NUTRITIONAL ASSESSMENT c. How treated?

d. Dietary modifications?
Definition of Terms
e. Recent cancer therapy/radiation?
1. Assessment 6. Vomiting, diarrhea and constipation. Any
2. Parameters – distinguishing characteristics problems?
3. Nutritional Status – degree of balance between 7. Food allergies/intolerances
nutrient intake and nutrient requirement a. Any problematic foods?
b. Type of reaction?
Nutritional Status c. How long?
1. Optimal nutrition – when foods eaten will create a 8. Medications and/or nutritional supplements
healthy body, a healthy body composition, and a. Prescribed?
allow you to feel energize through your day and b. Non-prescribed?
your workouts c. Over a 24-hour period?
2. Undernutrition – nutrients are undersupplied d. Type of vitamin/mineral/alternative
relative to the amounts required for normal growth, supplement?
development and metabolism e. Amount?
3. Overnutrition - nutrients are oversuppliedrelative to f. Duration of use?
the amounts required for normal growth, 9. Self-care behavior
development and metabolism a. Meal preparation facilities?
b. Transportation for travel to market?
Purposes c. Adequate income for food purchase?
d. Who prepares meals and does shopping?
1. To identify individuals who are malnourished or at
e. Environment during mealtimes?
risk of developing malnutrition
10. Alcohol/Illegal drug use
2. To provide data for designing a nutrition plan of
a. When was the last drink of alcohol?
care that will present/minimize the development of
b. Amount taken that episode?
malnutrition
c. Duration of use?
3. To establish baseline data for evaluating the
11. Exercise and Activity Patters
efficacy of nutritional care
a. Amount?
5 forms of assessment b. Type?
12. Family History
1. IPPA a. Effect of each on eating patterns?
2. Lab results b. Effect on activity patterns?
Assessment: Subjective Cues Additional Nutritional History on Infants
1. Eating Patterns 1. Gestational Nutrition
a. Number of meals/snacks per day? a. Maternal history of alcohol/illegal drug
b. Kind and mount of food eaten? use?
c. Fad/special diets? b. Any diet-related complications during
d. Where is food eaten? gestation?
e. Food preferences and dislikes? c. Infant birth weight?
f. Religious/cultural restrictions? d. Any evidence of delayed physical and
g. Able to feed self? (Geriatrics, amputation, mental growth?
physical limitations 2. Infant breastfed or bottle fed
2. Usual Weight a. Type, frequency, amount and duration of
a. What is the usual weight? feeding?
b. 20% below or above desirable weight? b. Any difficulties encountered?
c. Recent weight change? c. Timing and method of weaning?
d. How much lost/gained? 3. Child’s willingness to eat what you prepare
e. Over what time/period? a. Any special likes or dislikes?
f. Reasons for loss/gain? b. How much will the child eat?
3. Changes in appetite, taste, smell, chewing and c. How do you control non-nutritious snack
swallowing foods?
a. Type of change?
b. When did change occur? Additional Nutritional History on Adolescents
4. Recent surgery, trauma, burn and infection
1. Your present weight
a. When?
a. What would you like to weigh?
b. Type?
b. How do you feel about your present
c. How treated?
weight?
d. Conditions that increase nutrient loss such
c. On any special diet to lose weight? If so/
as draining wounds, effusions, blood loss,
were they successful?
and dialysis)
d. Constantly think about “feeling fat”?
5. Chronic Illnesses
e. Intentionally vomit/use of laxatives?
a. Type?
2. Use of anabolic steroid or other agents to increase
b. When diagnosed?
muscle size and physical performance
 a. When?
b. How much?
3. What snack/fast foods do you like to eat
a. When?
b. How much?
4. Age first started menstruating
a. What is your menstrual flow like?
Additional Nutritional History on Pregnant Women
1. How many times have you been pregnant?
a. When?
b. Any problems encountered during previous
pregnancy?
c. Problems with pregnancy?
2. What foods do you prefer when pregnant?
a. What food do you avoid?
b. Crave any particular foods?
Additional Nutritional History on Aging Adults
1. How does your diet differ from when you were in
your 40s and 50s
a. Why?
b. What factors?
Assessment: Objective Cues

Area of Examination Normal Signs associated with Nutrient Deficiency

malnutrition
Skin  Smooth; no rashes, no  Dry, flaky Vitamin A, B complex
bruises, no flaking Petechiae/Ecchymosis Linoleic Acid
Follicular hyperkeratosis Vitamin C & K
Pellagrous dermatitis Vitamin A, Linoleic Acid
Nasolabial seborrhea Niacin
Acneiform forehead rash Riboflavin
Eczema Vitamin B6
Xanthomas Linoleic Acid
Excessive serum levels of
LDLs/VLDLs
Hair  Shiny, firm, does not  dry
easily fall out
Eyes  corneas are clear, shiny;  Foamy plaques (Bitot’s Vitamin A
membranes are pink and spots) Fe
moist; no sores at corners Xeropthalmia Riboflavin
of eyelids Keratomalacia B complex
Pale Conjunctiva Biotin
Red Conjunctiva (sore eyes:
conjunctivitis)
Blepharitis (inflammation of the
eyelids
Lips  Smooth, not chapped Cheilosis Riboflavin
or swollen Angular stomatitis Niacin
Fe, Vitamin B6
Tongue  Red in appearance; not Glossitis Vitamin B complex
swollen, smooth; no Pale Fe
lesions Papillary Atrophy Niacin
Papillary Hypertrophy Multiple Nutrient
Magenta/purplish colored Riboflavin
Gums  Reddish-pink, firm, no Bleeding Vitamin C
swelling, bleeding
Nails  Smooth, pink  Brittle, ridged, or Fe
spoon shaped
(Koilonychias)
MS  Erect posture, no Pain in calves Thiamin
malformation, muscle Osteomalacia Vitamin D and Vitamin C
tone, can walk/run Rickets Vitamin D and Vitamin C
without pain Joint Pain Vitamin C
Muscle wasting Protein, Carbs, fats
Neurologic  Normal reflexes Peripheral neuropathy
Hyporeflexia
Disorientation