NR 449 Skills Module Nutrition Feeding Eating Solved
Nutritional status refers to a person’s health condition and is determined by the intake and utilization of nutrients. Optimal nutritional status is achieved by having a sufficient intake of sources of energy, essential nutrients, and other dietary components not containing toxins or contaminants (Dipasquale, Cucinotta & Romano, 2020). The WHO defines malnutrition as excesses, deficiencies, or imbalances in an individual’s energy and nutrients intake. Malnutrition is a global problem due to the developmental, social, economic, and medical impacts on individuals, their families, communities, and countries (Dipasquale et al., 2020). This paper seeks to discuss methods that can be used to assess nutritional status and those at risk for malnutrition and explore health conditions that increase the risk of malnutrition.
Methods That Can Be Used To Assess Nutritional Status
Nutritional status is assessed through a nutritional assessment, which is conducted by the clinician. According to Reber et al. (2019), there are limited tools available to assess nutritional status. The commonly used assessment tool is the Subjective Global Assessment (SGA). The SGA obtains information on an individual’s medical history, including weight loss, dietary intake changes, and gastrointestinal and functional impairment (Reber et al., 2019). It also includes a physical examination to assess muscle wasting, loss of subcutaneous fat, ankle edema, sacral edema, and ascites (Reber et al., 2019). In the SGA, every person is categorized as being well nourished (SGA A), moderately or suspected of being malnourished (SGA B), or severely malnourished (SGA C). The limitation of SGA is that it does not consider slight changes in a person’s nutritional status and does not include biochemical values.
Methods That Can Be Used To Identify Those at Risk for Malnutrition
Nutritional screening is performed to identify persons at risk of malnutrition. Methods used in screening individuals for malnutrition risk include using tools, such as the Nutritional Risk Screening 2002 (NRS-2002), Malnutrition Universal Screening Tool (MUST), and Mini Nutritional Assessment (MNA) (Reber et al., 2019). The NRS-2002 is used to detect patients at risk of malnutrition who would significantly gain from nutritional therapy. The MUST is used to identify malnourished patients in all care settings (Reber et al., 2019). It categorizes the risk of malnutrition as low, medium, and high and the treatment guidelines of each, such as routine clinical care, observation, and treatment. The MNA is commonly used to screen for the risk of malnutrition in institutionalized geriatric patients and incorporates screening and assessment features.
Specific Health Conditions That Increase the Risk of Malnutrition
In addition to the general risk factors for malnutrition, disease-specific aspects are known to increase the risk for malnutrition, primarily in geriatrics. According to Prell and Perner (2018), disease-specific risk factors for malnutrition include Parkinson’s disease, Stroke, Epilepsy, Multiple sclerosis, Amyotrophic lateral sclerosis, and Dementia. These health conditions are mostly accompanied by diminished appetite, difficulties in swallowing, poor oral health, and dental hygiene, further increasing the risk of malnutrition.
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Association between Nutritional Status and Health Outcomes
Malnutrition is associated with a reduced quality of life, prolonged hospital stays, increased readmission rates, and increased morbidity and mortality rates. According to Reber et al. (2019), malnutrition is an independent risk factor that adversely influences patients’ quality of life, clinical outcomes, body function, and autonomy. Prell and Perner (2018) state that malnutrition causes an altered body composition such as a decreased fat-free mass and body cell mass, which results in a reduced physical and mental function and impaired health outcomes from a disease.
Interventions That Improve Adherence to Recommendations on Nutritional Intake
Nutritional therapy includes a wide range of different interventions aimed at increasing caloric and nutrient intake. Prevention and treatment of malnutrition are accomplished using multiple interventions. Dietitians and health providers provide patients with or at risk of malnutrition with dietary advice tailored to improve their nutritional intake (Baldwin et al., 2018). Interventions known to increase adherence to dietary recommendations include serving meals in a dining room and using assistance to help feed the sick and geriatrics that have lost or are at risk of losing weight. According to Baldwin et al. (2018), changes to the feeding environment increases pre‐meal sensory stimulation and, as a result, increases nutritional intake. Another intervention that increases caloric intake is modifying meal profile or pattern such as flavor modification, food fortification, and improving the presentation of pureed foods.
Conclusion
The common method used to assess nutritional status is using the SGA tool, which uses subjective and objective findings. Tools used to screen patients at risk of malnutrition include Nutritional Risk Screening 2002, Malnutrition Universal Screening Tool, and Mini Nutritional Assessment, which categorize the patient as per the degree of risk. Diseases that increase the risk of malnutrition include Parkinson’s, Stroke, Epilepsy, Multiple sclerosis, Amyotrophic lateral sclerosis, and Dementia. Poor adherence to dietary recommendations can adversely affect a patient’s health and wellbeing and is associated with an economic burden. Interventions that improve adherence include changes to the feeding environment and modification of meal profile and patterns.
References
Baldwin, C., Kimber, K. L., Gibbs, M., & Weekes, C. E. (2016). Supportive interventions for enhancing dietary intake in malnourished or nutritionally at-risk adults. The Cochrane database of systematic reviews, 12(12), CD009840. https://doi.org/10.1002/14651858.CD009840.pub2
Dipasquale, V., Cucinotta, U., & Romano, C. (2020). Acute Malnutrition in Children: Pathophysiology, Clinical Effects, and Treatment. Nutrients, 12(8), 2413. https://doi.org/10.3390/nu12082413
Prell, T., & Perner, C. (2018). Disease-Specific Aspects of Malnutrition in Neurogeriatric Patients. Frontiers in aging neuroscience, 10, 80. https://doi.org/10.3389/fnagi.2018.00080
Reber, E., Gomes, F., Vasiloglou, M. F., Schuetz, P., & Stanga, Z. (2019). Nutritional Risk Screening and Assessment. Journal of clinical medicine, 8(7), 1065. https://doi.org/10.3390/jcm8071065