Nutrition Assessment

92 Pages·2016·3 MB·English

by  Pamela Charney

EBOOKS Nutrition Assessment C
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It has long been known that nutritional deficiencies are associated with
LIBRARY Katie Ferraro, Editor
morbidity and mortality in hospitalized patients. Registered dietitians
(RDs) are responsible for the diagnosis and treatment of malnutrition
Create your own in all practice settings. Accurate diagnosis of malnutrition depends
Customized Content on the skills of RDs in completing the nutrition assessment combined
Bundle — the more with critical thinking skills. There are five components of the nutrition
assessment; they are as follows:
books you buy,
the higher your
• Nutrition-focused physical exam
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• Client history
• Food and nutrition history
THE CONTENT • Anthropometric measures
• Biochemical measures, procedures, and tests
• Nutrition and
Dietetics Practice
RDs must consider each component in order to accurately diagnose
• Psychology Nutrition
nutrition problems.
• Health, Wellness,
The Nutrition Care Process (NCP) provides RDs with a solid
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and Exercise framework that describes the critical thinking process that RDs use u
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Science in all practice settings. The four steps of the NCP include nutrition rit Assessment
• Health Education assessment, nutrition diagnosis, nutrition intervention, and nutrition ion
monitoring/evaluation. While the NCP applies to all practice settings, A
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the dietetics terminology gives RDs an agreed upon set of terms that e
THE TERMS describe the work of the clinical RD. ssm
• Perpetual access for e
n
a one time fee Pamela Charney, PhD, RD is a registered dietitian with over 20 years t
• No subscriptions or experience. She has a great deal of experience in all care settings,
ranging from 30 bed critical access hospitals to 500 bed academic
access fees
medical centers. She received her baccalaureate degree from the
• Unlimited
University of West Florida, completed a dietetic internship at W alter
concurrent usage
Reed Army Medical Center, and is a US Army veteran. She has master’s
• Downloadable PDFs
degrees in nutritional sciences and clinical informatics and patient
• Free MARC records
centered technology from the University of Washington and a PhD in
health sciences from Rutgers University. Dr. Charney has a long record
of professional service and was a charter member of the Academy
For further information,
of Nutrition and Dietetic’s Nutrition Care Process and Dietetics
a free trial, or to order,
Terminology Committees. She is also a sought-after speaker at local,
contact: 
national, and international levels and has written extensively on the
[email protected]
nutrition care process, critical thinking in dietetics practice, nutrition Pamela Charney
assessment, and evaluation of quality of nutrition care.
ISBN: 978-1-60650-751-3
Nutrition Assessment

Nutrition Assessment
Pamela Charney, PhD, RD
MOMENTUM PRESS, LLC, NEW YORK
Nutrition Assessment
Copyright © Momentum Press, LLC, 2016.
All rights reserved. No part of this publication may be reproduced,
stored in a retrieval system, or transmitted in any form or by any
means—electronic, mechanical, photocopy, recording, or any other
except for brief quotations, not to exceed 400 words, without the prior
permission of the publisher.
First published in 2016 by
Momentum Press, LLC
222 East 46th Street, New York, NY 10017
www.momentumpress.net
ISBN-13: 978-1-60650-751-3 (paperback)
ISBN-13: 978-1-60650-752-0 (e-book)
Momentum Press Nutrition and Dietetics Practice Collection
Cover and interior design by Exeter Premedia Services Private Ltd.,
Chennai, India
First edition: 2016
10 9 8 7 6 5 4 3 2 1
Printed in the United States of America.
Abstract
It has long been known that nutritional deficiencies are associated with
morbidity and mortality in hospitalized patients. Registered dietitians
(RDs) are responsible for the diagnosis and treatment of malnutrition in
all practice settings. Accurate diagnosis of malnutrition depends on the
skills of RDs in completing the nutrition assessment combined with criti-
cal thinking skills. There are five components of the nutrition assessment;
they are as follows:
• Nutrition-focused physical exam
• Client history
• Food and nutrition history
• Anthropometric measures
• Biochemical measures, procedures, and tests
RDs must consider each component in order to accurately diagnose
nutrition problems.
Once the nutrition diagnosis has been made, RDs must develop and
implement interventions to treat malnutrition and other nutrition diag-
noses. Nutrition interventions must be targeted and appropriate to the
nutrition diagnosis, the patient, and the situation.
Health care providers in today’s complex health care environment are
often called upon to justify the need for their services. RDs must monitor
and evaluate the outcomes of nutrition interventions in order to demon-
strate the impact of nutrition therapy on health outcomes.
The Nutrition Care Process (NCP) provides RDs with a solid frame-
work that describes the critical thinking process that RDs use in all prac-
tice settings. The four steps of the NCP include nutrition assessment,
nutrition diagnosis, nutrition intervention, and nutrition monitoring/
evaluation. While the NCP applies to all practice settings, the dietetics
terminology gives RDs an agreed upon set of terms that describe the work
of the clinical RD.
vi ABSTRACT
Keywords
care process, critical thinking, dietetics, dietetics practice, nutrition assess-
ment, nutrition diagnosis, nutrition intervention, nutrition monitoring/
evaluation, registered dietitian or nutritionist
Contents
Chapter 1 Relationship Between Nutrition and Health .....................1
Chapter 2 Nutrition Care Process and Model ....................................5
Chapter 3 Nutrition Assessment ......................................................11
Chapter 4 Nutrition Diagnosis ........................................................29
Chapter 5 Nutrition Intervention ....................................................41
Chapter 6 Nutrition Monitoring and Evaluation .............................55
References ���������������������������������������������������������������������������������������������67
Index ���������������������������������������������������������������������������������������������������77

CHAPTER 1
Relationship Between
Nutrition and Health
Introduction
History is replete with references to the strong connection between
nutrition and health (Cannon 2005). Hippocrates was among the first
to describe nutritional therapy as primary treatment for disease (Cross
2010). Multiple descriptions of the role of diet in maintaining health can
be found in manuscripts from the Middle Ages and Renaissance periods
(Cannon 2005). While most agree that this connection exists, modern
health systems often place insufficient emphasis on the identification and
treatment of nutrition problems.
Prevalence of Nutrition Problems in Different Health
Care Settings and Populations
Hospitalized Patients
It has long been known that hospitalized patients who have inadequate
intake, weight loss, and other signs that are often associated with malnu-
trition may have more complications and longer length of stay than nor-
mally nourished patients. During the Crimean War, Florence Nightingale
noted that wounded soldiers who had access to a healthy diet were more
likely to survive their injuries than soldiers who had a poor diet. In her
Notes on Nursing, she discussed the importance of nutrition to recovery
and carefully described aspects of meal service that might enhance food
intake (Nightingale 1860).
In the 1930s, Hiram Studley, a gastrointestinal surgeon, noticed that
patients who had lost weight prior to surgery for peptic ulcer had more
complications and higher mortality than those who had not lost weight