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NCLEX & CGFNS Practice Questions
Imbalance Nutrition: More than Body Requirements
  • Actual
  • Risk for (Potential)

Related To: [Check those that apply]

  • Excessive intake in relation to metabolic need
  • Lack of knowledge of nutritional needs, food intake, and/or appropriate food preparation
  • Poor dietary habits
  • Use of food as coping mechanism
  • Metabolic disorders
  • Sedentary activity level

As evidenced by: [Check those that apply]

  • Weight 20% over ideal for height and frame
  • Triceps skin fold greater than 15 mm in men, 25 mm in women
  • Reported or observed dysfunctional eating patterns
  • Eating in response to internal cues other than hunger
  • Eating in response to external cues such as time of day or social situation

Patient’s Diagnosis: –
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Objective/Expected Outcome;The patient will:

  • verbalizes measures necessary to achieve weight reduction.
  • demonstrates appropriate selection of meals or menu planning toward the goal of weight reduction.
  • begins an appropriate program of exercise.
  • Others

Note: you need to indicate time frame/target as objective must be measurable.

Nursing Interventions Scientific Rationale
Document weight; do not estimate. Patients may be unaware of their actual weight.
Determine body fat composition of skinfold measurements. Skin calipers can be used to estimate amount of fat.
Perform a nutritional assessment. This should include types and amount of foods eaten, how food is prepared, the pattern of intake (time of day, frequency, other activities patient is engaged in while eating).
Explore the importance and meaning of food with the patient. When food is used as a coping mechanism or as a self-reward, the emotional needs being met by intake of food will need to be addressed as part of the overall plan for weight reduction.
Assess ability to read food labels. Food labels contain information necessary in making appropriate selections, but can be misleading. Patients need to understand that low-fat" or "fat-free" does not mean that a food item is calorie-free."
Assess ability to plan a menu, making appropriate food selections. Cultural or ethnic influences need to be identified and addressed.
Assess ability to accurately identify appropriate food portions. Serving sizes must be understood to limit intake according to a planned diet.
Assess usual level of activity. Patients may confuse routine activity with exercise necessary to enhance and maintain weight loss.
Establish appropriate short- and long-range goals. One pound of adipose tissue contains 3500 calories. Therefore to lose 1 lb per week, the patient must have a calorie deficit of 500 calories a day.
Encourage calorie intake appropriate for body type and lifestyle. Diet change is a complicated process that involves changing patterns that have been firmly established by culture, family, and personal factors.
Encourage patient to keep a daily log of food or liquid ingestion and caloric intake. Memory is inadequate for quantification of intake, and a visual record may also help patient to make more appropriate food choices and serving sizes.
Encourage water intake. Water assists in the excretion of byproducts of fat breakdown and helps prevent ketosis.
Encourage exercise. Exercise is an integral part of weight reduction programs.
Incorporate behavior modification strategies. Education as the sole intervention is unlikely to achieve and maintain weight loss. Multifactorial programs that include behavioral interventions and counseling are more successful than education alone.
Include family, caregiver, or food preparer in the nutrition counseling. Success rates are higher when the family incorporates a healthy eating plan.

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