Care
Reading labels and % Daily Value (%DV)
Less than 5% DV = Low in that nutrient; More than 20% DV = High in that nutrient
24-hour Recall Nutrition Assessment
Pt shares everything they ate and drank yesterday.
Underweight
Less than 18.5
Fat-Soluble Vitamins A, D, E, and K Functions and remember risk for toxicity b/c stored in the liver and fatty tissues.
Vitamin A: Bone formation, vision, tooth formation, immune function, cellular function; Vitamin D: Bone and teeth development, absorption and metabolism of calcium and phosphorus; Vitamin E: Fight infection, healthy red blood cells; Vitamin K: Blood clotting and bone health.
Nutrition Considerations for Infants 1 month - 12 months
Breastfeeding: Exclusive for 6 mo; continue with foods up to 2+ yrs Formula: Iron-fortified; no cow’s milk in 1st year. Fluids: No juice/water <4 mo; excess water → hyponatremia risk. Weaning: Start when infant ready (6–12 mo). Process: Gradual, one feeding at a time; bedtime feed usually last
Symptoms of Dysphagia
Painful swallowing; Food stuck in throat/chest; Coughing/choking during meals; Regurgitation; Weight loss from poor intake
Food Diary Nutrition Assessment
Pt records intake for 3–5 days, including weekends. Notes type, amount, and how food was prepared.
Strength: Gives a clearer, more realistic picture. Limitation: Requires effort and honesty
Normal Weight
18.5 to 24.9
Educate on How to Cut Down on Salt
Skip table salt & don’t add during cooking; Avoid processed meats (lunch meats, bacon, sausage, hot dogs); Choose “no salt added” foods; Limit soups unless labeled low-sodium; Read food labels for sodium content
Nutrition Considerations Toddlers 1- 3 years
Eating Habits: Picky; prefer favorites; finger foods help independence. Milk: 2–3 cups/day; switch to low-fat after age 2; Juice: Limit to 4 oz/day (100% juice). Portions: 1 tbsp per year of age. Safety: Cut food, supervise; avoid choking hazards. Guidance: Avoid using food as reward or punishment
Oral Care: Unconscious Patient
Care every 1–2 hours → prevents infection & discomfort; Keep HOB 30–45° or side-lying → reduces aspiration risk. Always face pt toward you for safety. Use minimal fluid → avoid aspiration. Suction secretions as needed. Bite block/guard keeps mouth open.
Food Insecurity
Food insecurity is a health problem — nurses must screen, educate, and connect patients to support.
Overweight
25 to 29.9
My Plate: What portions?
Use MyPlate as a simple visual guide (½ plate fruits & veggies, ¼ grains, ¼ protein, plus dairy).
Nutrition Considerations Preschoolers 3-6 years
5-2-1-0 framework, which includes that preschoolers have 5 servings of fruits and vegetables per day, 2 hr or less of screen time, 0 servings of sugar-sweetened beverages, and 1 hr of physical activity per day.
Aspiration: What is it? Risk Factors? Types
Aspiration = food, liquid, or other material enters the lungs instead of the stomach. Risk Factors: Dysphagia, stroke, reflux, mouth sores, dental issues Types Overt: Obvious signs → coughing, wheezing, choking, throat clearing, congestion, chest discomfort. Silent Aspiration: No visible symptoms → very dangerous because it’s unnoticed.
Waist circumference and Waist-to-hip ratio
Waist circumference + BMI → better risk assessment. High risk waist size: >35 in (women), >40 in (men)
Waist-to-hip ratio linked to disease risk -•Apple shape (abdominal fat): ↑ risk HTN, heart disease, type 2 diabetes; Pear shape (hip fat): ↑ risk inflammation, insulin resistance, metabolic syndrome
Obese
30.0 and above
Obesity (Class I): 30.0–34.9
Obesity (Class II): 35.0–39.9
Obesity (Class III / Morbid Obesity): ≥ 40
Basics of a Healthy Diet
Nutrition Considerations School Age 6-12 years
Eat adult-sized portions by the end of the school-age years; you'll need healthy snacks. Risks of obesity: Low self-esteem, DM, heart disease, HTN. Parent guidance: Don’t use food as a reward; Encourage daily physical activity; Provide balanced diet & healthy choices; Limit fast food; don’t skip meals; Brush & floss daily
Prevention Techniques for Aspiration
Sit upright (High Fowler’s/chair), support head & neck; Chin tuck when swallowing; No straws; Watch for aspiration: coughing, choking, drooling, food pocketing; Stay semi-Fowler’s 1 hr after meals; Oral care after meals/snacks
When would a nutritional assessment be most likely conducted?
On admission to establish a baseline AND When nutrition problems are suspected (eating disorders, chronic illness, weight changes).
Morbid/Extreme Obesity
Obesity (Class III / Morbid Obesity): ≥ 40
FYI
Obesity (Class I): 30.0–34.9
Obesity (Class II): 35.0–39.9
Best Way to Know if patient is getting enough Water?
Pale yellow (like lemonade) → Well hydrated; Dark yellow or amber → Dehydration likely, need more fluids; Clear all the time → Possibly overhydration (drinking too much water)
Nutrition Considerations Adolescents 12-20 years
↑ Nutrient needs due to rapid growth & high metabolism. Risks: Overweight, obesity, anorexia, bulimia
Healthy Weight Loss Safe rate; Requires; Benefits
Safe rate: 1–2 lbs per week
Requires diet + lifestyle changes + regular exercise. Losing 5–10% of body weight improves: •Blood pressure •Blood glucose •Cholesterol
Know the Expected Findings of Poor Nutrition
ATI Fundamentals Chapter 39 page 218
Compared to other children of the same age and sex.
How much salt (sodium) do experts recommend each day?
< 2,300 mg of sodium per day for healthy adults — about 1 teaspoon of table salt.
For people with HTN, heart disease, diabetes, or kidney disease 1,500 mg per day.
Older Adults Nutrition Considerations
Barriers: Limited income, mobility, depression, dementia, isolation; Meds: Affect taste, appetite; restrictive diets ↓ enjoyment. Fluids: Incontinence → restrict; constipation common. Metabolism: ↓ calories needed but must ↑ nutrient-dense foods