NTP chapter 4

Nutrition Intervention

1. Nutrition Intervention Chapter 4

2. 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. Standards of Practice

4. 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. Factors Affecting Nutritional Intake during Illness

6. “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. 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. Principles of Clear and Full Liquid Diets

9. Nutrition Interventions to Increase Nutrient Density

10. 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. 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. 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. 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. 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. Nutrition Counseling Supportive process, collaborative, goal setting and individualized action plans Ultimate goal is for the patient/client to take responsibility for behaviors

16. Nutrition Counseling Counseling Supportive Process Collaborative Relationship Individualized Self-care

17. Characteristics of Counselors that Promote a Positive Relationship

18. Effective Communication Skills

19. 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. Theoretical Basis/Approach for Nutrition Counseling and Education

21. Strategies to Accomplish Nutrition Interventions Motivational interviewing Self-monitoring Cognitive restructuring

22. 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. 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. Nutrition Diagnosis Status Terms Resolved Improvement shown Unresolved No longer appropriate