INSTITUE OF LIVER AND BILLIARY SCIENCES

DEMONSTRATION ON
NUTRITIONAL ASSESSMENT

SUBMITTED TO: MS. TARIKA SHARMA SUBMITTED BY: RINY KHURSHID

LECTURER M.SC. NURSING FIRST YEAR
CON ILBS CON ILBS
OBJECTIVES
General Objectives:
At the end of the demonstration, the students will be able to develop fair knowledge about Nutritional Assessment and demonstrate and develop
skills in performing in clinical practice.
Specific objectives
At the end of the demonstration, the students will be able to,
1. Introduce the topic Nutritional Assessment.
2. Discuss in brief about the Nutritional Assessment.
3. Define Nutritional Assessment.
4. List down the article required in Nutritional Assessment.
5. Relates concepts of nutrition and metabolism with GI assessment and elimination.
6. Identify patient at risk for developing malnutrition.
7. Use nutritional assessment in the provision of health care.
Document finding using correct medical terminology.
8. Conclude the topic.
LESSON PLAN
Topic : Nutritional assessment
Name : Riny Khurshid
Year : MSc Nursing 1st year
Date of presentation : 16th February 2023
Time and duration of presentation : 30 min
Venue :
Name of supervisor : Ms. Tarika Sharma
Group : M.Sc. Nursing 1st year
Method of teaching : demonstration, explanation, discussion
AV Aids :
Subject : Clinical Specialty I
Previous knowledge : Students are expected to have basic knowledge regarding Nutritional assessment.
NUTRITIONAL ASSESSMENT
S TI ME SPECIFIC CONTENT TEACHI NG EVALUATION
. OBJECTIVE LEARNI NG
N ACTIVITIES

1 30sec To introduce INTRODUCTION Student What is thetopic

the topic Nutritional assessment is the systematic process of collecting and teacher will of
interpreting information in order to make decisions about the nature and introduce the demonstration?
cause of nutrition relatedhealth issues that affect an individual. topic to group.

2 30sec To define the DEFINITI0N Student teacher Define

Nutritional Nutritional assessment can be defined as the interpretation from dietary, knowabout the Nutritional
assessment laboratory, anthropometric, and clinical studies. It is used to determine the definition of Assessment
care. nutritional status of individual or population groups as influenced by the intake Nutritional .
and utilization of nutrients. assessment by
lecture.
3 2min List downthe INDICATIONS FOR NUTRIONAL ASSESSMENT Student teacher List downthe
indicationof 1. patients with gastrointestinal problems such as inflammatory bowel indicationof indicationof
Nutritional disease orliver cirrhosis may have malnutrition issues Nutritional
assessment. 2. patients with lung problems may not have enough oral intake due assessment by
to difficultybreathing lecture and
3. diabetes patients will have inadequate glucose homeostasis discussion
4. patients who have psychiatric disorders or depression may have
functionalimpairments that cause poor nutritional intake
5. cancer patients may result cancer cachexia and malnutrition
6. patients who are in pain may decrease oral intake
4 1min To PURPOSE Student What are
enumerate The purpose of nutritional assessment is teacher know the
about the about the purposes of
purpose of • To rapidly identify patients at high nutritional risk. purposes of Nutritional
Nutritional • To define a patient’s nutritional status Nutritional assessment?
assessment • To define clinically relevant malnutrition assessment.

• To monitor changes in nutritional status.

5 2min To enlist TYPES OF NUTRITIONAL ASSESSEMENT Student enlist the

the types of • Anthropometric teacher enlist types of
Nutritional • Biochemical the types of Nutritional
assessment • Clinical Nutritional assessment?
• Dietary assessment
by demonstra
tion.
6 5min To explain PREPARATION OF THE PATIENT AND ENVIRONMENT
the steps of Nutritional assessment is an ongoing component for daily assessment especial
Nutritional for patients with nutritional concerns and patients who are at risk for nutritional
assessment deficits. Student Explain the
• Obtain health history teacher known steps of
• Food allergies about the steps procedure
• Medical dietary requirements (for example, Gluten-free diet for history of of procedureof of
celiacdisease) Nutritional Nutritional
• Dietary supplements (for example, vitamins or protein drinks) Assessment assessment?
• Cultural/ethnic/religious need
• Dietary intake history (for example, eating habits, like and dislike foods)

Dietary and nutritional differences can be found among racial and

socioeconomicgroups.

