What is the nutrition intervention diagnosis
What is the nutrition intervention diagnosis for a 78 year old rancher hospitalized three days ago after suffering a stroke. His weight on admission was 175 pounds. His family states that his height is about 6 feet. He has been eating less than half of his meals since admission and has lost 4 pounds. His family has reported to the nurse that Frank has been coughing frequently while eating and seems to have difficulty swallowing his food.
Frank’s initial nutrition diagnosis is “Inadequate oral food and beverage intake to difficulty swallowing as evidenced by less than 50 percent expected oral intake, significant weight loss, and observation of coughing with attempts to eat.”
What is the appropriate nutrition intervention that helps resolve Frank’s nutrition problem. Remember to consider interventions that change a) nutritional intake, b) nutrition-related knowledge or behavior, c) environmental conditions, or d) access to supportive care and services. Indicate in each box how you would accomplish each step of the intervention.
Prioritize the nutrition diagnosis. Critical thinking: What nutrition intervention will help resolve the identified nutrition problem?
Worksheet 4-2: Using Standards of Practice to Implement a Nutrition Intervention
Frank H. is a 78-year-old rancher hospitalized three days ago after suffering a stroke. His weight on admission was 175 pounds. His family states that his height is “about 6 feet.” He has been eating less than half of his meals since admission and has lost 4 pounds. His family has reported to the nurse that Frank has been coughing frequently while eating and seems to have difficulty swallowing his food.
Frank’s initial nutrition diagnosis is “Inadequate oral food and beverage intake related to difficulty swallowing as evidenced by less than 50 percent expected oral intake, significant weight loss, and observations of coughing with attempts to eat.”
1. Use the steps suggested in Table 4.1 and the steps outlined below to implement an appropriate nutrition intervention that helps resolve Frank’s nutrition problem. Remember to consider interventions that change a) nutritional intake, b) nutrition-related knowledge or behavior, c) environmental conditions, or d) access to supportive care and services. Indicate in each box how you would accomplish each step of the intervention. (Hint: See Chapter 14 for more information on swallowing difficulties.)
| Step One: Plan the Nutrition Intervention | |
| Prioritize the nutrition diagnosis.
Critical thinking: What nutrition intervention will help resolve the identified nutrition problem? |
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| Base intervention on best available evidence.
Critical thinking: What evidence-based practice guidelines will you use to plan your nutrition intervention? |
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| Refer to policies and program standards.
Critical thinking: Are there specific protocols and policies that will influence your plan of care for this patient? |
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| Confer with patient and caregivers.
Critical thinking: What additional information do you need to plan an effective intervention?
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| Determine patient-focused goals and expected outcomes.
Critical thinking: What are the immediate as well as long-term goals for this patient? |
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| Detail the nutrition prescription.
Critical thinking: What is the individualized dietary recommendation for this patient?
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| Define time and frequency of care.
Critical thinking: When and how will nutrition intervention be provided?
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| Utilize standardized language for defining interventions.
Critical thinking: How can you use established terminology to describe the nutrition intervention? Refer to Chapter 2. |
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| Identify resources or referrals needed.
What additional resources may help resolve this patient’s nutrition problem?
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| Step Two: Implement the Nutrition Intervention | |
| Collaborate with colleagues.
Critical thinking: What additional information might need to be obtained to improve your nutrition intervention? |
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| Communicate the plan of care.
Critical thinking: Who will need to be informed? How and by whom will they be informed? |
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| Initiate the plan of care.
Critical thinking: How will you begin the nutrition intervention?
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| Continue data collection.
Critical thinking: What data will be important to monitor the patient’s response to the intervention? |
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| Individualize nutrition intervention.
Critical thinking: Is this intervention tailored to the patient’s needs?
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| Follow up and verify nutrition intervention.
Critical thinking: How will you monitor whether the patient is receiving the nutrition care you have planned? |
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| Adjust intervention strategies if needed.
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| Document
Critical thinking: What procedure will you use to record the patient’s response to the nutrition intervention? |
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2. Using ideas from Table 4.4, describe at least two intervention strategies that would provide additional protein and calories to this patient within his nutrition prescription
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