How to Complete a Nutrition Assessment in the Acute Care Setting + NFPE

Summary

This video demonstrates a typical nutrition assessment in an acute care setting, where a dietitian evaluates a patient's dietary habits, food intake, and nutritional needs. The assessment includes discussing the patient's eating habits, current nutrition, and any changes in appetite or weight loss. The dietitian conducts a physical exam to check for signs of malnutrition, muscle depletion, and vitamin deficiencies. Recommendations are made to increase calorie and protein intake, and the patient is introduced to nutrition supplements. The goal is to reduce reliance on tube feeding as the patient starts eating more on their own.

Takeaways

• 😀 The dietitian conducts a thorough nutrition assessment in an acute care setting, beginning with patient identification and their medical history.
• 😀 Tube feeding (enteral nutrition) is used when a patient cannot eat by mouth, providing essential nutrients until the patient is able to resume eating normally.
• 😀 The dietitian gathers detailed information about the patient's typical daily intake, including their breakfast, lunch, dinner, and snacks.
• 😀 The patient’s food preferences and any potential digestive issues (e.g., difficulty with dairy) are discussed to tailor nutrition recommendations.
• 😀 A typical day for the patient includes breakfast with cereal or eggs, coffee, and limited evening meals, with some occasional snacks like chips or ice cream.
• 😀 The patient reports a significant decrease in food intake (about 50% less) over the last two weeks due to a lack of appetite, contributing to weight loss of 5-7 pounds.
• 😀 The dietitian performs a head-to-toe physical exam, checking for signs of malnutrition, dehydration, or vitamin deficiencies (e.g., dry skin, hair, and nails).
• 😀 The assessment includes checks for muscle mass depletion in key areas like the shoulders, arms, and legs, focusing on whether the patient has noticed any changes.
• 😀 The dietitian suggests strategies to increase caloric intake, such as adding butter or cheese to eggs and encouraging the patient to try nutrition supplement drinks (like strawberry-flavored drinks).
• 😀 The patient’s feeding pump is checked to ensure the proper amount of formula has been administered, and a calorie count will be kept to track progress toward meeting the patient’s nutrition goals.

Q & A

What is the purpose of the nutrition assessment in the acute care setting?

The purpose of the nutrition assessment is to evaluate the patient's dietary intake, weight history, and physical condition to determine their nutritional needs and identify any deficiencies or signs of malnutrition, which can guide treatment and recovery.

What was Jane's typical breakfast like before her hospitalization?

Jane typically had cereal or eggs for breakfast, along with 2% milk on her cereal and a cup or two of coffee, with about a teaspoon of sugar added to her coffee.

How has Jane's eating habits changed since her hospitalization?

Since her hospitalization, Jane has been eating less, typically around 50% of her usual intake. She has been unable to eat as much due to feeling unwell, which has resulted in weight loss.

What type of snacks does Jane typically have between meals?

Jane usually snacks on chips or a couple of scoops of frozen yogurt, though she prefers frozen yogurt because regular ice cream upsets her stomach.

What dietary supplements is Jane currently taking?

Jane is occasionally taking a general adult multivitamin, though she sometimes forgets. She was also prescribed vitamin D by her doctor, with a dosage of 2,000 units.

What are some signs the dietitian looks for during the physical exam?

The dietitian checks for signs of fat and muscle depletion, as well as any changes in the hair, eyes, skin, nails, and overall muscle tone that may indicate nutrient deficiencies or malnutrition.

What changes in Jane's skin and hair did the dietitian notice during the exam?

Jane's skin was noted to be dry, which is typical for her during the winter months. There was no hair loss observed, but she reported occasional dryness in her scalp.

What recommendations did the dietitian make to improve Jane's calorie intake?

The dietitian recommended adding butter or shredded cheese to Jane's eggs, having egg salad on bread, and adding peanut butter to her banana. Additionally, Jane was encouraged to try nutrition supplement drinks to help increase her calorie and protein intake.

What specific nutrition supplement drink options were suggested to Jane?

The dietitian suggested that Jane try one to two nutrition supplement drinks per day, available in chocolate, vanilla, and strawberry flavors. Jane expressed a preference for strawberry flavor.

What is the purpose of the calorie count the nurse will track?

The calorie count helps track Jane's food intake and compares it to her calorie and protein goals. This will help determine when she is consistently eating enough to potentially stop the tube feeding.