Name of Patient: L.G.

68 years old

Risk for Imbalanced Nutrition: Less than Body Requirements

ASSESSMENT Objective: Reported inadequate food intake, altered taste sensation, loss of interest in food Decreased subcutaneous fat or muscle mass 10% to 20% below ideal body weight or weight below normal for age, height, and build ( V/S taken as follows T: 36.6C

DIAGNOSIS

PLANNING

INTERVENTION INDEPENDENT: 1. Monitor daily food intake; have patient keep food diary as indicated.

RATIONALE

EVALUATION

Risk for imbalanced nutrition: Less than body requirements related to loss of appetite.

After 3 hours of nursing interventions, the patient will be able to demonstrate behaviors, lifestyle changes to regain and/or maintain appropriate weight

Identifies nutritional strengths/defi ciencies.

2. Assess weight; measure or calculate body fat and muscle mass via triceps skinfold and midarm muscle circumference or other anthropometric measurements 3. Assess skin/mucous membranes for pallor, delayed wound healing, enlarged parotid glands.

To establish a baseline prarameters

Goal partially met. After 3 hours of nursing interventions, the patient was be able to demonstrate behaviors, lifestyle changes to regain and/or maintain appropriate weight

Helps in identification of proteincalorie malnutrition, especially when weight and

PR: 86 RR: 20 BP: 130/90 V/S taken as follows: T= 36.6 C RR= 18 bpm PR= 80 bpm BP= 110/90 mmHg

anthropometri c measurement s are less than normal. 4. Give small, frequent feedings; include patient likes or dislikes in meal preparation as much as possible, and incorporate home foods, as fitting. 5. Control environmental factors (e.g., strong/noxious odors or noise). Avoid overly sweet, fatty, or spicy foods. 6. Encourage use of relaxation techniques, visualization, guided imagery, and moderate exercise before May improve patients craving for food and quantity of intake.

As this may trigger nausea/vomit ing response.

May prevent onset or reduce severity of nausea, decrease anor exia, and

meals. DEPENDENT: 1. Administer antiemetic on a regular schedule before/durin g and after administratio n of antineoplasti c agent as indicated. COLLABORATIVE: 1. Refer to dietitian/nut ritional support team.

enable patient to increase oral intake. Nausea/vomit ing are frequently the most disabling and psychologicall y stressful side effects of chemotherapy . Provides for specific dietary plan to meet individual needs and reduce problems associated with protein/calori e malnutrition and micronutrient deficiencies.