Republic of the Philippines

PAMANTASAN NG LUNGSOD NG MAYNILA

University of the City of Manila
College of Nursing
A.Y. 2021-2022

COLLEGE OF NURSING
(Dalubhasaan ng Narsing)

NUTRITIONAL CARE PLAN

(Pregnant)

SUBMITTED BY:
CARIAGA, Claire Marie I.
CATALUÑA, Lady Miqueclaire
CHAN, John Kenneth B.
CLAR, Keeshia Cassandra E.
CONCEPCION, Ada Beatrice C.
CORONEL, Angela Marie R.
CRUZ, Justin Mae Z.
CRUZ, Rossel S.
DE JESUS, Elaidah Joannah S.
DELOS REYES, Janna Claire S

SUBMITTED TO:
Prof. Albina L. Garcia
Prof. Almeida A. Nierves

November 2021
PATIENT’S NAME: L.M.J.C
AGE: 20 years old
DATE: November 25, 2021
PRIORITY PROBLEM:
Imbalanced Nutrition: More Than Body Requirements
SUBSTANTIAL/OTHER OBSERVED PROBLEM/S:
Knowledge deficit related to food and nutrition
NUTRITION
ASSESSMENT
SUBJECTIVE
DATA/CUES:
Anthropometric
Measurement:
Usual weight 132 (lbs.) 60
kg)
Recent changes in
weight
Pre-pandemic - 57 kg
Post pandemic -72 kg
After 2 weeks of workout
and a calorie deficit diet -
71 kg
Planned change? Go
back to 57 kg, min of 55kg
NUTRITION DIAGNOSIS
Ineffective Health
Maintenance related to
Inadequate Health
Teaching. As evidenced
by client’s (+) overweight,
(+) Excess Carbohydrates
intake, (+) Measurements
of food intake, (+) Time
and duration or intervals
of food intake.
Imbalanced nutrition
more than body
requirement related to
previous Unhealthy
dietary patterns/lack of
exercise as evidenced by
(+) clients BMI (+)
overweight.
PLANNING/GOALS NUTRITION NUTRITION
INTERVENTION MONITORING AND
EVALUATION
SPECIFIC The client agrees with After 2 and 3 weeks of
the following nutrition intervention:
The client will be able to interventions:
change her behavior and
attitude in relevance to diet
in order to lower her caloric ● The client will ● The client
intake. demonstrate demonstrated
behavior behavior
MEASURABLE modification modification
techniques: self- techniques: self-
The client should be able monitoring monitoring
to lose approximately 1 kg
of body weight every week. ● The client can ● The client was able
formulate a current to monitor her meal
eating plan to reach plan calories for
ACHIEVABLE enough calorie each day via
The client must be mindful intake by installing MyFitnessPal.
regarding the nutrients the MyFitnessPal
present in the foods that application to
she is consuming, through monitor daily food
Dietary Intake Data: Risk for Obesity:
overweight related to food
“I am on a caloric deficit intake that exceeds body
and I am not guided by a needs and socioeconomic
nutritionist. The status evidenced by
following are my caloric abnormal weight of the
intake in a day; a client which is moreover
minimum of 1000 kcal optimum body weight,
and a maximum of 1500 excess body fat by
kcal” as verbalized by the skinfold, and intakes more
patient. than body requirements.
“I have one snack, one Risk for Disturbed Body
dinner, and then Image: related to alteration
magkasama na yung in self-perception possibly
lunch and breakfast ko evidenced by negative
every day. For brunch, I feelings about the body;
had 100 g of Rice, 100 g fear of rejection or reaction
of Sauteed sayote, and 1 toward others.
serving of chicken
breasts. For dinner, I had Risk for Impaired
100 g of Rice, 2 sticks of Physical Mobility: related
Barbeque,1 serving of to obesity, physical
Beef Mami, and 1 serving deconditioning,
of Asado siopao. For my malnutrition, possibly
snacks, I had 100 g of evidenced by abnormal
Biko Rice Cake '' as BMI results and objective
verbalized by the patient. data assessment.
Meal Time/Usual Meal Risk for Infection: related
Time: to insufficient knowledge in
Brunch: 11 am avoidance of exposure to
Snack: 3pm pathogens, malnutrition,
Dinner: 7pm exposure to soiled areas
as evidenced by drainage
Meal Place: Home facilities being open, and
targeting nutrient-dense intake ensuring its
foods which are high in proper amount.
nutrients but low in
calories.
REALISTIC ● The client should ● The usual meals of
choose appropriate
The client should be able and healthy food
to increase her self- choices with
efficiency in terms of relevance to the
improving her lifestyle to type of diet (Caloric
achieve her desired weight. Deficit Diet).
TIME-BOUND
● The client will
● In a span of 2 - 3 modify her diet by ● From the client’s
weeks, the client reducing the
will be able to consumption of
slowly incorporate food rich in
the suggested carbohydrates
modifications in her (pies, rice cakes,
food choices, food siopao). Lean more
intake, diet, and into protein-rich
exercise and foods (beef,
progressively chicken, fish,
achieve proper and yoghurt) through
balanced nutrition nutrient-dense
towards her foods.
planned change of
weight.
● The client should
know that an ● Given that the
increase in the
intake of fluids
particularly water,
the patient such as
barbeque, beef
mami and asado
siopao were
successfully shifted
in accordance with
her Caloric Deficit
Diet.
usual consumption
of carbohydrates
which is 616. 56
kcal to 1592.063
kcal. The patient
relies on foods that
are rich in protein
such as beef,
chicken, fish and
yoghurt.
patient has a 0.10
rate in uric acid, the
patient consumed
“I usually drink 2 L of open garbage containers. ideally 11.5 cups 2L of water a day.
water a day” (2.7 liters) per day
is an integral part of
Habits: being healthy.

