Nutrition (Jarvis)

Subjective Data

• Eating Patterns

  • Inquiry about:

    • Number of meals/snacks per day

    • Type and amount of food eaten

    • Fad, special, or alternative diets involved

    • Food preferences and dislikes

    • Religious or cultural dietary restrictions

    • Self-feeding ability

  • Rationale: Understanding food consumption is crucial for effective nutritional education. Misconceptions should be addressed to promote self-care and healthy eating patterns. Many alternative diets lack scientific support for their safety and effectiveness.

• Usual Weight

  • Questions include:

    • What is your usual weight?

    • Are you 20% below or above desirable weight?

    • Have you experienced recent weight changes? If yes, how much and in what time frame?

    • What is the reason for the weight change?

  • Rationale: Excess weight can increase the risk of conditions like hypertension and diabetes. Understanding weight history helps assess nutrient needs, which can be greater in certain health conditions.

• Changes in Appetite, Taste, Smell, Chewing, Swallowing

  • Inquiry about:

    • Type of changes and duration

  • Rationale: Changes can interfere with nutrient intake. Individuals experiencing these symptoms may have heightened calorie and nutrient needs, often 2-3 times higher than usual.

• Recent Surgery, Trauma, Burns, Infection

  • Questions include:

    • When did it occur? What type? How was it treated?

    • Are there conditions that increase nutrient loss? (e.g., draining wounds)

• Chronic Illnesses

  • Inquiry about:

    • Type of chronic illness, when diagnosed, and treatment history

    • Dietary modifications related to treatment

    • Recent chemotherapy or radiation?

  • Rationale: These illnesses significantly raise the risk of nutritional deficits, necessitating careful management.

• Nausea, Vomiting, Diarrhea, Constipation

  • Inquiry into:

    • Any problems present? Causes? Duration?

  • Rationale: Gastrointestinal symptoms disrupt nutrient absorption and intake.

• Food Allergies or Intolerances

  • Questions about:

    • Any known food allergens, type of reaction, and duration of issues?

  • Rationale: Public health concerns regarding food allergies, particularly peanut allergies, are increasing; intolerances can lead to nutrient deficiencies.

Additional Patient Information

• Medications and Nutritional Supplements

  • Inquiry about:

    • Prescription and nonprescription medications? Usage over 24 hours?

    • Any weight loss supplements? Duration of use?

    • Any herbal or botanical products? Effects and dosage?

  • Rationale: Certain medications impair nutrient absorption and metabolism, and dietary supplements can cause harmful effects when misused. Be cautious of unregulated products.

• Patient-Centered Care

  • Questions about:

    • Meal preparation facilities and shopping accessibility

    • Adequate income for food purchase?

    • Who prepares meals?

  • Rationale: Socioeconomic factors can significantly impact nutritional status and access to food.

Adolescent Health History

• Present Weight

  • Inquiry into:

    • Desired weight? Feelings about current weight?

    • History of dieting

    • Do they feel fat? Exercises excessively?

    • Engaging in purging behaviors?

  • Rationale: Adolescents may be prone to disordered eating and body image issues due to societal pressures.

• Use of Anabolic Steroids or Performance Enhancers

  • Questions about:

    • Usage history and associated problems?

    • Use of energy-boosting drinks?

  • Rationale: Early use of performance enhancers leads to various health risks, including organ damage.

• Risk Factors for Overweight and Obesity

  • Inquiry into:

    • Eating patterns (binging, meal skipping)

    • Common snacks and beverages?

  • Rationale: Understanding eating habits helps identify risk for obesity and associated health issues.

• Menstrual Health

  • Questions about:

    • Age of first menstruation?

    • Menstrual flow characteristics?

  • Rationale: Nutritional deficiencies can affect menarche and menstrual health.

Additional History for Pregnancy and Aging

• Pregnancy Health History

  • Inquiry into:

    • Number and history of pregnancies, complications during current or previous pregnancies?

    • Use of prenatal vitamins?

  • Rationale: Previous complications can indicate nutritional risks in the current pregnancy; adequate nutrient intake is vital.

• Food Preferences During Pregnancy

  • Questions about:

    • Foods avoided or craved?

    • Fish consumption?

  • Rationale: Assessing dietary intake during pregnancy is crucial to prevent complications, such as mercury exposure.

• Nutritional History of Aging Adult

  • Questions about dietary changes compared to previous decades?

  • Rationale: Aging can affect how individuals manage their nutrition; assess for adequate vitamin D and calcium for bone health.