9 Nutrition Care Process Nutrition Diagnosis

Summary

This session on nutrition diagnosis, led by Professor Africa from the Institute of Human Nutrition, guides professionals on applying nutrition assessment processes to identify and address nutritional problems. The session covers essential domains like intake, clinical, and behavioral/environmental problems, with a focus on documenting diagnoses using standardized codes. Examples of diagnosis documentation based on signs, symptoms, and etiology are provided, emphasizing critical thinking, clinical reasoning, and decision-making in nutrition interventions. The session concludes with a case study highlighting how to identify and document a nutrition diagnosis, offering actionable solutions for improving patient health outcomes.

Takeaways

• 😀 Nutrition diagnosis identifies and describes specific nutrition problems that can be improved or solved through nutrition interventions.
• 😀 Nutrition diagnosis is based on the evaluation of information obtained during a nutrition assessment conducted by a registered nutritionist.
• 😀 The documentation of nutrition diagnosis follows the P/E/S format, where 'P' stands for the problem, 'E' for the etiology (root cause), and 'S' for the signs and symptoms.
• 😀 The three domains in nutrition diagnosis are: intake (related to food and nutrient intake), clinical (related to medical/physical conditions), and behavioral/environmental (related to food access, safety, and knowledge).
• 😀 Intake issues can include problems like excessive or inadequate intake of energy, nutrients, fluids, or bioactive substances.
• 😀 Clinical problems refer to issues related to medical or physical conditions, such as difficulty swallowing or altered gastrointestinal function.
• 😀 Behavioral/environmental problems encompass knowledge gaps, attitudes, beliefs, food access, and food safety issues.
• 😀 Codes are crucial for proper documentation in nutrition diagnosis and help categorize problems, ensuring consistency and clarity.
• 😀 Critical thinking and clinical reasoning are vital skills in making sound nutrition diagnoses, as they help prioritize the most urgent nutrition issues to address.
• 😀 The nutrition diagnosis process should always be followed by a nutrition prescription, which outlines the intervention needed to address the identified nutrition problem.
• 😀 The example case study of Miss Hoffman demonstrated how a lack of knowledge about iron-rich vegetarian foods led to inadequate iron intake, which was resolved with a nutrition intervention aimed at increasing iron intake.

Q & A

What is the main objective of the session on nutrition diagnosis?

The main objective is to enable participants to apply the process of nutrition diagnosis and to fully understand its components and the proper documentation method.

What is nutrition diagnosis, and why is it important?

Nutrition diagnosis is the process of identifying and describing specific nutrition problems based on the information gathered from nutrition assessments. It is important because it helps nutritionists provide appropriate interventions and treatments to improve or solve nutrition-related issues.

What does the P-E-S approach stand for in nutrition diagnosis?

The P-E-S approach stands for Problem, Etiology, and Symptoms. It is used to document nutrition diagnosis, where the 'Problem' refers to the nutrition issue, 'Etiology' refers to the underlying cause, and 'Symptoms' are the signs and evidence of the issue.

What are the three domains related to nutrition diagnosis?

The three domains are: Intake (issues related to the consumption of food, nutrients, fluids, or bioactive substances), Clinical (nutrition problems related to medical or physical conditions), and Behavioral-Environmental (problems related to knowledge, attitudes, beliefs, physical environment, or food access).

How is intake-related nutrition diagnosis documented?

Intake-related issues are documented using specific codes that categorize problems such as inadequate or excessive energy intake, nutrient intake, fluid intake, and bioactive substance intake. Each intake issue has a designated code, such as 'NI 1.5' for excessive energy intake.

What is the significance of the clinical domain in nutrition diagnosis?

The clinical domain is important because it identifies nutrition problems related to medical or physical conditions. These problems can include functional issues (e.g., difficulty swallowing), biochemical problems (e.g., altered lab values), or weight-related issues (e.g., underweight or overweight).

What are the key components of the behavioral-environmental domain?

The behavioral-environmental domain includes problems related to food knowledge, attitudes, and beliefs; physical activity; self-care; quality of life; and access to food or food safety. These factors can significantly impact a person's nutrition and health outcomes.

Why is it important to critically evaluate the information gathered during a nutrition assessment?

Critical evaluation ensures that nutrition diagnosis is accurate and based on reliable data. It allows nutritionists to identify the most relevant problems, understand their root causes, and make informed decisions about interventions and treatments.

How does clinical reasoning and decision-making play a role in nutrition diagnosis?

Clinical reasoning and decision-making help nutritionists evaluate and interpret assessment data to prioritize problems. It ensures that the selected interventions address the most urgent and significant issues, improving patient outcomes.

Can you explain the nutrition diagnosis for Miss Hoffman based on the case study?

Miss Hoffman’s nutrition diagnosis was inadequate iron intake, with the etiology being undesirable food choices due to limited knowledge of iron-rich vegetarian foods. The symptoms were evidenced by a 24-hour food recall showing less than 30% of the recommended intake for iron, along with her stated lack of knowledge about vegetarian iron sources.