ASSESSMENT:

10% to 20% below ideal body weight or weight below normal for age, height, and build
· Abdominal cramping, hyperactive bowel sounds, diarrhea
· Abnormal laboratory results: vitamin/mineral and protein deficiencies, electrolyte imbalances
Amenorrhea
Bradycardia; cardiac irregularities; hypotension
· Changes in gastric motility and stool characteristics
· Changes in gums, oral mucous membranes
· Decreased tolerance for activity, weakness
· Decreased triceps skin-fold measurement
Diarrhea
Documented inadequate caloric intake
Excessive loss of hair; increased growth of hair on body (lanugo)
Hypothermia
Imbalances in nutritional studies
Increased ketones (end product of fat metabolism)
Increased urinary output, dilute urine
· Lack of interest in food, aversion to eating, altered taste sensation
· Loss of muscle mass/subcutaneous fat, and development of negative nitrogen balance
Loss of weight with or without adequate caloric intake, decreased subcutaneous fat/muscle mass (wasting)
Pale conjunctiva; poor skin turgor
· Sore, inflamed buccal cavity
Weakness of muscles required for swallowing or mastication

DIAGNOSIS:
Imbalanced Nutrition: Less Than Body Requirements: Intake of nutrients insufficient to meet
metabolic needs.

PLANNING:

STO: within 24 hours of nursing intervention, Patient will indicate understanding of significance of nutrition to
healing process and general health.
LTO: within 120 hours of nursing intervention, Patient will demonstrate nutritional ingestion sufficient to meet
metabolic needs as manifested by stable weight or muscle-mass measurements, positive nitrogen balance,
tissue regeneration and display improved energy level.

IMPLEMENTATION:

Dx.

 Review abdomen, noting incidence or character of bowel sounds, abdominal distention, and reports of
nausea.
 Observe or discover manners toward eating and food.
 Review laboratory values that signifies nutritional health or worsening
 Weigh patient weekly.
Tx.

 Administer medications between meals (if tolerated) and minimize fluid intake with meals, except fluid
has nutritional value.
 Advocate rest before meals.
 Arrange diet with patient or significant other, suggestive of foods from home if suitable. Offer small,
frequent meals or snacks of nutritionally dense foods and nonacidic foods and beverages, with
preference of foods appetizing to patient. Persuade high-calorie or nutritious foods, a number of of
which may be considered appetite stimulants. Note time of day when appetite is finest, and aim to
serve bigger meal at that time.
 Build up and persuade a pleasing milieu for meals. Dish up foods in well-ventilated, pleasing
environment, with unhurried ambiance, friendly company.
 Eliminate existing noxious environmental stimuli or situations that provokes gag reflex.
 Give small, frequent feedings; include patient likes or dislikes in meal preparation as much as possible,
and incorporate “home foods,” as fitting.
Ed.

 Avoid beverages that are caffeinated or carbonated.

 Persuade exercise or as much physical activity as feasible.
 Persuade patient to sit up for meals.
 Persuade small, frequent meals with foods high in protein and carbohydrates.
 Persuade utilization of herbs or spices, such as the following: garlic, onion, pepper, parsley, cilantro,
and lemon.
 Persuade/help out with fine oral hygiene; before and after meals, use soft-bristled toothbrush for
gentle brushing. Offer dilute, alcohol-free mouthwash if oral mucosa is ulcerated.