Nutrition Assessment and Oral Diets

Jun 4, 2024

Nutrition Assessment and Oral Diets

Key Components of a Nutritional Assessment

  • Obtain patient's height and weight
    • Ask about recent weight gain or loss
    • Electronic health records often calculate BMI
  • Assess for difficulty with chewing or swallowing
    • Procedure example: small sip of water test
      • Keep NPO if difficulty or coughing occurs
      • Refer to speech-language pathologist for comprehensive swallow evaluation
  • Review any known swallowing issues
    • Admit with aspiration pneumonia = keep NPO until evaluated
  • Ask about:
    • Food allergies
    • Dietary restrictions
    • Religious or cultural dietary preferences
  • Key lab results:
    • Prealbumin: 15-36 mg/dL (Decreased = malnutrition)
    • Albumin: 3.5-5 g/dL (Decreased = malnutrition, liver disease, kidney disease)
  • Assess for signs of malnutrition:
    • Dry, brittle hair
    • Dry, scaly skin
    • Poor wound healing
    • Muscle wasting
    • Lethargy and weakness
  • Consult dietician/nutritionist if concerns about nutritional status
  • Patients with acute illness or wounds need extra protein and calories

Types of Oral Diets

  • NPO (Nothing by mouth): Nothing to eat or drink
    • Diet advancement stages: NPO → clear liquid diet → full liquid diet → soft diet → regular diet
  • Clear liquid diet: Items clear at room temperature
    • Examples: ice chips, water, clear soda, Jello, coffee, tea, clear broth
  • Full liquid diet: Any liquids
    • Examples: milk, orange juice, soup
  • Puréed diet: Foods with smooth consistency, no solid pieces
    • Examples: mashed potatoes, puréed meat, pudding
  • Soft diet: Soft consistency, low fiber, easy to digest
    • Examples: low-fat dairy, eggs, cooked vegetables, tofu, lean skinless meat
  • Dysphagia diet: For patients with difficulty swallowing
    • Includes: thickened liquids, moist soft or puréed foods
  • Regular diet: No dietary restrictions

Quiz Questions

  1. Which interdisciplinary team member performs a swallow evaluation for a patient?
    • Answer: Speech-language pathologist
  2. What is the significance of a decreased pre-albumin level?
    • Answer: Indicative of malnutrition
  3. What means nothing by mouth?
    • Answer: NPO
  4. Which diet includes thickened liquids and moist, soft foods?
    • Answer: Dysphagia diet