Malnutrition

Malnutrition

1. Nursing Diagnosis

   • Imbalanced nutrition:less than body requirements
   • Self care deficit
   • risk for impaired skin integrity

2. S/S

   • Eyes: pale or red conjunctiva, biotots spots, dry dull appearance, redness of eyelid corners
   • Skin: dry, alopecia, dry lips, brittle nails, decreased tone and elasticity, changes in pigment, peripheral edema
   • glossitis, hypertophic papillae, dental caries, gums disease, distended abdomen, ascites, hepatomagy, decreased bowel sounds, steatorrhea
   • decreased respiratory rate , weak cough, crackles
   • decreased/loss of reflexes, tremor, irritability, confusion, syncope, peripheral neuropothy
   • decreased muscle mass, poor tone, "wasted" appearance, beaded ribs, knock knees, chest deformity, prominent bony structures
   • increased/decreased HR, decreased BP, dysrhythmias

3. related factors

   • Inablility to consume foods
   • inablility to digest foods
   • unwillingness to eat
     • aneroxia nervosa
   • knowledge deficit
   • inalbility to obtain adequate food and adequate amounts of food
     • limited financial resources
   • increased metobolic needs
     • Physical illness
     • injury
     • surgery

4. Nursing assessment

   • Document actual weights
     • weigh patient weekly
   • monitor and assess attitudes toward eating and food
   • monitor eating environment
   • monitor labs
     • serum albumin
     • RBC
     • WBC
     • Serum electrolytes
     • Transferrin
   • Identify ethnic, religious preferences, or restrictions
   • assess/monitor V/S
   • perform physical assessments

5. Nursing Interventions

   • provide ample time for meals
   • assist patient with meals as needed
     • provide assistive devices
   • Consult other necessary professions
   • Encourage a pleasant environment
     • provide companionship
   • Perform good oral hygiene
   • ensure proper sitting position
   • encourage use of spices and seasonings
   • offer liquid supplements
   • Elevate HOB
   • Educate patient and family
     • importance of maintaining healthy weight
     • Community resources
       • Social services
       • food programs
       • home health
       • cooking/nutrition classes
     • healthy eating habits
       • heaalthy food options
     • Discuss potential need for EN/PN
   • Encourage exercise

6. Dietitian,PT, OT, ST, Dentist, Psychology

7. Outcomes

   • Patient will achieve appropriate weight
   • Patient will addherer to eating approriate/ sufficent amount of calories
     • diet will be well balanced
   • Patient will not have adverse consequences related to amlnurishment
   • patient will maintain physical function and ability