. Many facilities use standardized formats to facilitate communication of information gathered in the nutrition assessment and nutrition diagnosis. Nutrition Intervention The nutrition intervention relates to the etiology and translates assessment data into activities that will enable the patient to meet established objectives. Intervention can begin once the nutrition diagnosis is identified and objectives are determined. Intervention may include food and nutrition therapies ( changing the diet prescription, providing food or nutrition supplements, initiating a tube feeding for a patient who cannot eat). A nutrition diagnosis includes identification of the problem, etiology, and signs/ symptoms in a simple, clear statement. Intervention should be specific; they are the " what, where, when, and how " of the care plan Monitoring and Evaluation of Nutrition Care : The last step in the NCP is to monitor and then evaluate the care provided. This step makes the nutrition care plan dynamic and responsive to the patient’s needs.