nutritional care, the substances, procedures, and setting involved in ensuring the proper intake and assimilation of nutriments, especially for the hospitalized patient. ▪ METHOD: Depending on the patient’s condition, nutritional requirements may be provided by regular meals with menus selected from the ordered diet, by tube feeding, or by parenteral hyperalimentation. Meals are served on attractive trays in an environment conducive to eating. Distasteful procedures are avoided before and after mealtime. Patients who are unable to feed themselves are assisted, and abnormal intake of food is recorded and reported. Supplemental nourishment is supplied when indicated, and fluids are offered between meals. The nutritional assessment includes observations of the patient’s appetite; food preferences; allergies; height; intake and output; weight; measurements of the head, arms, abdomen, and skinfold thickness; skin color and turgor; and condition of the mouth, eyes, nails, and hair. Any cutaneous lesions, thyroid enlargement, dental caries, loose teeth, ill-fitting dentures, gum problems, nausea, vomiting, dehydration, diarrhea, or constipation is noted. ▪ INTERVENTIONS: The nurse sees that food is presented attractively, offers a washcloth and oral hygiene before and after meals, and, when necessary, feeds the patient to maintain an adequate intake. If indicated, such as in obese patients or those with disorders requiring a highly restricted diet, the nurse restricts food intake as ordered. Tube feedings are administered as ordered. ▪ OUTCOME CRITERIA: Obvious good health, maintenance of a normal body mass index, and the absence of GI symptoms usually indicate that the individual’s nutritional requirements are being fulfilled.
