NUTRITION

INTERVENTION

WMSU
SHALLAINE R. DELA CRUZ, RND
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NUTRITION INTERVENTION
-is defined as “purposefully planned action/s
designed with the intent of changing a nutrition-
related behavior, risk factor, environmental
condition or aspect of nutritional health status”.

-it focuses on resolving the Etiology.

-is to identify the aim of nutrition care

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• The first task is to write a Nutrition
Prescription (NP-1.1)
• The role of the prescription is to state
concisely what the patient’s intake of
energy and selected foods and nutrients
should be, based on current reference
standards and dietary guidelines.
• Needs to reflect the Comparative
Standards in NCP Step 1.
• Remember to consider individual-and-
family-centered short-and-long-term goals
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FOUR DOMAINS OF NUTRITION INTERVENTION
DOMAIN DESCRIPTION EXAMPLES OF
TERMS/CODES
The Food and/or Nutrient • Meals and Snacks (ND-1)
Delivery (ND) domain includes • Enteral and Parenteral
prescribing nutritionally Nutrition (ND-2)
fortified meals, adding high • Nutrition Supplement
protein or high energy snacks, Therapy (ND-3)
FOOD AND/OR changing textures of foods (or • Feeding Assistance (ND-4)
NUTRIENT thickness of beverages), • Managing Feeding
DELIVERY (ND) providing enteral or parenteral Environment (ND-5)
nutrition, assisting with meals,
having mealtime environments
that optimize nutritional intakes
and managing nutrition-related
medications appropriately.

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FOUR DOMAINS OF NUTRITION INTERVENTION
DOMAIN DESCRIPTION EXAMPLES OF TERMS/CODES
The Nutrition Education • Nutrition Education – Content
(E) domain tends to be (E-1)
fact-based and includes -Purpose of nutrition
ways of improving patient education (E-1.1)
knowledge and skills, such
NUTRITION • Nutrition Education-
as reading product labels Application (E-2)
EDUCATION (E)
or making recipe -Result interpretation (E-2.1)
modifications. Knowledge
does not equate to
behavior change but
people need to have the
basic knowledge in order
to start making better food
choices

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FOUR DOMAINS OF NUTRITION INTERVENTION
DOMAIN DESCRIPTION
The Nutrition Counseling ( C )
domain involves helping patients
identify and solve their own issues in
nutrition. From there they may
change behaviors. There are several
NUTRITION counseling models including
COUNSELING cognitive-behavioral theory and
(C) Transtheoretical/stages of change.
Counseling helps to establishing
priorities and goals. Strategies
include motivational interviewing,
self-monitoring, problem solving,
social support, stimulus control and
stress management. The Counseling
Strategies Matrix in the Tool Kit
shows how the strategies and
counseling models work together.
EXAMPLES OF TERMS/CODES
• Theoretical Basis/Approach
(C-1)
- Cognitive-behavior theory (C-
1.1)
- Health belief model (C-1.2)
- Social learning theory (C-1.3)
- Transtheoretical model/stages
of changes (C-1.4)
• Strategies (C-2)
- Motivational interviewing (C-
2.1)
- Goal setting (C-2.2)
- self monitoring (C-2.3)
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FOUR DOMAINS OF NUTRITION INTERVENTION
DOMAIN DESCRIPTION EXAMPLES OF TERMS/CODES
The Coordination Of Nutrition Care • Collaboration and Referral
by a Nutrition Professional (RC) of Nutrition Care (RC-1)
domain underlines the importance of - Team meeting (RC-1.1)
dietitians working within - Referral to RND with
different expertise (RC-1.2)
interdisciplinary or multidisciplinary
COORDINATION teams to achieve the best possible • Discharge and Transfer of
OF NUTRITION nutrition outcomes. This may include Nutrition Care to New
CARE BY A consulting with and referring to other Setting of Provider (RC-2)
NUTRITION health professionals (diabetes
PROFESSIONAL educator, exercise physiologist,
(RC) psychologist), or coordinating
nutrition care with other health care
providers and institutions or
dietitians with specialist skills
(diabetes education, bariatric
surgery).
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Documentation of Intervention
• Documentation is an on-going process that
supports all of the steps in the Nutrition Care
Process.
• Quality documentation of nutrition interventions
should be relevant, accurate, and timely. It
should also support further intervention or
discharge from care.
• Changes in patient/client/group’s level of
understanding and food-related behaviors must be
documented along with changes in clinical or
functional outcomes to assure appropriate
care/case management in the future.

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Inclusion of the following information would further
describe quality documentation of this step:
• Date and time;
• Specific treatment goals and expected outcomes;
• Recommended interventions, individualized for
patient;
• Any adjustments of plan and justification;
• Patient’s receptivity;
• Referrals made and resources used;
• Any other information relevant to providing care and
monitoring progress over time;
• Plans for follow-up and frequency of care; and
• Rationale for discharge if appropriate.
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Determination for Continuation of Care
• If the patient/client/group has met
intervention goals or is not at this time
able/ready to make needed changes, the
dietetics professional may include
discharging the client from this episode of
care as part of the planned intervention.

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ACTIVITY

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 Nutrition Diagnosis
1. Excessive caloric intake (problem) “related to” frequent consumption of large portions
of high fat meals (etiology) “as evidenced by” average daily intake of calories
exceeding recommended amount by 500 kcal and 12-pound weight gain during the
past 18 months (signs)
2. Inappropriate infant feeding practice RT lack of knowledge AEB infant receiving
bedtime juice in a bottle.
3. Unintended weight loss RT inadequate provision of energy by enteral products AEB 6-
pound weight loss over past month.
4. Risk of weight gain RT a recent decrease in daily physical activity following sports
injury.
5. Inadequate Fiber Intake related to undesirable food choices resulting from limited
nutrition knowledge of fiber rich food sources as evidenced by 24-hour food recall
showing less than 38g Recommended Dietary Allowance (RDA) for fiber.
6. Undesirable food choices related to history of anorexia nervosa and self-limiting
behavior as evidenced by diet history and weight loss of 5 lb.
7. Overweight, Adult or Pediatric related to frequent intake of energy-dense foods and
reduced activity since retirement as evidenced by BMI 29.4 kg/m².
8. Physical Inactivity related to lack of awareness of significance of recent changes in
activity relative to energy expenditure as evidenced by less than 30 minutes of
moderate activity on most days compared to previous moderate activity level before
retirement.
9. Swallowing difficulty related to stroke as evidenced by coughing following drinking of
thin liquids.
10.Inadequate energy intake related to lack of financial resources to purchase sufficient
food as evidenced by weight loss of 6 pounds in the last 2 months.
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