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Patient’s Diagnosis: –
Date:-
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Nursing Interventions | Scientific Rationale |
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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. |