Dietary selections can be affected by religious, spiritual, or philosophical beliefs

2. Obtain chief complaints

• Pain
• Changes in the taste of food
• Feeling tiredness
• Recent changes in appetite
• Nausea/Vomiting
• Change in bowel habit
• Involuntary weight loss, recent changes in weight.

Chief complaints should be considered because it may indicate the patient to be at

riskfor nutritional deficits.

Problems with intake such as indigestion, heartburn, bloating, difficulty

chewing orswallowing will affect nutritional status.
If the patient has a specific concern about hair, skin, or nails, a focused assessment
regarding to the specific sign/symptom should be performed

3. Check

• Height and weight

• Vital signs

Note the size of the patient and calculate BMI to determine normal, overweight, or
obesity.

Waist circumference can also be measured for adult patients to determine if the patient is
at risk for cardiovascular disease. Normal waist for men should be less than 40 inches;
for women, less than 35 inches.

Abdominal Girth Measurement

4. General inspection and examination

• General appearance
• Integumentary – hair and skin
• GI & GU – frequency of bowel movement and urination
• Neuro and Musculoskeletal – assessing for any physical problems for eating and
drinking

During the meal time, observe the patient’s dietary intake and compare with
recommended food groups for specific age groups and activity levels.

Expected findings are alert & oriented, normal proportion of body structure, normal skin
tone and skin color appropriate to ethnicity, no signs of malnutrition.

Many diseases are directly or indirectly caused by a lack of essential nutrients in the
diet. Changes in the skin and mucosal membranes can offer valuable clues to the
presence of nutritional deficiencies. For example, gingivitis and bleeding gums may
cause by vitamin C deficiency.

For integumentary system, in malnutrition patients, hair is likely to be brittle and dry,
and or hair loss; skin is likely to be pale, dry, and rough; wounds will tend to take longer
time to heal.

Physical difficulties, such as tremors, will affect dietary intake. Nurses should assess if
equipment is needed to help with eating and drinking.

5. Review related laboratory results

Some laboratory values may reflect the patient’s nutritional status such as albumin,
prealbumin, transferrin, electrolytes, and etc.
6. Report and document assessment findings and related health problems

Accurate and timely documentation and reporting promote patient safety.

Recommend additional nutritional evaluation referrals such as dietitian to determine the

need for nutritional supplements.

NURSING CONSIDERATION
1. Determine real, exact body weight for age and height. Do not estimate.
2. Determine the patient’s height.
3. Determine the patient’s body mass index (BMI).
BMI is determined by combining two anthropometric variables: weight in kilograms
(kg) and height in square meters (m2). A high BMI can indicate too much fat on the
body, while a low BMI can indicate too little fat on the body. The higher an individual’s
BMI, the greater their chances of developing certain serious conditions, such as heart
disease, high blood pressure, and diabetes. A very low BMI can signify various health
problems, including anaemia, decreased immune function, and bone loss.

Calculating for the BMI:

BMI is calculated the same way for people of all ages. However, BMI is interpreted
differently for adults and children. The formula is BMI = kg/m2, where kg is a person’s
weight in kilograms and m2 is their height in meters squared.

Adults aged 20 and older can interpret their BMI based on standard weight status
categories.
BMI Weight Status

Below 18.5 Underweight

18.5 – 24.9 Normal

25.0 – 29.9 Overweight

30.0 and above Obese

4. Assess the patient’s nutritional risk using nutritional risk screening tools.
5. Assess the patient’s eating pattern.
6. Assess the patient’s food choices by taking a nutritional history with the
participation of significant others.
CONCLUSION
Nutritional assessment is and will continue to be an essential part of the nursing role and
as nurses we have a professional duty to develop our knowledge and skills in this area.

It is vital that patients who require additional nutritional support be identified quickly in
order that the appropriate referrals can be made and nutritional support provided. In the
busy healthcare environment, the importance of nutritional assessment cannot be
underestimated and must not be forgotten.

BIBLIOGRAPHY

• Centers for Disease Control and Prevention. Healthy Weight, Nutrition, and
Physical Activity: About adult BMI. Available at
https://www.cdc.gov/healthyweight/assessing/bmi/adult_bmi/index.html#Interpr
etedAdults
• Ernstmeyer, K., & Christman, E. (Eds.). (2021). Open RN Nursing Fundamentals
by Chippewa Valley Technical College is licensed under CC BY 4.0.
• Hinkle, J. L. & Cheever, K. H. (2018). Brunner & Suddarth’s Textbook of
Medical-surgical Nursing. (14th ed.). Philadelphia, PA: Wolters Kluwer.