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NUTRITIONAL ASSESSMENT
Perdana Samekto T.S., M.Sc, RD
Nutrition scope
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Nutritional assessment
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Wasting
prevalence≥15%
1. Ransom
Serious 2. Supplementary feeding for
vulnerable population, especially
Wasting prevalence situation infants and pregnant women
3. Blanket supplementary feeding
10-14.9%
+ aggravating
factors
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Nutrition screening
• Nutrition screening is the process of identifying characteristics
known to be associated with nutrition problems.
• Its purpose is to pinpoint individuals who are malnourished or at
nutritional risk
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Nutrition assessment
• Obtain adequate information in order to identify nutrition-related
problems
• Systematic process of:
• Obtaining data
• Verifying data
• Interpreting data
• Make decisions about the nature and cause of nutrition related
problems
• Re-assessment at subsequent encounters addresses Monitoring and
Evaluation parameters
Nutrition assessment
• The purpose of nutrition assessment is to obtain, verify, and
interpret data needed to identify nutrition-related problems, their
causes, and significance.
• It is an ongoing, nonlinear and dynamic process that involves data
collection and continual analysis of the patient/client’s status
compared to specified criteria.
• This contrasts with nutrition monitoring and evaluation where food
and nutrition professionals use the same data to determine changes
in patient/client* behavior, nutritional status, and the efficacy of
nutrition intervention
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•Anthropometric Measurements
•Biochemical Data, Medical Tests, Procedures
•Clinical-Physical Findings
•Dietary
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Food/Nutrition-Related History
• Food and nutrient intake
• Food and nutrient administration
• Medication
• Complementary/Alternative medicine use
• Knowledge/Beliefs
• Food and supplies availability
• Physical activity
• Nutrition quality of life
Anthropometric Measurements
• Height, weight,
• Body mass index (BMI),
• Growth pattern indices/percentile ranks
• Weight history
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Identifying
Fat
Wasting
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Identifying
Muscle
Wasting
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Identifying
Muscle
Wasting
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Dysphagia
------------------------------------------------------------------------
• Odynophagia: Pain during swallowing. Cause: Infection or
inflammation in the esophagus
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Client History
• Personal history
• Medical/Health/Family history
• Treatments and complementary/alternative medicine use
• Social history
Case Study
TERAPI DIET PADA KASUS BEDAH DIGESTIF
Skenario :
Pasien bernama Tn. W, usia 53 tahun adalah seorang petani, lulusan SLTP, datang ke RS dengan keluhan nyeri perut hilang
timbul sejak 1 minggu SMRS disertai mual dan muntah. Pasien memiliki riwayat hipertensi dan orangtuanya juga
mengidap hipertensi. Selama 20 HSMRS pasien tidak nafsu makan dan muntah ketika makan. Pasien BAB terakhir 20
HSMRS. Dua hari setelah masuk RS pasien menjalani operasi pengambilan tumor dan biopsi. Pada hari pengambilan
kasus, diagnosis medis pasien adalah Ileus Obstruksi Parsial ec massa intracolon descenden proximal post laparotomi
eksplorasi dan biopsi hari ke-3. Pasien mengeluh tidak nafsu makan, mual, dan perut terasa nyeri pascaoperasi.
Pascaoperasi, pasien mengeluh tidak nafsu makan dan mengalami nyeri perut ketika makan. Sebelum sakit, pola makan
pasien tidak teratur, sering menunda makan. Pasien makan 2x makanan utama sehari dengan 1-2x selingan. Nasi 2x/hari,
LH: ikan 2-3x/minggu,telur dan ayam jarang, LN: Tempe atau tahu 2-3x/hari, digoreng atau dicampur sayur, buah: jeruk,
pepaya 1-2x/minggu, sayur: daun kelor, daun singkong, atau bayam 1-2x/hari. Pasien jarang minum air putih dan gemar
teh manis/ kopi di pagi hari. Pasien sering mengonsumsi kopi dan merupakan perokok berat.
Hasil pengukuran antropometri didapatkan panjang ulna 26 cm, LLA 25 cm. Hasil pemeriksaan laboratorium adalah
albumin 2,5 g/dl, total protein 5,22 g/dL, Hb 12,4 g/dl, leukosit 13,7 103/uL, neutrofil 74,0 %, MCV 75,4 fL, MCH 22,5 fL,
MCHC 29,8 gr/dl, ureum 55 mg/dL, kreatinin 1,24 mg/dL, BUN 25,7 mg/dL. TD 150/90 mmHg, suhu 36,8ᵒ C, RR 20 x/mnt,
nadi 86 x/mnt. Kesan umum compos mentis, BB pasien turun ± 10% dalam 1,5 bulan Tanda fisik lain hipertimpani (+), BU
(+). Asupan makan pasien sehari sebelumnya 13% energi, 5,6% protein, 10.5% lemak, dan 17.7% KH. Terapi medis yang
diperoleh: infus RL:D5:aminofluid 1:1:1, metronidazol, ceftriaxone, paracetamol, ranitidin
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Summary
• Nutrition Assessment is the first step of the NCP
• Dynamic process that develops throughout the NCP
• Data is used for all other steps of the NCP
• New information may provide reason for
reassessment or change in approach and
intervention
TERIMA KASIH
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