Imbalanced Nutrition: Less than Body Requirements

AssessmentPlanningInterventionScientific RationaleEvaluation

Subjective:wala na kong gana kumain kaya ang payat payat ko na. as verbalized by the patient

Objective:Weight lossLethargic Vital Signs taken as follows:BP = 130/70mmHgTemp: 36.3 degCCHR: 87 bpmRR: 17 cpmWt: 78 kg from 81kgAfter 24 hours of nursing intervention the patient will be able to demonstrate behavior, lifestyle changes to regain appropriate weight

Assess patients ability to chew, taste, and swallow.

Auscultate bowel sounds.

Weigh as indicated. Evaluate weight in terms of premorbid weight. Compare serial weights and anthropometric measurements.

Note drug side effects.

Plan diet with patient and include SO, suggesting foods from home if appropriate. Provide small, frequent meals and snacks of nutritionally dense foods and non-acidic foods and beverages, with choice of foods palatable to patient. Encourage high-calorie and nutritious foods, some of which may be considered appetite stimulants. Note time of day when appetite is best, and try to serve larger meal at that time.

Schedule medications between meals (if tolerated) and limit fluid intake with meals, unless fluid has nutritional value.

Antiemetics: prochlorperazine (Compazine), promethazine (Phenergan), trimethobenzamide (Tigan

Lesions of the mouth, throat, and esophagus (often caused by candidiasis, herpes simplex, hairy leukoplakia, kaposis sarcoma other cancers) and metallic or other taste changes caused by medications may cause dysphagia, limiting patients ability to ingest food and reducing desire to eat.

Hypermotility of intestinal tract is common and is associated with vomiting and diarrhea, which may affect choice of diet/route. Lactose intolerance and malabsorption (with CMV, MAC, cryptosporidiosis) contribute to diarrhea and may necessitate change in diet or supplemental formula.

Indicator of nutritional adequacy of intake.Because of depressed immunity, some blood tests normally used for testing nutritional status are not useful.

Medications used can have side effects affecting nutrition, ZDV can cause altered taste, nausea and vomiting; Bactrim can cause anorexia, glucose intolerance and glossitis; Pentam can cause altered taste and smell; Protease inhibitors can cause elevated lipids, blood sugar increase due to insulin resistance.

Including patient in planning gives sense of control of environment and may enhance intake. Fulfilling cravings for non institutional food may also improve intake. In this population, foods with a higher fat content may be recommended as tolerated to enhance taste and oral intake.

Gastric fullness diminishes appetite and food intake.

Reduces incidence of nausea and vomiting, possibly enhancing oral intake.After 24 hours of nursing intervention the Patient was able to partially demonstrate behavior, lifestyle changes to regain appropriate weight