The Nursing diagnosis of nutrition

March 10th, 2010 | Posted in Nursing Diagnosis

The Nursing diagnosis of nutrition
Initially, the nutrients in the NANDA diagnosis is “Disturbance nutritional needs less / more than the body needs”. But since the edition of 2000s, the diagnosis was revised to a few:
1. Imbalanced nutrition: less than body requirements (148) or nutritional imbalance: less than body requirements
2. Imbalanced nutrition: more than body requirements (149) or nutritional imbalance: more than body requirements
3. Readiness for enhanced nutrition (150th) or the potential increase in nutrients (nursing diagnosis welfare / wellness)
4. Risk for imbalanced nutrition: more than body requirements (151) or the risk of nutritional imbalance: more than body requirements

Of the four nursing diagnoses, perhaps the first diagnosis is frequently used. The diagnosis of “imbalance nutrition: less than body requirements” is a diagnosis for patients who have nutritional deficiencies intake of less than metobolisme needs. Borrowing the term Carpenito, that there should be a diagnosis of major data, it prioritizes diagnostic sign “weighing less than 20% ideal body weight”. So that when a patient should not eat (only once or twice only) may not be able to lift this diagnosis. Especially if there is no weight data of patients during hospitalization and after care. Anyone ever asks: “If patients do not want to eat because of feeling nauseated, what diagnosis should not lift it?”. Why, lha existing weight loss yet? If that data is “only” because of sickness, why not raise a diagnosis of “sick” (Nausea, NANDA pp. 142-143) alone? The problem is, until the 2007-2008 NANDA, not yet / no diagnosis “Risk nutritional imbalance: less than body requirements”. Maybe if there was such a diagnosis, could have raised this with the nutritional diagnosis diagnostic category of “risk”.
In addition to weight loss, other data for this diagnosis are:
1. stomach cramps
2. abdominal pain
3. diarrhea
4. hair loss
5. underfed
6. less information
7. less interested in food
8. weight loss with food intake adequat
9. misconceptions
10. misinformation
11. pale mucous membranes
12. inability to digest food
13. muscle weakness
14. etc.
Etiology that can be connected:
1. biological factors
2. economic factors
3. inability to absorb foods
4. inability to eat
5. inability to digest food
6. psychological factors.
If data is found not just “sick”, but more than that according to the list of signs of the above symptoms, should raise the risk of diagnosis, although in NANDA’s no risk for this diagnosis. Diagnosis is to risk the “Risk nutritional imbalance: more than body requirements related to ….”. But for the “less than body requirements” was not currently exist.
The diagnosis of “imbalance nutrition: more than body requirements” can be appointed for patients with weight 20% more than ideal BB.
Then there is an interesting question: “If the patient is connected naso Gastric Tube (NGT), whether the diagnosis of nutrients needed to be removed this? Is not there a regular schedule for feeding through NGT earlier, the patient may not have nutritional deficiencies …. “.
In my opinion, this case is similar to the risk of infection for the diagnosis infusion installation or other invasive procedures. Well, why do patients fitted NGT? Because swallowing disorders, decreased awareness, etc.. NGT prior to installation, of course, the nurse will conduct assessments in advance. For example, “Oh, the patient experienced a decrease of consciousness”. Nurses should be lifted diagnosis “Risk of nutritional imbalance: less than body requirements”. Intervention will include: installation of NGT, giving fooding sonde 5 x 400 ml for example. The problem, the nurse then had the assumption that the patient have been installed since the poly NGT or ER, means need not be appointed nutrition diagnosis. The question is: “Nurses provide food through NGT 400 ml. Once you’ve done, the progress notes where she will document this intervention? ”
So, the nurse who put NGT (in poly, ER, or anywhere else), would have had a diagnosis of nutrients that she needs to put NGT. Furthermore, nurses in the inpatient or home care would go through with the intervention of the first nurse who put NGT. The problem: “How can the documentation of nursing process in poly / ER / first place?”