Nutrition Fundamentals and Medical Nutrition Therapy

Identify Nutrition Problems and Client Rights

Corresponds with LEARNING PLAN 10Copyright 2016 Association of Nutrition and Foodservice Professionals

10

Objectives

Classify the types of information that are relevant to nutrition care

Verify information to ensure accuracy

Review documentation for nutritional care follow-up

Honor client rights while providing nutritional care

Nutrition Fundamentals and Medical Nutrition Therapy • Identify Nutrition Problems and Client Rights • Learning Plan 10

Medical Record

Formal documentation of all aspects of care

Written orders from the physician including medication» Diet order

Activities and interventions of all healthcare team members

Laboratory data

Nutrition Fundamentals and Medical Nutrition Therapy • Identify Nutrition Problems and Client Rights • Learning Plan 10

Physical and social history

Progress notes

Care plan

Resource for information on an on-going basis

Legal document

Brain Break

What is the first document a CDM should review to begin nutrition screening?

» Medical Record because it contains the diet order, laboratory tests, height and weight, and medical history

Nutrition Fundamentals and Medical Nutrition Therapy • Identify Nutrition Problems and Client Rights • Learning Plan 10

Direct Observation/InterviewsMeal Time Observation

Focus on food» % of food intake» Likes and dislikes» Enjoyment» Chewing or swallowing difficulties

Focus on fluid» Adequate intake of fluids» Coughing, drooling, choking

Focus on feeding issues» Positioning» Tray set-up» Use of utensils, opening of packages

Nutrition Fundamentals and Medical Nutrition Therapy • Identify Nutrition Problems and Client Rights • Learning Plan 10

Nutrition Care Documents

Weight record» Facility approved policy» Accurately dated» Recommend re-weigh if accuracy is questionable» Determine significant weight loss or weight gain

Communications with Healthcare Team» Each team member contributes specific expertise

- Through direct contact- Through observations

Nutrition Fundamentals and Medical Nutrition Therapy • Identify Nutrition Problems and Client Rights • Learning Plan 10

Drug-Nutrient Interactions

Adverse reactions more likely to occur» With drugs taken over many years» Several drugs are taken daily» Nutrition status is poor

Interaction may affect availability of nutrients needed

Interaction may affect effectiveness of prescribed medicines

Nutrition Fundamentals and Medical Nutrition Therapy • Identify Nutrition Problems and Client Rights • Learning Plan 10

Brain Break

What drug/food interactions would be expected from the following» Antibiotics and milk» Blood thinners and spinach» Diuretics and bananas

» Dairy products limit the absorption of antibiotics» Leafy green vegetables promote clotting so it hinders the

work of blood thinners» High-potassium foods hinder diuretics

Nutrition Fundamentals and Medical Nutrition Therapy • Identify Nutrition Problems and Client Rights • Learning Plan 10

Honor Client Rights

HIPAA – client’s right to confidentiality» Health Insurance Portability and Accountability Act

Client rights» To be treated with dignity and respect» To be informed in writing about services and fees» To have the right to privacy and personal belongings» To be informed about medical condition

- Right to refuse medications and treatment- Right to receive care to promote quality of life, including food

preferences

Nutrition Fundamentals and Medical Nutrition Therapy • Identify Nutrition Problems and Client Rights • Learning Plan 10

Honor Client Rights

Ways to implement client right regulations» Actively seek dietary information from clients» Liberalize the diet whenever possible to increase

consumption» Honor choices and requests» Listen to client and family» Eliminate trays in the dining room

Nutrition Fundamentals and Medical Nutrition Therapy • Identify Nutrition Problems and Client Rights • Learning Plan 10

Brain Break

Imagine you are working with a long-term care resident on a sodium restricted diet who tells you, “I just can’t eat the food at meals. The food just doesn’t taste good.” What are some interventions and steps you may take to address this problem?

» Visit with the client about low-salt condiment options» Review the client’s favorite foods and what he/she likes

about them» Review the reason for the restriction; perhaps the diet can be

liberalized

Nutrition Fundamentals and Medical Nutrition Therapy • Identify Nutrition Problems and Client Rights • Learning Plan 10