Proper nutrition is a vital part of the healing process. Imbalanced nutrition can lead to poor wound healing, heart disease, bone loss and other damage to the body. Recognizing unhealthful eating patterns is part of a nurse's duty. A diagnosis of imbalanced nutrition can be given to a patient who takes in more or less than the body requires. It can also be a risk diagnosis and the cause of another diagnosis.
More than Body Requirements
A nursing diagnosis of "Imbalanced Nutrition: More than Body Requirements" is applied to a patient who takes in more than he needs to support body functions, either through overeating or excessive use of supplements. It can be related to genetics, emotional issues, a sedentary lifestyle, disease or many other factors. Possible goals include having the patient begin an exercise program and learn to make healthful choices. Help the patient establish weight-loss goals, consult a nutritionist and provide positive reinforcement.
Less than Body Requirements
When a patient takes in less nutrition than required to support metabolic functioning, a diagnosis of "Imbalanced Nutrition: Less than Body Requirements" is appropriate. There are many reasons patients eat less than they need, including eating disorders, depression, financial difficulties and loss of appetite due to disease. The major goal is getting the patient as close to ideal weight as possible. This can be accomplished by assisting patients with meals if needed, providing company and encouragement while they are eating and, in extreme cases, discussing the need for feeding tubes with the patients' doctor and family.
Risk for Imbalanced Nutrition
A diagnosis of "Risk for Imbalanced Nutrition" is given when the nurse notices a pattern that indicates the patient may be eating too little or too much. For example, a patient expressing loss of appetite may be at risk for eating less than body requirements, while a patient who is constantly requesting extra food over a period of several days could be at risk for taking in more than the body requires. Document weight changes and monitor the patient's intake. Educate the patient about the need for proper nutrition and continue to monitor eating patterns.
Imbalanced Nutrition as Cause
Imbalanced nutrition can also be the etiology, or cause, of other diagnoses, including constipation or diarrhea, chronic low self-esteem, social isolation and risk for infection. When writing a diagnosis using imbalanced nutrition as the etiology, write out the actual problem rather than just stating "imbalanced nutrition." For example, "constipation related to inadequate fiber intake" or " impaired skin integrity related to protein malnutrition." Goals and interventions address the cause as well as the actual diagnosis.
A patient's eating habits are a sensitive subject and should be approached as gently as possible. While it is important to make sure the patient is getting the right amount of nutrition, it is also important to make sure he or she feels comfortable talking to you about it. When a patient is offended, he or she may become defensive and feel judged, which makes it difficult to keep an open dialogue and provide education. State the facts, explain the need for good eating habits, but do it with tact and kindness.
- Fundamentals of Nursing; Carol Taylor et al; 2008
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