Step 2 - ND (New) PDF
Step 2 - ND (New) PDF
(NCP)
Step 2:Nutrition
Diagnosis
Nutrition Counseling
FNU 425
Outline
Overview of nutrition diagnosis
2. Clinical (NC)
Nutrition problems that relate to medical or physical
conditions
3. Behavioral/environmental (NB)
Knowledge, attitudes, beliefs, physical environment,
access to food, food safety
What is PES statement?...
PES statement
Problem: (Diagnostic Label)
related to …Etiology…
as evidenced by …Signs/symptoms
But…
Will intervention resolve the problem by addressing the etiology? If not, can intervention
at least improve the signs and symptoms?
Signs/Symptoms:
Will measuring the signs and symptoms tell you if the problem is resolved or improved?
Are the signs and symptoms specific enough that you can measure/evaluate changes at the
next visit to document resolution or improvement of the problem (diagnosis)?
PES Overall:
Does your nutrition assessment data support the identified problem, etiology and signs
and symptoms?
Step 3:Nutrition Intervention
“to resolve or improve the identified nutrition problem
by planning & implementing appropriate interventions”
Nutrition
Intervention
4 categories:
- Food and/or Nutrient Delivery (ND)
- Nutrition Education (E)
- Nutrition Counseling (C)
- Coordination of Nutrition Care (RC)
Nutrition Nutrition Nutrition
Assessment Diagnosis Intervention
4 categories
Nutrition
Nutrition Nutrition Nutrition Monitoring
Assessment Diagnosis Intervention &
Evaluation
-- Mom states that she has had 4-5 previous sessions w/ the dietitian
regarding his diet?
From her intake records & patterns, you identify that she is
consuming hidden milk products ( in cheese sauces, cream
sauces, & salad dressings) & doesn't ask about food
ingredients at restaurants or read labels.
Has been gaining weight over the last 5 years in his group home. His
doctor said he needs to exercise more or he’ll become obese; he
doesn't want to be told he needs to exercise for his health.
When he first came to the group home he was much more active than
currently. He would go for walks in a park by himself when the
weather was good. He bowled every week with the other men in the
group home and was very good at it. A year later he climbed a Mt.
with 1of the staff. The staff person left his job at the group home
about 3 mon later and no one else was interested in taking him
hiking. He worked out at the YMCA for a period of time but he didn't
find other people to workout with him & he quit.
He started eating more food within the next year as he started to gain
wt.
ا. استشارات غذائيه نهى سليماني-١٤٣٢ الفصل الدراسي الثاني-هـ١٤٣٣
28/2/2012 30
Case study: 5 con’t
Nutrition
Assessment
Serum Alb= 3.4 g/dl; blood Glu= 110 mg/100 ml; &
HbA1c= 5%.
avoids food & calorie-containing beverages;
excessive physical activity.
ا. استشارات غذائيه نهى سليماني-١٤٣٢ الفصل الدراسي الثاني-هـ١٤٣٣
28/2/2012 33
Case study: 6 con’t
Nutrition
Assessment
Alb=3.4 g/dl,
Avoids food & Before pregnancy: 15 yrs, female,
HgA1c=5%
calorie-containing Wt=43 kg; Ht=155;BMI=17.9; pregnant teen;
Glu=110mg/100ml
beverages; Hx of disordered
excessive During 24 weeks of Pregnancy: eating; hospitalized
physical activity Wt= 45 kg; BMI= 18.7 for this problem 2yrs
ago