TOPIC
Assessing the level of nutrition of a patient in home care
PREBRIEFING
In today’s class we will learn how to manage a patient with malnutrition.
We are aware that the consequences of malnutrition are a serious threat to health and life. Knowledge of its causes and consequences can contribute to improving health. The nurse has the opportunity to directly influence patient management. To be effective, it is essential to acquire knowledge, skills and social competences. In this scenario you will consolidate your knowledge and acquire the skills needed to care for a malnourished patient. In today’s medical simulation class you will learn how to recognise symptoms and carry out appropriate tests and measurements on a malnourished patient. Skills required:
- conduct an interview for the diagnosis of malnutrition,
- take vital function measurements according to the procedure (blood pressure, pulse, body temperature) using medical equipment and breathing, and interpret the results,
- calculation of BMI,
- interpret and document the results of measurements and communicate the patient’s condition to the therapeutic team.
Do you remember the importance of food in the human body? What do you think is the daily need for nutrients? Do you recall what types of malnutrition we have? Do you remember what the risk factors for malnutrition are?
Do you know what the symptoms of malnutrition can be? How do you think we can assess malnutrition in an older person? Answer: We can ask how much the patient eats, we can measure basic vital signs (RR), we can assess arm circumference and calf circumference, and we can evaluate the test results. Is it important to do these tests?
Do you have any ideas about what else you could ask the patient? Check: https://www.mna-elderly.com/sites/default/files/2021-10/mna-mini-english.pdf.
How do you calculate BMI? Check: https://www.calculator.net/bmi-calculator.html.
Imagine that you are working as a family health nurse and there is a malnourished patient at home.
Two people will take part in the scenario. One person will act as the first nurse, who will be the team leader and will be responsible for collecting the interview. The other will be the nurse responsible for taking measurements of basic vital signs. Do you understand all the information and know what you are responsible for?
REFERENCES, MATERIALS FOR CLASSES
- https://d9qc22597pyja.cloudfront.net/Uploads/i/u/x/20200629malnutritionsupplementv4_889820.pdf
- Tanvir Ahmed and Nadim Haboubi. Assessment and management of nutrition in older people and its importance to health. Clin Interv Aging. 2010; 5: 207–216.
PREREQUISITES
The student has knowledge of:
- Risk factors and health threats in patients of different ages
- Etiopathogenesis, clinical symptoms, course, treatment, prognosis and principles of care
nursing care for patients in selected diseases - Principles of diagnosing and planning patient care in nursing
- Geriatric
- Nursing standards and procedures used in the care of patients of different age and health condition
The student has the skills:
- Gather information, formulate a nursing diagnosis, and set goals and care plans
- Implement nursing interventions and evaluate nursing care
- Provide counseling in the field of self-care of patients of different age and health status regarding malformations, diseases and addictions
- Prevent complications occurring in the course of diseases
INTRODUCTION
Adam Kowal, aged 88, has been feeling weak for several days. He is at home, lying in bed. This is the second visit of the health nurse. On the first visit, the nurse assessed the patient’s family status.
CURRENT CLINICAL CONDITION
Patient lying in bed, weakened. Skin dry. He reports drowsiness and headache and lowered mood. He has suffered from hypertension for 20 years – treated for this and takes medication in pills.
INTERVIEW
Time of onset of first symptoms – a few days before
- Patient passes hard stools every other day with difficulty.
- Patient has incomplete teeth, has dentures but got them done at age 65.
- The patient’s daughter noticed that she had to take the patient’s pyjama trousers in. She also noticed that the shirt was too wide.
- In the interview, the patient states that he is not hungry, his wife does not cook anymore and his daughter does not do it very well. This is too salty, that is too hard. He does not like modern food.
- He does not like yoghurt or other processed food.
- Treatment – Hydrochlorothiazide 1 x 1 tab, Indapamide 1 x 1 tab, Perazine p. o. 25 mg 2 x day, Spironolactone 1 x 1 tab, Hydroxyzine 10 mg at night.
- Allergies – none.
