Nutritional Assessment

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.Assessment of nutritional

Purpose
1. To identify individuals or population group. Risk of becoming malnourished 2. Identify individuals who are malnourished
3. To develop health care program
4. To measure the effectiveness of the nutritional assessment

Method:
1. Direct method deals w/ individual and measure objective criteria A. Anthropometrics methods- measurement of ht, wt & proportion. Accurate measurement of ht and wt is essential. Measurement for children/infants

-mid-arm circumference
-skin fold thickeness
-head circumference
-head-chest ratio
-hip-waist ratio
Measurement for Adults
-ht
-wt
-BMI
-waist circumference
Level1 is the maximum acceptable waist
LEVEL2 DENOTES OBESITY AND REQUIRES MANAGEMENT
-HIP CIRCUMFERENCE
-WAIST/HIP RATIO
b. Biochemical, laboratory methods
C. Clinical method
D. Dietary evaluation methods
dIETARY Assessment: assessed in 5 methods
-24 hrs dietary recall
-food frequency questionnaire
-dietary hx since early life
-food diary technique
-observed food consumption
Part of Assessment: Screening for warning signs of poor nutritional health d-diseases, illness, chronic condition
e-eating poorly
t-tootloss/ mouth pain
e-economic hardship
r-reduced social contact
m-multiple medicines
i-involuntary wt loss/gain
n-needs assistance in self care
e-elderly years above 80

2. Indirect- use community health indices that reflect nutritional influences.
3 Categories:
-Ecological Variables including crop production
-Economic Factors e.g. per capita income, population density & social habits. -Vital health statistics particularly infant & under 5 mortality &fertility index

Clinical assessment
-Is an essential of all nutritional service.
-It is the simplest & most practical method of ascertaining the nutritional status of a group of individual -Good nutritional history should be obtained
-Gen. clinical exam w/ special attention to organs.

Detection of relevant signs
-Hair
Spare & thin - protein, zinc, biotin deficiency
Easy to pull out- protein deficiency
Corkscrew coiled hair- vit A&C def
-Mouth
Glossitis- riboflavin, niacin, folic acid, b12
Bleeding gums- vit. C,A,K, folic acid & niacin
Angular stomatitis, cheilosis & fissured tongue- b2,6 & niacin
Leukoplakia- Vit A,B12, B-complex, folic &niacin
Sore mouth- b12, 6, c, niacin, folic acid
-Eyes
Night blindness/ exopthalmia- Vit a Def
Photop[hobia, blurring, conjuctival inflame- vit b2 &vit A def. -Nails
Spooning – iron def
Transverse lines- protein def
-Skin
Pallor- folic acid iron b12 def
Follicular hyper keratosis- vit b & c
Flaking dermatitis- PEM, vit b12, A, zinc & niacin
Pigmentation desquamation- niacin & pem
Bruising, purpura- K,C & folic

Signs of nutritional def
-Thyroid gland
In mountain areas and far from sea areas- goiter
-Joints &bones
Survey and rickets

Initial Lab. Assessment
-hemoglobin estimation
-stool exam
-Urine dipstick

Interpretation of dietary data
1. Qualitative method- using food pyramid & the basic food grps methods. Different nutrients are classified into 5 groups. Determine the no. of serving from each grp & compare it w/ minimum requirement.

Outcome identification and planning
Goal: maintain or restore optimal nutrition or status using the food likes or tolerates as appropriate to their situation.

Outcome Criteria
-attain ideal body wt as indicated by BMI
-eat variety of food
-follow appropriate modified diet

Prob. Nuurg. Diag
1. Imbalance nutria: less than body req.
2. Imbalance nutria: more than body req
3. Risk for imbalanced nutria: more than body req
4. Risk for imbalanced nutria: less than body req.

Nursg. Inter.
1. Monitor nutritional stat.
2. 2. Stimulates appetite
-serve small frequent feeding
-solicit preference
-control pain, nausea or...
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