Diet and Nutri - ADIME

A systematic approach to providing high-quality nutrition care

Nutrition Care Process (NCP)

What are the four interrelated steps of the Nutrition Care Process?

Nutritional Assessment, Nutrition Diagnosis, Nutrition Intervention, and Nutrition Monitoring and Evaluation

To collect and document information about the individual’s nutritional status

Nutritional Assessment

What guides the nurse in selecting the appropriate nutrition diagnosis?

Data collected during the nutrition assessment

To select interventions directed at the root cause of the nutrition problem and alleviate its signs and symptoms

Nutrition Intervention

To determine if the client has achieved or is making progress toward the planned goal.

Nutrition Monitoring and Evaluation?

The degree to which an individual’s need for nutrients is met by the food they eat; it represents the balance between nutrient intake and nutrient needs.

nutritional status or nutriture.

Examination of physical condition, growth and development, behavior, blood and tissue nutrient levels, and the quality and quantity of nutrient intake.

evaluation of nutritional status

What three components are considered in a thorough nutritional status assessment?

Nutritional history, physical assessment, and other sources of data

What is the most accurate method of assessing dietary intake?

Direct observation of food intake.

A record of everything eaten and drunk each day, typically for three days (two weekdays and one weekend day

food diary

To assess habitual diet by asking how often certain foods or food groups are consumed over a reference period

Food Frequency Questionnaire (FFQ)

A structured interview that captures detailed information about all foods and beverages consumed in the past 24 hours.

24-hour recall

The measurement of variations in physical dimensions and gross composition of the human body at different ages and nutritional levels

anthropometry

What is weight-for-age used for?

To assess body mass and serve as a sensitive indicator of current nutritional status

Give two advantages of using weight-for-age measurements.

simple

can be done accurately with minimal training.

Give two disadvantages of using weight-for-age measurements.

Requires accurate age determination

may be affected by edema.

What does BMI stand for, and what is its purpose?

Body Mass Index — it identifies lean, overweight, or obese individuals

What does height-for-age assess?

Linear growth of legs, pelvis, spine, and skull; indicates chronic malnutrition or past nutritional status

What does weight-for-height or length measure?

Current state of nutrition and leanness or wasting.

What is skinfold thickness used for?

To assess body composition, fat distribution, and calorie reserves.

The circumference of the left upper arm at the midpoint between the shoulder and elbow; used to assess nutritional status.

mid-arm circumference

A five-step tool to identify adults who are malnourished, at risk of malnutrition, or obese; includes management guidelines for care planning

Malnutrition Universal Screening Tool (MUST)

What is the purpose of the Subjective Global Assessment (SGA)?

To evaluate whether an individual’s nutrient intake and absorption meet requirements

What is the Mini Nutritional Assessment (MNA) designed for?

To identify elderly patients (65+) who are malnourished or at risk, especially those with chewing/swallowing problems.

A simple tool used to assess nutritional risk, particularly in patients with diabetic foot ulcers or amputations

Geriatric Nutritional Risk Index (GNRI)

What are the five domains of nutrition assessment terminology?

Food/Nutrition-related history

Anthropometric measurements

Medical tests/procedures

Nutrition-focused physical findings

Client history

What is the overall goal of the Nutrition Assessment step in the ADIME process?

To gather and analyze data that accurately reflect the individual’s nutritional health and needs.

It is the identification and labeling of an existing nutrition problem that a nurse or dietetics practitioner is responsible for treating.

Nutrition Diagnosis

How does a Nutrition Diagnosis differ from a Medical Diagnosis?

A medical diagnosis identifies a disease (e.g., diabetes), while a nutrition diagnosis identifies the nutrition problem related to that disease (e.g., excessive carbohydrate intake).

What are the three main domains of Nutrition Diagnosis terminology?

Intake

Clinical

Behavioral/Environmental.

Problems involving too much or too little food or nutrients compared to needs.

Intake domain

Nutrition problems related to medical or physical conditions.

Clinical domain

Problems related to knowledge, attitudes, beliefs, physical environment, access to food, or food safety.

