NUTRITION

1. General nutritional deficiencies
   1. Assessment:
      1. Subjective data:
         1. Mental irritability or confusion.
         2. History of poor dietary intake.
         3. History of lack of adequate resources to provide adequate nutrition.
         4. Lack of knowledge about proper diet, food selection, or preparation.
         5. History of eating disorders.
         6. Paresthesia (burning and tingling): hands and feet.
      2. Objective data:
         1. Appearance: listless; posture: sagging shoulders, sunken chest, poor gait.
         2. Muscle: weakness, fatigue, wasted appearance.
         3. GI: indigestion, vomiting, enlarged liver, spleen.
         4. Cardiovascular: tachycardia on minimal exertion; bradycardia at rest; enlarged heart, elevated BP.
         5. Hair: brittle, dry, thin, sparse; lack of natural shine; color changes; can be easily plucked out.
         6. Skin: dryness (xerosis), scaly, dyspigmentation, petechiae, lack of fat under skin.
         7. Mouth:
            1. Teeth: missing, abnormally placed, caries.
            2. Gums: bleed easily, receding.
            3. Tongue: swollen, sore.
            4. Lips: red, swollen, angular fissures at corners.
         8. Eyes: pale conjunctiva, corneal changes.
         9. Nails: brittle, ridged.
         10. Nervous system: abnormal reflexes.
         11. Lab data: blood: decreased albumin, iron binding capacity, lymphocyte, hemoglobin, and hematocrit.
         12. Anthropometric measurements document nutritional deficiencies.
   2. Analysis/nursing diagnosis:
      1. Altered nutrition, less than body requirements, related to poor dietary intake.
      2. Knowledge deficit related to nutritional requirements.
      3. Altered health maintenance related to inability to provide own nutritional care.
      4. Ineffective individual coping related to eating disorders.
      5. Ineffective family coping, disabling, related to inadequate resources or knowledge to provide appropriate family nutrition.
   3. Nursing care plan/implementation:
      1. Goal: prevent complications of specific deficiency. Identify etiology of nutritional deficiency, b. Recognize signs of nutritional deficiencies.
         1. Identify foods high in deficient nutrient.
         2. Evaluate economic resources to purchase appropriate foods.
         3. Identify community resources for assistance.
         4. Monitor progress for potential additional illnesses.
      2. Goal: health teaching.
         1. Effects of nutritional deficiencies on health.
         2. Foods to include in diet to avoid deficits.
   4. Evaluation/outcome criteria:
      1. Complications do not occur.
      2. Patient gains weight.
      3. Patient selects appropriate foods to alleviate deficiency.