Nutrition Assessment and Fluid Management: Key Concepts and Signs

Dietary history

Includes food preferences, allergies, access to food, and what the patient is eating.

History of eating disorders

Past or current anorexia, bulimia, binge eating, or restrictive eating behaviors.

Recent weight loss or gain

Assess amount, timeframe, and whether intentional or unintentional.

Difficulties with eating

Problems chewing, swallowing, pain with eating, nausea, decreased appetite.

Healthy BMI range

18.5-24.9.

Underweight BMI

Less than 18.5.

Overweight BMI

25-29.9.

Obese BMI

30 or higher.

Labs for nutritional status

Glucose, cholesterol, triglycerides, hemoglobin, A1C, electrolytes, albumin, iron.

Poor nutrition sign: mental status

Mental status changes such as confusion or irritability.

Poor nutrition sign: hair/nails

Dry, brittle hair and nails.

Poor nutrition sign: dental

Poor dental health and bleeding gums.

Poor nutrition sign: eyes

Dull-appearing eyes.

Poor nutrition sign: posture

Poor or weak posture.

Poor nutrition sign: bony areas

Prominent bony protrusions.

Poor nutrition sign: strength

Weakness and fatigue.

NPO

Nothing by mouth.

Clear liquid diet

Clear fluids such as broth, juice, and gelatin.

Full liquid diet

All liquids including dairy; includes foods liquid at room temperature.

Soft diet

Easy-to-chew foods.

Mechanical soft diet

Soft, altered-texture foods; may include pureed or thickened.

Diet as tolerated

Progress diet based on patient tolerance.

Regular diet

No dietary restrictions.

Kidney/Renal diet

Limits potassium, phosphorus, and sodium; may restrict fluids.

Heart-healthy diet

Low sodium (2 g or less), whole grains.

Diabetic diet

Low carbohydrates and controlled carb intake.

Sodium-restricted diet

Low sodium; often used for respiratory or fluid retention issues.

Soft foods diet

Foods that require minimal chewing.

Burn patient diet

High protein diet for healing.

Thickened liquids

Used for swallowing issues to prevent aspiration.

Nectar-thick liquids

Slightly thick liquids; example: V8 juice.

Honey-thick liquids

Thicker liquids that pour like honey.

Spoon-thick liquids

Very thick liquids eaten with a spoon; example: pudding.

Fluid restrictions

Amount of allowed fluid (mL or oz) ordered by provider.

How fluid restrictions are divided

By day/evening/night or by nursing shifts.

What counts as intake

Anything liquid at room temp, IV fluids, and IV medications.

Ice chips conversion

100 mL ice equals 50 mL liquid.

Definition of intake

All fluids taken in orally, via tube feedings, IV, or injections.

More intake than output

Indicates fluid excess or hypervolemia.

Signs of fluid excess

Weight gain, swelling, crackles, increased blood pressure.

Definition of output

Fluids leaving the body such as urine, liquid stool, vomit, blood.

More output than intake

Indicates fluid deficit or dehydration (hypovolemia).

Third spacing

Fluid shifts into tissues, causing edema.