Dietitian's Guide to Assessment and Documentation by Jacqueline Morris

By Jacqueline Morris

Dietitian s advisor to review and Documentation takes an investigative method of foodstuff overview reviewing the gathering and research of proof to figure out the genuine nutrition-related challenge, figuring out the underlying challenge and its influence on dietary prestige, and delivering intervention to handle the matter - thereby bettering dietary healthiness. this article will support scholars tips on how to: Formulate interview questions; Create objectives and sufferer educating ideas; Interpret lab information; Write a care plan; rfile in a scientific list. This consultant, which makes use of usual nutrients Care strategy language, outlines the most important steps to assist scholars and dietitians the right way to administer an intensive review and comprehend the right kind documentation. those talents are crucial within the therapy of sufferers to boot the prevention or protection of lawsuit and the guidance for Joint fee or kingdom survey. Dietitian s consultant to overview and Documentation additionally contains a reference part for interpretation of lab information and an appendix with everyday abbreviations.

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Protein-calorie malnutrition (PCM)—a condition of body wasting related to dietary deficiency of calories and protein—is found in 65–90% of patients with advanced liver disease and in almost 100% of candidates for liver transplantation (Henkel & Buchman, 2006). Patients with hepatitis accompanied by ascites and varices should receive a sodium-restricted diet. 5 g/kg of body weight. 0 g/kg is considered adequate because severe restriction of protein may cause further malnutrition. A high ammonia level in the absence of neurologic changes is not considered hepatic encephalopathy.

Niacin is also used with good effect but can cause increased bleeding when used in combination with anticoagulants. Niacin should not be used in patients with kidney problems. Aspirin or other anticoagulants such as Coumadin (warfarin) are added to prevent blood clots. Monitor the patient’s platelets and International Normalized Ratio (INR) regularly when on anticoagulants to ensure that there is no bleeding. pSyChiatriC review 33 For patients with diabetes, check their lipid profile one to two times a year.

Tighten glycemic control in the diabetic patient to glucose < 200 mg/dL. 7. Do not stop feeding, but repeat residuals in 4 hours. 8. If no improvement occurs, consider total parenteral nutrition (TPN). Monitor patients who are receiving enteral nutrition carefully for electrolyte balance. Dilantin (phenytoin), an anticonvulsant, should be given 2 hours before or after tube feeding to increase bioavailability of the drug. Parenteral Nutrition Parenteral nutrition is usually administered into the veins.

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