“There are no food

restrictions for me, any ● The client will follow
food is acceptable. I am the proportioning of ● The patient applies
not picky when it comes food groups in in her meal the right
to food, and I eat MyPlate to have an proportion of food
whatever is available. appropriate amount groups based in
However, vegetables and of nutrients; e.g., 2 MyPlate with the
foods high in protein are cups of fruits, 2 ½ following groups:
my food preferences.” cups of vegetables,
6 ounces of grains, ● Dairy = 2-3
“The usual preparation 3 cups of dairy servings
for our meats are either products, and 5 ½ ● Protein = 2-
boiled, fried, grilled, or ounces of meat 3 servings
saute. The vegetables daily to balance ● Vegetable =
are usually sauteed, consumption. 3-5
fried, or boiled." servings
● Fruit = 2-4
“I do exercises six times servings
a week for two hours ● Grains = 6-
each time. Weight loss, 11 servings
cardio, and strength are
the kinds of exercise I ● The client followed
do” as verbalized by the ● The client will a strict proportion of
patient. control food portion food by meal
sizes through meal replacements.
Risk Factors: replacements.

Ventilation is good. ● Every 2-4 weeks

● The client will the patient
“Kulob kasi, bale walang reassess calorie repeatedly
bintana and exhaust fan. requirements every assesses her
Minsan mainit dalawa 2-4 week.(changes calorie
lang din kasi ang in metabolism requirements of:
opening na parang door occur)
type yung isa gate na ● Protein =
mismo” 882.78 kcal
● Fats = 709.
General sanitary condition 335 kcal
is good. ● Carbohydra
tes = 1592.
“We clean every day and 063 kcal
we also do general
cleaning. Nevertheless,
since our drainage is ● Each week the
open the insects and ● The client should patient assessed
vermin are assess weight and her weight and
uncontrollable” blood pressure blood pressure
once or twice each once or twice.
Drainage facility is open. week.
● The client takes
The garbage container is ● The client should note on how to read
open. be able to food labels and
demonstrate how to calories on food
OBJECTIVE DATA: read food labels products, also
Vital Signs: and calories on considers foods
Temperature – 36.5 C food products, as that are low in
Blood pressure – 110/70 well as to choose Carbohydrates and
Pulse rate – 68 bpm foods that are low added sugars.
Respiratory rate – 17 bpm in Carbohydrates
and added sugars.
Anthropometric
Measurement: ● The patient
● The client returned from her
Height 161 cm verbalized a plan to work-out routine for
Present weight 157.63 continue her cardio, strength and
(lbs.) exercise regimen weight loss, every 2
71.5 (kg) for cardio, strength, hours a day and 6
Triceps skin fold 21.1
(mm)
Standard 27.7
Body Mass Index:
𝐵𝑀𝐼 = 𝑊𝑒𝑖𝑔ℎ𝑡 𝑖𝑛 𝑘𝑔 𝐻𝑒𝑖𝑔ℎ𝑡
𝑖𝑛 𝑚2 = 71.5 𝑘𝑔 1.612 =
27.58
*As interpreted in the
calculation of the body
mass index of the client,
she is overweight.*
Required basal metabolic
rate as calculated by the
student nurse:
Basal Metabolic Rate:
Caloric Deficit
(157.63 lbs.) (14) =
2206.82 - 400 = 1806.82
CHON
(157.63 lbs.) (1.4 g) =
220.682 g x 4 = 882.728
kcal
Fats
(157.63 lbs.) (.5) = 78.815
g x 9 = 709.335 kcal
CHO
882.728 kcal + 709.335
kcal = 1592.063 kcal
1592.063 – 1806.82 =
214.757 kcal
and weight loss for times a week.
2 hours a day and 6
times a week. This
shall be designed ● The client took her
along with their vitamins and
primary healthcare minerals
provider. supplements after
meals as
● The client should recommended by
take vitamins and her doctor.
mineral
supplements as
prescribed by the
doctor.
● The client will utilize ● The client utilized
proper measuring measuring devices
devices to attain like measuring
adequate serving spoons and cups
sizes for her diet. for her daily meal.
After 6-12 months of
nutrition intervention:
● The client will ● The client attended
attend routine four follow-up visits
consultations with a with a dietician and
dietitian to improve improved her diet
her diet plan and plan and caloric
caloric intake. intake.
Biochemical Data:

Laboratory:
Uric Acid – 0.46
SGOT – 13.0
Calcium - 2.11
Globulin – 38.1
Stab – 0.01

Clinical Data:
Teeth: Dentures: N/A but
the client is wearing
braces

Dietary Intake Data:

Kcal count for

Carbohydrates
(154.14 g) (4 kcal) =
616.56 kcal

Kcal count for Protein

(83.74 g) (4 kcal) = 334.96
kcal

Kcal count for Fats

(36.25 g) (9 kcal) = 326.25
kcal

Total Kcal Count:

616.56 kcal + 334.96 kcal
+ 326.25 kcal = 1,277.77
kcal
 REFERENCES

Protein. (n.d.). Better Health Channel. Retrieved November 24, 2021, from https://www.betterhealth.vic.gov.au/health/healthyliving/protein

Sampson, W. (2019, May 29). How to lower uric acid levels naturally. Medical News Today.
https://www.medicalnewstoday.com/articles/325317

Wayne, G. (2021, September 1). Imbalanced Nutrition: More Than Body Requirements Nursing Care Plans. Nurselabs.
https://nurseslabs.com/imbalanced-nutrition-more-body-requirements/