5. Imbalanced Nutrition, Less Than Body Requirements

5. Imbalanced Nutrition, Less Than Body Requirements
related to: dyspnoea, anorexia, nausea, vomiting.

As evidenced by:[Check those that apply]

Major: (Must be present)	(_) Reported inadequate food intake less than recommended daily allowance with or without weight loss and/or actual or potential metabolic needs in excess of intake.
Minor: (May be present)	(_) Weight 10% to 20% or more below ideal for height and frame. (_) Tachycardia on minimal exercise and bradycardia at rest. (_) Muscle weakness and tenderness. (_) Mental irritability or confusion. (_) Decreased serumm albumin.

Date & Sign.	Plan and Outcome[Check those that apply]	Target Date:	Nursing Interventions[Check those that apply]	Date Achieved:
	The patient will: (_) Experience adeuqate nutrition through oral intake. (_) Experience an increase in the amount or type of nutrients ingested. (_) Gain weight. (_) Other:		(_) Assess and document patient's dietary history, patters of ingestion, intolerance to foods. (_) Assess patient likes and dislikes. Inform dietary. (_) Teach techniques to maintain adequate nutritional intake and stimulate appetite: administer/instruct pt. on good oral hygiene before and after feedings maintain pleasant environment for patient (_) Determine proper denture fit and profice adhesive as necessary. (_) Increase social contact with meals by:____________________ _______________________ (_) Plan care so that unpleasant/painful tests/tx's don't take place before meals. (_) Medicate pt. for pain 2 hrs before meals per physician's orders. (_) Consult with dietitian re: calorie count change in food consistency spacing meals provision of high caloric supplements provision of high protein supplementation food intolerances/preferences extra fluids on tray dietetic teaching, food selelction therapeutic diet restrictions: __________________ (_)Consult with PT/PT re: strengthening exercises prosthetic devices swallowing disorders (_) Environmental support to improve intake: be sure pt. is alert and responsive before eating sit upright 60-90 degrees for 15-20 min. before, during & after eating decrease distractions demonstrate patience by providing specific directions until finished assure good mouth care (_) Weigh patient q______ at _______ a.m./p.m. (_) Other:________________ ________________________ ________________________ ________________________