Nutrition Assessment & Data Collection

Nutrition Assessment & Data Collection

 Nurses play a key role in identifying nutritional needs.
 Assessment spans acute and chronic care settings.
 Incorporate family habits and community education.
 TJC mandates nutrition screening within 24 hrs of
admission.
 Referral to dietitian for malnutrition risks is required.

Collaborative Care Approach

 Providers and nurses gather physical assessment data.
 Nurses act as liaison to dietitians and health care team.
 Registered Dietitians complete detailed assessments.
 Nurses monitor progress and evaluate care outcomes.

Diet History: Key Components

 Meals: time, type, amount for all meals and snacks.
 Fluids: type, amount, frequency including caffeine.
 Special foods: celebration or habitual foods.
 Food prep methods and frequency of eating out.
 Diet type: vegetarian, prescribed, allergies, preferences.
 Use of supplements and satisfaction with current diet.

Indicators of Malnutrition

Dry, brittle hair and dry skin patches.
 Slow wound healing, sores, muscle wasting.
 Subcutaneous fat loss, irregular heart rate.
 Enlarged spleen/liver, weakness, poor coordination.

Anthropometric Tools: Weight & Height

 Consistent time and clothing for weight checks.
 Daily changes may reflect fluid balance.
 % Weight Change = (Usual - Current)/Usual × 100
 Height: measure standing or recumbent for children.
 Use Hamwi method for ideal body weight estimation.

Body Mass Index (BMI)

 Formula: BMI = weight (kg) ÷ height (m²)
 Underweight: <18.5 | Healthy: 18.5–24.9
 Overweight: 25–29.9 | Obesity: ≥30
 Adjust interpretation for muscular individuals or fluid
retention.

Clinical Values: Fluids & Proteins

 Fluid intake: 2,000–3,000 mL/day; output: 1,750–3,000
mL/day.
 Albumin (chronic status): 3.5–5 g/dL.
 Prealbumin (acute status): 15–36 mg/dL; <10.7 = severe
deficiency.
 Prealbumin used to assess response to parenteral
nutrition.

Nitrogen Balance

 Intake = protein (g) ÷ 6.25.
 Output = urinary nitrogen + 4 g.
 Balance = Intake - Output.
 Positive: growth, pregnancy, healing.
 Negative: starvation, illness, injury.

Risk Factors for Inadequate Nutrition

 Biophysical: diseases, age, genetic predisposition.
 Psychological: stress, depression, eating habits.
 SDOH: access, food insecurity, education, environment.

Social Determinants of Health (SDOH)

 Neighborhood: pollution, food deserts, transport issues.
 Social Context: food prep safety, housing instability.
 Economic: income limits food options, insurance access.
 Health Care: limited follow-up, lack of school nurses.
 Education: low literacy affects food choices and labels.

Effect of Risk Factors on Nutrition

 Edema: diuretics & low-sodium diets alter appetite.
 Osteoporosis: prevent with calcium, Vit D, exercise.
 Mental health: self-concept affects eating behavior.

Nursing Actions & Interventions

 Assess dietary intake and
contributing factors.
 Coordinate with providers to
alter care plans as needed.
 Prevent interruptions, fatigue,
and discomfort at meals.
 Provide individualized client
education and support.