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NSE 22A/B (44)

Module 6: Nutrition and Enteral Needs

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MOD 6 Nutrition and Enteral NeedsThursday October 21 20101046 PMModule 6 Nutrition and Eternal NeedsReview the components of a thorough nutritional nursing assessment including cultural 1considerations Nutritional assessments are to determine if the client is in or at risk for malnutrition Nutritional status NS of a client is assessed when a condition interferes with the ability to ingest digest or absorb adequate nutrition exists Focuses on 5 areas Anthropometry measurement system of the size and makeup of the body Height and weight are aobtained Ideal Body Weight IDW Body Mass Index BMI and Waist Circumferences WC are all ways of measuring the clients body size and health risk Laboratory and Biochemical Testscommon tests used to study NS of client may be measures of plasma bprotein albumin prealbumin transferrin retinol binding protein total iron binding capacity and hemoglobin The test results may be influenced by fluid balance liver function kidney function and presence of a disease Dietary Hx and Health HxDietary history focuses on clients habitual intake of food preferences callergies and ability to obtain food Gather info on activity level to determine energy needs compare energy needs with intake Also include heath status age culturalreligious background socioeconomic status psychological factors alcohol and drug use use of vitamins supplement herbal meds over the counter meds and clients knowledge about nutrition Clinical Observation and Physical Examination Monitor signs of nutritional alteration in clients when ddoing other assessments Assess for aspiration and dysphagia Clients with decreased LOC as at high risk for dysphagia Warning signs may be cough change in voice tone abnormal mouth movements slow weak imprecise speech regurgitation pharyngeal pooling etc Client ExpectationsClients depend on the nurse to help them with problems and questions Nurses emust be knowledgeable about nutrition screening assessment and referrals to meet clients expectations CulturalReligious ConsiderationsAsk the client if they have any culturalreligious obligations in terms of fooddrink intake Do not assume that they follow a certain restrictions just because of theyre ethnicreligious background Most religions limit or completely restrict alcohol Islam and Judaism restrict pork fast during certain times of the year and must adhere to strict ways of cooking foods especially meat Hindus do not consume meat 2 Identify the unique nutritional issues of the aging clientAging clients are often at risk for dysphagia and aspiration Warning signs may be cough change in voice tone abnormal mouth movements slow weak imprecise speech regurgitation pharyngeal pooling etc They may have trouble swallowing due to dentures bleeding gums and dry mouth Client with decreases LOC dementia Alzheimers and Parkinsons Feed small spoonfuls and slowly 3 Define and discuss nursing interventions for each conditionMalnutrition aNutritional Counselling Giving the client an individualized care plan with the help of the client family doctor therapist andor dietician Nutritional Monitoring Monitor the client monthly for weight gain and perform assessment of skin hair and muscle toneNutritional Management Encouraging the client to eat smaller mealsand drink liquids throughout the dayProgramsEncourage the client to take part in different types of community programs such as meal programs for children at schools collective cooking programs nutritious food choices programs and the Good Food boxGastroesophageal reflux disease GERDa NSE22 Page 1
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