MODULE 2: NURSING DIAGNOSIS comply, emotional health, financial status,
religious or ethnic background, and other
A. NURSING DIAGNOSIS
 It serves as a framework for the plan
of care.
 The diagnoses relate directly to
nutrition when the pattern of nutrition
and metabolism is the problem.
SAMPLE NURSING DIAGNOSIS
 Altered Nutrition: Intake exceeds the
body's needs.
 Altered Nutrition: Eating less than the
body needs
 Ineffective Breastfeeding
 Interrupted Breastfeeding
 Ineffective Infant Feeding Pattern
 High Risk of Aspiration
 Swallowing Disorder
 Altered Oral Mucosa
 Fluid Volume Deficits
 Excess Fluid Volume
 Impaired Skin Integrity
PLANNING
 Client-centered outcomes: give the client
the chance to actively participate in goal
setting. o Commitment to achieve the
goals is higher when the client "owns" the
goal.
 Set and meet the short-term goals.
 Then expand the plan by promoting
healthy eating: to reduce the risk of
chronic diet-related diseases.
NURSING INTEVERNTIONS
 To effectively and efficiently assist the
client achieve his goals, the nurse will
utilize the nursing intervention.
Interventions may include:
 Nutrition Therapy
 Client Teaching
NUTRITION THERAPY
 Factors such as the client's prognosis,
outside support systems, level of
intelligence and motivation, willingness to
medical conditions may cause the optimal
diet to be practical in either the clinical or
the home setting.
 Generalizations do not always apply to
all individuals. Also comfort foods (e.g.
chicken soup, mashed potatoes, ice cream)
are valuable for their emotional benefits if
not nutritional ones.
 Honor client's request for individual
comfort foods whenever possible.
CLIENT WAY TO PROMOTE AN ADEQUATE
INTAKE
 Reassure clients who are apprehensive
about eating.
 Encourage a big breakfast if
appetite deteriorate throughout the day.
 Replace meals withheld for diagnostic test.
 Display a positive attitude when serving
food.
 Request assistance with feeding or meal
setting setup.
 Get the patient out of bed to eat if
possible.
 Encourage good oral hygiene.
CLIENT TEACHING
 The patient’s ability to assimilate
new information may be compromised by
pain, medication, anxiety, or a distracting
setting.
 Time spent with dietitian, learning about
a "food patterns to consider" may be brief
or interrupted, and the patient may not
even know what questions to ask until long
after the dietitian is gone.
WAY TO FACILITATE CLIENT AND FAMILY
TEACHING
 Listen to the client's concerns and ideas.
 Encourage family involvement if
appropriate.
 Reinforce the importance of
obtaining adequate nutrition.
 Help the client to select appropriate
foods.
 Counsel the client about drug-
nutrient interactions.
 Avoid using the term "diet.
 Emphasize things "to do" instead of things
"not to do".
 Keep the message simple.
MONITORING AND EVALUATION
 Client Outcomes may be fully met, partially
met or not achieved at all.
 Evaluation includes deciding whether to
continue, change or abolish the care
plan.
TECHNIQUES IN MONITORING THE
CLIENT’S FOOD INTAKE
 Observe intake.
 Document appetite
 Provision supplements
 Request a nutritional consult.
 Assess tolerance.
 Monitor weight.
 Monitor progression of restrictive diets.
 Monitor the client's grasp of the information.
B. BASIC TOOLS IN NUTRITION
Guides to attain proper and good nutrition.
Food And Nutrition Research
Institute (FNRI) Food Guide Pyramid
EVOLUTION OF PHILIPPINE FOOD
GUIDE
1948

Introduction of country's first food guide.
 A practical grouping of locally available
foods classified according to their
specific nutrient contributions.
 Variety was the fundamental concept.
 There are "basic six" food groups.
1974
 Your Guide to Good Nutrition.
 A food-based translation of the then
Recommended Dietary Allowances.
 Simplified into three food groups
corresponding foods body-building
foods and body-regulating foods.
 Specified serving sizes from each food
group.
Late 1970s

Graphical
illustration was improved.
 The three rings merged to become a
single circle or wheel.
 The key message "Eat recommended
amount from each group everyday" was
retained.
2005
 Added another level to highlight the
need for drinking lots of fluids.
 Translated the qualitative
recommendations into quantitative
terms.
 Contained an additional base to
incorporate the concepts of regular
physical activity and good hygiene.
 Reinforced the NGF's recommendations
by including messages on food variety,
use of iodized salt and fortified foods.
 Specific guides were set up for the
following life stage and physiologic
groups.
 o Preschool children Daily Nutritional Guide Pyramid for
o School-age children Toddlers (1-6 yrs. Old)
o Adolescents
o Adults Daily Nutritional Guide Pyramid for Kids (7-
o Elderly 12 yrs. Old)
o Pregnant and Lactating Woman
C. NUTRITION GUIDELINES FOR FILIPINOS

 Daily Nutritional Guide Pyramid Daily Nutritional Guide Pyramid for Teens
 10 Kumainments
 Pinggang Pinoy

(13-19 yrs. Old)

Daily Nutritional Guide Pyramid for Adults Daily Nutritional Guide Pyramid for Old
(20-39 yrs. Old) Persons (60-69 yrs. Old)

Daily Nutritional Guide Pyramid for

Pregnant Women
 Daily Nutritional Guide Pyramid for PINGGANG PINOY
Lactating Woman
 Newly released.
 Utilizes familiar food plate model:
right food group proportion per meal
basis.
 It is a visual tool to guide Filipinos in
consuming the right amount of food
in every meal.
 Pinggang Pinoy of five populations
groups namely, kids, teens, adults,
elderly, pregnant, and lactating
woman vary from each other.
 Below are the following:
 Go Foods Equivalent Portion Size
per Meal.
 Grow Foods Equivalent Portion
Size per Meal.
 Glow Foods (Vegetables)
Equivalent Portion Size per Meal.
 Glow Foods (Fruits) Equivalent
Portion Size per Meal.

1O KUMAINMENTS

1. Kumain ng iba't-ibang pagkain.

2. Sa unang 6 months ni baby,
breastfeeding lamang; mula 6 months,
bigyan din siya ng ibang angkop na
pagkain.
3. Kumain ng gulay at prutas araw-araw.
4. Kumain ng isda, karne, at ibang pagkaing
may protina
5. Uminom ng gatas, kumain ng pagkaing
mayam sa calcium.
6. Tiyaking malinis at ligtas ang ating
pagkain at tubig.
7. Gumamit ng iodized salt.
8. Hinay-hinay sa maaalat, mamantika, at
matatamis.
9. Panatilihin ang tamang timbang.
10. Maging aktibo. Iwasan ang alak; huwag
manigarilyo.
 Recommended Nutrients Intake during meal planning which allows for
per day (Macronutrients) variations in meals for normal and
therapeutic diets.

RENI per day (Vitamins)

Food Exchange List

 Simplifies the calorie counting process

by grouping together food items with
approximately the same amount of
carbohydrate, protein, and fat content.
 It has 7 food list namely vegetables,
fruit, milk, rice, meat, fat, and sugar.
 Food items belonging in the same food
list can be exchanged with one another