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Chapter 7
Nutritional Assessment
Copyright 2002, Delmar, A division of Thomson Learning
Competencies
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Perform anthropometric
measurements.
Describe the most common
pathophysiologies for abnormal
findings.
Describe laboratory analyses needed
and their clinical significance to the
nutritional assessment.
Copyright 2002, Delmar, A division of Thomson Learning
Dietary Guidelines
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Recommended dietary allowances
(RDA)
Food guide pyramid
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Six food groups
Fats, oils, and sweets: use sparingly
Milk, yogurt and cheese: 2–3 servings/day
Meat, poultry, fish, eggs: 2–3 servings/day
(continues)
Copyright 2002, Delmar, A division of Thomson Learning
Dietary Guidelines
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Vegetables: 3–5 servings per day
Fruits: 2–4 servings per day
Breads, cereal, rice, pasta: 6–11
servings per day
Copyright 2002, Delmar, A division of Thomson Learning
Nutritional Guidelines
for Young and MiddleAged Adults
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Growth and caloric needs stabilize
Eating habits may be influenced by
activity levels, life stressors
Nutritional risks for development of
disease
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Obesity
Osteoporosis
Copyright 2002, Delmar, A division of Thomson Learning
(continues)
Nutritional Guidelines
for Young and MiddleAged Adults
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Type 2 Diabetes Mellitus
Atheroschlerosis
Copyright 2002, Delmar, A division of Thomson Learning
Nutritional Assessment
of Young and MiddleAged Adults
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Caloric intake?
Adherence to specific diet?
Satisfaction with current weight?
Physical activity?
Consumption of snacks?
Typical meal patterns?
Copyright 2002, Delmar, A division of Thomson Learning
Nutritional Guidelines
for the Older Adult
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Decreased caloric requirements
Adhere to food guide pyramid,
except consume decreased portion
size
Encourage to eat in a sitting position
Encourage adequate fluid intake and
high fiber diet
(continues)
Copyright 2002, Delmar, A division of Thomson Learning
Nutritional Guidelines
for the Older Adult
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Nutritional risk factors
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Difficulty chewing or swallowing
Decreased appetite
Decreased ability to feed self
Decreased taste and smell
Decreased esophageal emptying time
Copyright 2002, Delmar, A division of Thomson Learning
Nutritional Assessment
of Older Adults
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Presence of physical limitations that
affect eating?
Difficulty chewing or swallowing?
Presence of dental problems?
Difficulty obtaining or preparing
foods?
Do you eat alone?
Copyright 2002, Delmar, A division of Thomson Learning
Cultural Differences in
Nutrition
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Cultural beliefs related to the
consumption of food
Religious beliefs related to the
consumption of food
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Food restrictions
Periods of fasting
Copyright 2002, Delmar, A division of Thomson Learning
Components of
a Nutritional
Assessment
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Nutritional history
Physical assessment
Anthropometric measurements
Laboratory data
Diagnostic data
Copyright 2002, Delmar, A division of Thomson Learning
Nutritional History
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General diet information
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Changes in past 12 months
Ability to obtain and prepare foods
Food preferences
Adherence to particular diet
Consumption of fast foods
(continues)
Copyright 2002, Delmar, A division of Thomson Learning
Nutritional History
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Food intake history
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24-hour recall
Food diary
Calorie count
Evaluation of adequacy of diet
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Food guide pyramid
Copyright 2002, Delmar, A division of Thomson Learning
Physical Assessment
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Head to toe
Assess for subjective and
objective signs and symptoms of
poor nutritional status
Copyright 2002, Delmar, A division of Thomson Learning
Signs and Symptoms of
Poor Nutritional Status
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Subjective data
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Fatigue
Weight changes
Changes in appetite
Weakness
Changes in bowel habits
(continues)
Copyright 2002, Delmar, A division of Thomson Learning
Signs and Symptoms of
Poor Nutritional Status
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Objective data
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Weight changes
Dry, rough, scaly skin
Dry, cracked lips
Swollen, bleeding gums
Edema
Decreased muscle tone
Copyright 2002, Delmar, A division of Thomson Learning
Anthropometric
Measures
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Height
Weight
Ideal body weight, percent IBW
Percent weight change
Triceps skinfold
BMI
Mid-arm circumference
Waist/hip ratio
Copyright 2002, Delmar, A division of Thomson Learning
Laboratory Data
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Hematocrit and hemoglobin
Cholesterol and triglyceride levels
Transferrin, TIBC, iron
Total lymphocyte count
Albumin and prealbumin
Glucose
Creatinine and nitrogen
Copyright 2002, Delmar, A division of Thomson Learning
Diagnostic Data
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Radiographic studies
Copyright 2002, Delmar, A division of Thomson Learning