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Nutrition Care Process Model Tutorials: Nutrition Monitoring & Evaluation: Examples in Two Case Studies

This document provides a tutorial on nutrition monitoring and evaluation terminology using two case studies: a 67-year-old Hispanic male with heart failure, and an 8-year-old white male child with iron deficiency anemia and food allergies. Key terms from the Nutrition Care Process Terminology are identified and organized hierarchically for monitoring indicators like calorie intake, weight, and food variety for each case. The objective is to understand how to apply nutrition monitoring and evaluation terminology in clinical case examples.

Uploaded by

RSUD dr. Zubir Mahmud
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© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
296 views

Nutrition Care Process Model Tutorials: Nutrition Monitoring & Evaluation: Examples in Two Case Studies

This document provides a tutorial on nutrition monitoring and evaluation terminology using two case studies: a 67-year-old Hispanic male with heart failure, and an 8-year-old white male child with iron deficiency anemia and food allergies. Key terms from the Nutrition Care Process Terminology are identified and organized hierarchically for monitoring indicators like calorie intake, weight, and food variety for each case. The objective is to understand how to apply nutrition monitoring and evaluation terminology in clinical case examples.

Uploaded by

RSUD dr. Zubir Mahmud
Copyright
© © All Rights Reserved
Available Formats
Download as PDF, TXT or read online on Scribd
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Nutrition Care Process Model

Tutorials

Nutrition Care Process and Terminology Committee


Academy of Nutrition and Dietetics

Nutrition Care Process Terminology


2015 Edition

Nutrition Monitoring & Evaluation:


Examples in Two Case Studies

Objective
The objective of this presentation is to review
and feature the use of nutrition monitoring &
evaluation terminology in case study
material. By the end of the module, the
participant will be able to understand use of
nutrition monitoring & evaluation
terminology in two case examples:

• A 67 year old Hispanic male with heart failure


• An 8 year old white male child with iron
deficiency anemia and food allergies

Case #1

Referral from Family Practice Clinic to RDN:

67 year old Hispanic male with Heart Failure

1
Case #1
Description of patient:

• 67 year old Hispanic male


• medical diagnosis of heart failure (diagnosed 2 months
prior)
• retired engineer
• lives alone in apartment
• height: 5’6” ; weight: 135 lbs.
• weight loss of 20 lbs. from dyspnea
• inability to consume large meals
• unable to shop or cook
• 24-hour recall indicates he uses many frozen and
processed foods; intake between 1000 – 1200
kcal/day

Case 1: Monitoring & Evaluation


During the intervention phase we chose to
focus on the following PES statement for
planning the nutrition intervention:

Inadequate oral intake related to inability to


shop and cook as evidenced by a calorie
intake of 500 kcal less than estimated
requirements and 20 lbs. of weight loss in 2
months.

Nutrition Monitoring & Evaluation


Remember:

PES statements connect the nutrition


assessment, nutrition intervention, and
monitoring & evaluation steps.

• The Problem states the nutrition diagnosis.


• The Etiology tells you what type of intervention
is needed.
• The Signs and Symptoms tell you what needs
to be monitored and evaluated.

2
Nutrition Monitoring & Evaluation

Inadequate oral intake related to inability to


shop and cook as evidenced by a kcal intake
of 500 kcals less than estimated
requirements and 20 lbs. of weight loss in 2
months.
The RDN addressed the etiology of the
patient’s inability to shop and cook and
provided a means for an increased kcal diet.
During the monitoring & evaluation step the
signs and symptoms of low kcal intake and
weight loss can be effectively monitored.

Nutrition monitoring & evaluation


The signs and symptoms tell you what you will
need to monitor and evaluate.

Inadequate oral intake related to inability to


shop and cook as evidenced by a kcal intake
of 500 kcals less than estimated
requirements and 20 lbs. of weight loss in 2
months.

So, for this patient, the RDN will monitor &


evaluate the kcal intake and weight change.

Nutrition Monitoring & Evaluation

For this patient the nutrition prescription is:

Referral to community agencies/programs


(RC-1.6) for meal service of an Increased
energy diet (ND-1.2.2.1)

3
Nutrition Monitoring & Evaluation

For this patient the terminology used for


monitoring & evaluation is:

Total Energy Intake (FH-1.1.1.1)


Weight (AD-1.1.2)
Weight change (AD-1.1.4)

Nutrition Monitoring & Evaluation


Here the terms are shown in the hierarchy:
Domain: Food/Nutrition-Related History (FH)
Class: Food and Nutrient Intake (1)
Sub-Class: Energy Intake (1.1)
Sub-sub Class: Energy Intake (1.1.1)

 Record the Total energy intake (FH-1.1.1.1):

Domain: Anthropometric Measurements (AD)


