Inadequate Body Requirements Care Plan for Patients With Tube Feed

Imbalanced Nutrition: Less Than Body Requirements Nursing Care Plans Diagnosis and Interventions

Imbalanced Nutrition: Less Than Body Requirements Nursing Care Plans Diagnosis and Interventions

Nutritional imbalance occurs when there is an abnormal level in certain nutrients caused by a shortage or excess in supply. It is a significant health concern that can lead to serious diseases and can make underlying medical conditions worse.

Imbalanced Nutrition: Less Than Body Requirements is a NANDA nursing diagnosis that specifically refers to the state where the individual experiences nutritional deficits due to either a shortage of nutrient supply or higher metabolic demand.

It can occur secondary to several illnesses such as anorexia, stress, and depression. It can also be caused by side effects from certain medications and medical treatment.

Imbalanced Nutrition Less Than Body Requirments Nursing Diagnosis

Nursing Care Plan for Imbalanced Nutrition Less Than Body Requirments 1

Dysphagia

Nursing Diagnosis: Imbalanced Nutrition: Less Than Body Requirements related to inability to ingest food secondary to dysphagia as evidenced by weight loss and verbalization or documentation inadequate caloric intake in food diary or input/output monitoring

Desired Outcome: The patient will either regain normal swallowing capacity or be able to improve nutrition by tube feeding. He/she will also obtain understanding of food options to support nutrition supplementation.

Nursing Interventions for Imbalanced Nutrition Less Than Body Requirments	Rationales
Document the patient's weight. Weight the patient daily in the mornings.	Weight loss can be measured accurately with a patient's actual weight rather than by estimate. The patient's weight is also an ideal tool in the assessment of a person's nutritional requirements.
Start the patient on a food diary and assess caloric intake.	A record of what the patient eats can help direct treatment.
Assess what the patient can safely eat and drink.	Patients with dysphagia may be able to tolerate thickened liquids and pureed food. Assessing what the patient can tolerate will help support nutrition and arrange food choices to become available.
Promote a semi or full Fowler's position during feeding. An upright position or elevating the head to at least 30 degrees aids in swallowing and reduces the risk for aspiration.
Refer the patient to the dietitian and/or nutritionist.	A dietitian can help the medical team assess the patient's nutritional status and recommend food options that will supplement the patient's nutritional gaps.
Refer to speech and language therapy.	Speech and language therapists assess the patient's ability to swallow safely and can recommend food and food texture that is safe for the patient to eat/drink.
Weigh the patient regularly and document readings.	The patient's weight will help in the evaluation of the patient's progress.
Explain nutrition and the patient's personal nutritional needs.	Understanding the importance of maintaining proper nutrition will encourage the patient to become proactive in adhering to the treatment plan.
Discuss the nutritional recommendation of the team, nutritionist, and dietitian to the patient. Follow the recommended type of diet and thickness of fluids.	An explanation of the new food choices and the recommended type of diet and fluids to support the patient's nutritional requirements will promote compliance to treatment.

Nursing Care Plan for Imbalanced Nutrition Less Than Body Requirments 2

Burns

Nursing Diagnosis: Imbalanced Nutrition: Less Than Body Requirements related to increased metabolic needs secondary to burns as evidenced by severe burn injuries, muscle wasting, and weight loss (cachexia)

Desired Outcome: The patient will demonstrate adequate nutritional intake and meet metabolic needs as evidenced by weight gain.

Nursing Interventions for Imbalanced Nutrition Less Than Body Requirments	Rationales
Weigh the patient daily and document readings. Record the patient's choices of food and drinks.	A record of the patient's weight will help assess the progress of treatment. Creating a food diary can help monitor patient's progress, as well as his/her likes and dislikes in terms of food and drinks.
Encourage family members to bring food from home.	Administering what the patient likes to eat can increase caloric intake and promote weight gain. Also, the participation of the family can improve the patient's appetite.
Document food intake and include caloric count.	Burns can increase the metabolic needs of the body. It is recommended that an additional 40 kcal must be given per percentage of TBSA burn in adults.
Promote a conducive feeding environment.	The patient's environment can help induce appetite and promote the intake of food.
Educate the patient about proper oral hygiene.	A clean mouth enhances the taste and promotes a good appetite.
Refer the patient to a dietitian and/or nutritionist.	Dietitians can help in the assessment of the patient's nutritional status and nutritional needs. They can also recommend food to support nutritional gaps.
Administer supplemental nutrition through the insertion of a nasogastric tube or the administration of parenteral nutrition as indicated by the physician and as recommended by the dietitian team.	In cases where the throat has been affected or any part of the upper digestive system is impaired in a burns patient, supplemental nutrition may be necessary.

Nursing Care Plan for Imbalanced Nutrition Less Than Body Requirments 3

Depression

Nursing Diagnosis: Imbalanced Nutrition: Less Than Body Requirements related to an unwillingness to eat secondary to depression as evidenced by food aversion, loss of appetite, and weight loss

Desired Outcome: The patient will regain interest in food as evidenced by an increase in caloric intake and normal weight.

