This document discusses nutrition fundamentals and medical nutrition therapy. It covers identifying nutrition problems, client rights, reviewing medical records, observing mealtimes, documenting nutrition care, considering drug-nutrient interactions, and implementing client rights regulations. The objectives are to classify relevant nutrition information, verify accuracy, review follow-up documentation, and honor client rights during nutritional care.

1. Nutrition Fundamentals and Medical
Nutrition Therapy
Identify Nutrition Problems and Client Rights
Corresponds with
LEARNING PLAN 10
Copyright 2016 Association of Nutrition and Foodservice
Professionals

2. 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

3. 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

4. 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

5. Direct Observation/Interviews
Meal 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

6. 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

7. 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

8. 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

9. 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

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

11. 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