Class: Body composition/growth/weight history (1.1)

 Record the Weight (AD-1.1.2):


 Record the Weight change (AD-1.1.4):

Case #2

Referral from Pediatric Clinic to RDN – request for


RDN consultation for assistance with meal planning

8 year old white male child with Fe deficiency anemia

4
Case #2

Description of patient:
• 8 year old white male child
• allergies to eggs and peanuts
• diagnosed with Fe deficiency anemia
• growth recently slowed with current BMI at the 30th percentile
(44th percentile one year ago)
• food history questionnaire indicates an intake of 122 – 1500
kcal/day
• poor appetite
• food variety limited; intake of only 4 or 5 different foods.
• mother states he is more irritable and more fatigued than usual.

Mother requests assistance for planning bag lunches and other


meals that will help her child gain weight.

Case #2: Monitoring & Evaluation

During the intervention phase we chose to


focus on the following PES statement for
planning the nutrition intervention:

Food and nutrition related knowledge deficit


related to fear of allergens in foods as
evidenced by poor appetite and reported
intake of only 4-5 foods in 24 hour food
recall, and stated concern about food
allergies.

Nutrition Monitoring & Evaluation


Remember:

PES statements connect the nutrition


assessment, nutrition intervention, and
monitoring & evaluation steps.

• The Problem states the nutrition diagnosis.


• The Etiology tells you what type of intervention
is needed.
• The Signs and Symptoms tell you what needs
to be monitored and evaluated.

5
Case #2: Monitoring & Evaluation

Food and nutrition related knowledge deficit related


to fear of allergens in foods as evidenced by poor
appetite and reported intake of only 4-5 foods in 24
hour food recall, and stated concern about food
allergies.

The RDN addressed in the Nutrition Intervention step the food


and nutrition related knowledge deficit, assistance with
planning meals for bag lunches, and limited intake.

Nutrition Monitoring & Evaluation


The signs and symptoms tell you what you will
need to monitor and evaluate.

Food and nutrition related knowledge deficit related


to fear of allergens in foods as evidenced by poor
appetite and reported intake of only 4-5 foods in 24
hour food recall, and stated concern about food
allergies.

During the monitoring & evaluation step the RDN will monitor
weight, weight change, calorie intake, food variety intake,
and will re-assess the nutritional anemia profile during
future visits.

Nutrition Monitoring & Evaluation

For this patient the nutrition prescription is:

Nutrition education for Nutrition relationship


to health/disease (E-1.4) and Increased
energy diet (ND-1.2.2.1)

6
Nutrition Monitoring & Evaluation

For this patient the terminology used for


monitoring & evaluation is:

Total energy intake (FH-1.1.1.1)


Food variety (FH-1.2.2.5)
Height/length (AD-1.1.1)
Weight (AD-1.1.2)
Weight change (AD-1.1.4)
Growth pattern indices/percentile ranks (AD-1.1.6):
Limited number of accepted foods (FH-5.4.9)

Nutrition Monitoring & Evaluation

Here are the terms shown in the hierarchy:

Domain: Food/Nutrition Related History (FH)


Class: Food and Nutrient Intake (1)
Sub-Class: Energy Intake (1.1)
Sub-sub Class: Energy Intake (1.1.1)
 Record the Total energy intake (FH-1.1.1.1)

Sub-Class: Food and Beverage Intake (1.2)


Sub-sub Class: Food Intake (1.2.2)
 Record the Food variety (FH-1.2.2.5)

Nutrition Monitoring & Evaluation


Here are the terms shown in the hierarchy:

Domain: Anthropometric Measurements (AD)


Class: Body composition/growth/weight history (1.1)

 Record the Height/length (AD-1.1.1):

 Record the Weight (AD-1.1.2):

 Record the Weight change (AD-1.1.4):

 Record the Growth pattern indices/percentile ranks


(AD-1.1.6):

7
Nutrition Monitoring & Evaluation

Here are the terms shown in the hierarchy:

Domain: Food/Nutrition Related History (FH)


Class: Behavior (5)
Sub-Class: Mealtime Behavior (5.4)
 Record Limited number of accepted foods
(FH-5.4.9)

Summary
In this presentation we have reviewed the
nutrition monitoring & evaluation
terminology for two case studies:

• A 67 year old Hispanic male with heart


failure

• An 8 year old white male child with iron


deficiency anemia and food allergies

Summary
This concludes the nutrition monitoring &
evaluation tutorial, and is the final module in
this set of Nutrition Care Process Model
tutorials.

Instruction on obtaining CPE can be found


within the “Resources” tab on the eNCPT
Home Page by clicking “NCP Tutorials”

[http://ncpt.webauthor.com/encpt-tutorials]

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