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NTP chapter 4
- 1. © Cengage Learning 2016 Nutrition Therapy and Pathophysiology | 3e Nelms | Sucher | Lacey | Roth Marcia Nahikian-Nelms, PhD, RD, LD The Ohio State University Karen Lacey MS, RD, CD University of Wisconsin—Green Bay Nutrition Intervention Chapter 4
- 2. © Cengage Learning 2016 Nutrition Prescription • Concisely states individualized plan for best meeting nutritional needs • Drive nutrition intervention or frame context within which intervention is implemented • Based on evidence-based dietetics practice • See Table 4.1
- 3. © Cengage Learning 2016 Standards of Practice
- 4. © Cengage Learning 2016 Food and/or Nutrient Delivery (Oral Diets) • First step in prevention or treatment of malnutrition – Adequate supply of acceptable food composing individualized diet – See Figure 4.2
- 5. © Cengage Learning 2016 Factors Affecting Nutritional Intake during Illness
- 6. © Cengage Learning 2016 “House” or Regular Diet • Changes to the house diet – Caloric level – Consistency – Single nutrient manipulation – Preparation – Food restriction – Number, size, frequency of meals – Addition of supplements
- 7. © Cengage Learning 2016 Modification of Meals and Snacks • Texture & consistency modifications for dysphagia and other conditions • Soft diets • Clear or full liquid diets – Consider osmolality – Hyperosmolar liquids may not be tolerated • Preparation for a specific medical test
- 8. © Cengage Learning 2016 Principles of Clear and Full Liquid Diets
- 9. © Cengage Learning 2016 Nutrition Interventions to Increase Nutrient Density
- 10. © Cengage Learning 2016 Medical Food Supplements/Modified Foods • Medical food supplements – Commercial or prepared foods or beverages intended to supplement energy, protein, carbohydrate, fiber, and/or fat intake. • Modified foods and beverages – Add single nutrients via modular products
- 11. © Cengage Learning 2016 Vitamin/Mineral/Bioactive Supplements • Vitamin and mineral supplements – To meet recommendations – To maximize absorption and utilization • Bioactive substance supplements – Food substances added to a food product or taken as supplements that have a specific intended health purpose • Includes plant stanol or sterol esters, pre/probiotics, fiber, soy protein, caffeine
- 12. © Cengage Learning 2016 Nutrition Intervention: Feeding Assistance/Environment • Address diagnoses such as: – Inadequate energy or oral intake – Unintended weight loss – Disordered eating pattern – Self-feeding difficulty • May include: – Changing environment to allow food choice – Providing adaptive equipment
- 13. © Cengage Learning 2016 Nutrition-Related Medication Management • Addresses diagnoses such as: – Altered GI function – Impaired nutrient utilization – Altered nutrient-related laboratory values – Inadequate oral intake – Food–medication interaction
- 14. © Cengage Learning 2016 Nutrition Education • Instruction or training in a skill or knowledge • Group classes, individual instruction, written instruction, via phone or electronic communication • Outpatient setting more conducive to education – Most often provided in acute care setting
- 15. © Cengage Learning 2016 Nutrition Counseling • Supportive process, collaborative, goal setting and individualized action plans • Ultimate goal is for the patient/client to take responsibility for behaviors
- 16. © Cengage Learning 2016 Nutrition Counseling • Counseling – Supportive – Process – Collaborative – Relationship – Individualized – Self-care
- 17. © Cengage Learning 2016 Characteristics of Counselors that Promote a Positive Relationship
- 18. © Cengage Learning 2016 Effective Communication Skills
- 19. © Cengage Learning 2016 Theoretical Framework for Nutrition Counseling • Theories and models provide research based rationale for design and tailoring of interventions – Guides information needed at different times in the behavior change process – Identifies best tools and strategies to use – Uses outcome measures to determine effectiveness
- 20. © Cengage Learning 2016 Theoretical Basis/Approach for Nutrition Counseling and Education
- 21. © Cengage Learning 2016 Strategies to Accomplish Nutrition Interventions • Motivational interviewing • Self-monitoring • Cognitive restructuring
- 22. © Cengage Learning 2016 Coordination of Care • RDs work with numerous other health care professionals – To ensure successful transition from the health care facility to the patient’s home or other facility • Activities depend on specific nutrition interventions
- 23. © Cengage Learning 2016 Nutrition Monitoring and Evaluation • Four domains of nutrition care outcomes – Food-/nutrition-related history data – Anthropometrics – Biochemical data, medical tests, and procedures – Nutrition-focused physical findings
- 24. © Cengage Learning 2016 Nutrition Diagnosis Status • Terms – Resolved – Improvement shown – Unresolved – No longer appropriate
Editor's Notes
- Table 4.1 Standards of Practice: The Registered Dietitian’s Role in Nutrition Intervention
- Figure 4.2 Factors Affecting Nutritional Intake during Illness
- Table 4.2 Principles of Clear and Full Liquid Diets
- Table 4.4 Nutrition Interventions to Increase Nutrient Density
- Table 4.5 Characteristics of Counselors that Promote a Positive Relationship
- Table 4.6 Effective Communication Skills That Demonstrate Active Listening and Undivided Attention to Clients
- Table 4.7 Examples of the Theoretical Basis/Approach for Nutrition Counseling and Education