Behavioral/Environmental domain

What is the format used to document a Nutrition Diagnosis?

The PES statement format

What does PES stand for?

Problem

Etiology

Signs/Symptoms.

What is the correct format for a PES statement?

“___ (Nutrition problem label) related to ___ (Etiology) as evidenced by ___(Signs/symptoms).”

A purposely planned action designed to change a nutrition-related behavior, risk factor, or health condition to resolve or improve the nutrition diagnosis

Nutrition Intervention

What are the two interrelated steps of Nutrition Intervention?

Planning and Implementation

What is included in Oral Nutrition support?

Use of sterile liquids, semi-solids, or powders to supplement diet for clients who can’t meet nutritional requirements through food alone.

Delivery of nutrients through a functional GI tract in clients unable to eat, chew, or swallow.

Enteral Nutrition

Nutritional support via peripheral vein for patients with mild to moderate nutritional deficiency

Short-term Enteral Access

Nutritional support lasting more than 2 weeks for patients who cannot use the GI tract; e.g., Parenteral Hyperalimentation.

Long-term Enteral Access

Feeding method for clients without a functioning GI tract due to disease, surgery, trauma, or malignancy

Parenteral Nutrition

What are the five main steps in planning a nutrition intervention?

1. Prioritize interventions (based on urgency, impact, and resources).

2. Collaborate with the client to set goals.

3. Write a nutrition prescription based on client needs and standards.

4. Select effective, evidence-based intervention strategies.

5. Define time, frequency, and follow-up.

What happens during Implementation of the Nutrition Intervention?

The nurse collaborates with the client to carry out, communicate, modify, verify, and revise the nutrition care plan as needed.

What are the five domains of Nutrition Intervention terminology?

• Food and/or Nutrient Delivery

• Nutrition Education

• Nutrition Counseling

• Coordination of Nutrition Care

• Population-Based Nutrition Action

What does the domain Food and/or Nutrient Delivery focus on?

A customized approach for providing food and nutrients.

A formal process of instructing or training clients to manage or modify food and activity choices to improve health

Nutrition Education

A supportive, collaborative process between counselor and client to set goals, priorities, and action plans for self-care

Nutrition Counseling

Referral to or collaboration with other healthcare providers, institutions, or agencies to manage nutrition-related problems

Coordination of Nutrition Care

What is the main goal of Nutrition Monitoring and Evaluation?

To determine and measure the progress made by the nutrition intervention and to evaluate if the goals or expected outcomes are being met

What does Nutrition Monitoring and Evaluation provide evidence for?

Whether the intervention has been effective in changing the patient’s nutrition-related behavior or health status.

What does it mean to evaluate nutrition care outcomes?

It means assessing the results of nutrition interventions to determine if they have improved the client’s condition or achieved the planned goals

Why is standardizing the language for nutrition monitoring important?

It promotes uniformity within the dietetics profession in assessing the effectiveness of nutrition interventions

What does Nutrition Monitoring and Evaluation identify?

Outcomes or indicators relevant to the nutrition diagnosis, intervention plans, and goals.

What are the four domains of terminology used in Nutrition Monitoring and Evaluation?

• Food/Nutrition-Related History Outcomes

• Anthropometric Measurement Outcomes

• Biochemical Data, Medical Tests, and Procedure Outcomes

• Nutrition-Focused Physical Finding Outcomes

What does Food/Nutrition-Related History Outcomes include?

Food and nutrient intake, nutrient administration, medication, complementary/alternative medicine use, knowledge/beliefs, food availability, physical activity, and nutrition quality of life.

What are Anthropometric Measurement Outcomes?

Indicators like height, weight, BMI, growth pattern indices, percentile ranks, and weight history.

What are examples of Biochemical Data and Medical Test Outcomes?

Lab data such as electrolytes, glucose, gastric emptying time, and resting metabolic rate

Observations on physical appearance, muscle and fat wasting, swallow function, appetite, and affect.

Nutrition-Focused Physical Finding Outcomes