Nursing Interventions for Imbalanced Nutrition Less Than Body Requirments	Rationales
Assess the patient's eating pattern.	This will give the team an understanding of what needs the patient may require and what interventions might be helpful.
Weigh the patient regularly and document the readings.	The patient's actual weight can help assess weight loss and nutritional status.
Encourage the patient to eat with others.	Socialization can reduce the patient's focus on food and may encourage him/her to eat more without noticing.
Assess the patient's food choices.	Serving food that the patient likes can improve appetite.
Encourage small, frequent feedings.	Consistently offering the patient something to eat can improve their total caloric intake. This can also prevent dehydration, weight loss, and constipation.
Allow the patient to choose what to eat and give enough time to do so.	Giving the patient a sense of control can increase their intake and their interest in food.

Nursing Care Plan for Imbalanced Nutrition Less Than Body Requirments 4

Cancer

Nursing Diagnosis: Imbalanced Nutrition: Less than Body Requirements related to abdominal pain and cramping secondary to gastric cancer, as evidenced by  abdominal cramping, stomach pain, bloating, weight loss, nausea and vomiting, and loss of appetite

Desired Outcome: The patient will be able to achieve a weight within his/her normal BMI range, demonstrating healthy eating patterns and choices.

Nursing Interventions for Imbalanced Nutrition Less Than Body Requirments	Rationale
Explore the patient's daily nutritional intake and food habits (e.g., meal times, duration of each meal session, snacking, etc.)	To create a baseline of the patient's nutritional status and preferences.
Create a daily weight chart and a food and fluid chart. Discuss with the patient the short term and long-term nutrition and weight goals.	To effectively monitory the patient's daily nutritional intake and progress in weight goals.
Help the patient to select appropriate dietary choices to increase dietary fiber, caloric intake and alcohol and coffee intake.	To promote nutrition and healthy food habits, as well as to boost the energy levels of the patient. Dietary fiber can help reduce stool transit time, thus promoting regular bowel movement.
Refer the patient to the dietitian.	To provide a more specialized care for the patient in terms of nutrition and diet in relation to newly diagnosed gastric cancer.
Symptom control: Administer the prescribed medications for abdominal cramping and pain, such as antispasmodics. Promote bowel emptying using laxatives for constipation as prescribed.	To reduce cramping, relieving the stomach pain and helping the patient to have a better appetite. To treat persistent and/or severe constipation, which is a common symptom of gastric cancer.

Nursing Care Plan for Imbalanced Nutrition Less Than Body Requirments 5

Diarrhea (as a symptom of a disease or a side effect of medication)

 Nursing Diagnosis: Imbalanced Nutrition: Less than Body Requirements related to altered absorption of nutrients secondary to diarrhea, as evidenced by watery stools abdominal pain and cramping, weight loss, nausea and vomiting, and loss of appetite

Desired Outcome: The patient will be able to achieve a weight within his/her normal BMI range, demonstrating healthy eating patterns and choices.

Nursing Interventions for Imbalanced Nutrition Less Than Body Requirments	Rationale
Explore the patient's daily nutritional intake and food habits (e.g., meal times, duration of each meal session, snacking, etc.)	To create a baseline of the patient's nutritional status and preferences.
Create a daily weight chart and a food and fluid chart. Discuss with the patient the short term and long-term nutrition and weight goals related to diarrhea.	To effectively monitory the patient's daily nutritional intake and progress in weight goals.
Help the patient to select appropriate dietary choices to reduce the intake of milk products, caffeinated drinks, alcohol and high fiber, high fat foods.	To relieve abdominal pain and cramping, alleviate diarrhea, and healthy food habits. Caffeine is a stimulant of gastric acid production, which can worsen the condition.
Refer the patient to the dietitian.	To provide a more specialized care for the patient in terms of nutrition and diet in relation to diarrhea.
For severe or persistent diarrhea, consider placing the patient on a nothing by mouth (NBM) status, and gradually progress to clear liquids, followed by bland diet, and the low residue diet. The patient can then have a low fat, low fiber diet on a long-term basis.	Nothing by mouth (NBM) status can help rest the bowel by decreasing peristalsis. Gradual progression from NBM up to a low fat and low fiber diet can help manage the symptoms of diarrhea.
Administer anti-diarrhea medication as prescribed.	Anti-diarrheals can help stop or slow down the diarrhea.
If the diarrhea is a side effect of a medication, consider stopping this drug and placing the patient on an alternative. Reduction of the dose is another option to discuss with the prescribing physician.	To treat diarrhea, which causes the imbalance in nutrition.

Nursing References

Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care . St. Louis, MO: Elsevier.  Buy on Amazon

Gulanick, M., & Myers, J. L. (2017). Nursing care plans: Diagnoses, interventions, & outcomes . St. Louis, MO: Elsevier. Buy on Amazon

Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2020). Medical-surgical nursing: Concepts for interprofessional collaborative care . St. Louis, MO: Elsevier.  Buy on Amazon

Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination . St. Louis, MO: Elsevier.  Buy on Amazon

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Please follow your facilities guidelines and policies and procedures.

The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes.

This information is not intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment.

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