Lecture Notes: Nutritional Assessment and Oral Diets

Introduction

• Presenter: Cathy from Level Up RN
• Focus on nutritional assessment and types of oral diets
• Includes a quiz to test understanding
• Reference: Level Up RN Nutrition Flashcards

Nutritional Assessment

Key Components

• Height and Weight:
  • Obtain patient's height and weight
  • Identify recent weight changes (gain or loss)
  • BMI calculated by electronic health record systems
• Chewing or Swallowing Difficulties:
  • Assess per facility's policy (e.g., water sip test)
  • Patients with issues are kept NPO until evaluated by a speech-language pathologist
• Swallow Evaluation:
  • Conducted by a speech-language pathologist
  • Patients with known swallowing issues or aspiration pneumonia are kept NPO until evaluation
• Food Allergies and Dietary Restrictions:
  • Enquire about any food allergies
  • Discuss religious or cultural dietary preferences
• Key Lab Results:
  • Prealbumin: 15-36 mg/dL (decrease indicates malnutrition)
  • Albumin: 3.5-5 g/dL (decrease may indicate malnutrition or liver/kidney disease)
• Signs of Malnutrition:
  • Dry, brittle hair
  • Dry, scaly skin
  • Poor wound healing
  • Muscle wasting
  • Lethargy and weakness
• Consults:
  • Recommend consult with dietician or nutritionist if needed
  • Patients with acute illnesses/wounds need additional protein and calories

Types of Oral Diets

NPO (Nothing by Mouth)

• No eating or drinking
• Diet often advanced in stages:
  1. NPO
  2. Clear liquid diet
  3. Full liquid diet
  4. Soft diet
  5. Regular diet

Clear Liquid Diet

• Includes clear items at room temperature:
  • Ice chips, water, clear soda, Jello
  • Coffee, tea, clear broth

Full Liquid Diet

• Includes all liquids:
  • Clear liquid items + milk, orange juice, soup

Puréed Diet

• Smooth consistency (no solid pieces/lumps)
  • Examples: Mashed potatoes, puréed meat, pudding

Soft Diet

• Soft consistency, low in fiber, easy to digest
  • Examples: Low-fat dairy, eggs, pudding, cooked vegetables, tofu, lean skinless meat

Dysphagia Diet

• For patients with swallowing difficulties
• Includes thickened liquids, moist and soft or puréed foods

Regular Diet

• No dietary restrictions

Quiz

1. Swallow Evaluation Team Member: Speech-language pathologist
2. Significance of Decreased Prealbumin Level: Indicative of malnutrition
3. NPO Meaning: Nothing by mouth
4. Diet with Thickened Liquids and Moist Foods: Dysphagia diet

Conclusion

• Video recap and encouragement to subscribe and share
• Engagement: Like, comment, and feedback