Nursing Diagnosis, Care Plan, and Interventions for Imbalanced Nutrition

Nursing Diagnosis, Care Plan, & Interventions for Imbalanced Nutrition- Student’s Guide

Introduction

Balanced nutrition is the key to a healthy and productive life. Unfortunately, many of us have difficulty maintaining an appropriate diet due to various reasons such as lack of knowledge or access.

Imbalanced nutrition can lead to problems in our physical, emotional, and psychological health. In this blog post, we will discuss what imbalanced nutrition means, how it affects your body, nursing diagnosis for an imbalance of nutrients that may occur, as well as care plans and interventions to guide nursing students.

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Disclaimer: The information presented in this article is not medical advice; it is meant to act as a quick guide to nursing students, for learning purposes only, and should not be applied without an approved physician’s consent. Please consult a registered doctor in case you’re looking for medical advice.

Let’s look at the terms associated with nutritional imbalance.

What is Nutrition?

Nutrition is the science of obtaining food and nutrients to maintain a healthful life by eating. It has been long established that diet plays an essential role in the prevention and treatment of disease and other aspects of human health. The World Health Organization (WHO) defines “good nutrition” as having all essential nutrients for growth, repair, and maintenance of body tissues; supplying energy at levels needed for physical activity; minimizing exposure to substances that may be toxic or detrimental to health.

What is Body Metabolism

Metabolism is a term that describes all chemical reactions of the body that convert food into energy, coordinate development, repair of tissues, and eliminate waste products. Food eaten is broken down to release nutrients absorbed through the intestinal tract, then carried by blood into tissues and cells for use. Some of these nutrients are converted into energy, while others are stored in the body. By means of metabolism, our bodies control how fast we convert food into energy. Our bodies use this energy to accomplish tasks such as breathing, digestion, circulation, and much more.

What is Imbalanced Nutrition?

Imbalanced nutrition or less than body requirements means less amount of nutrients are consumed than body needs. This can lead to either malnutrition or obesity, which is an abnormal accumulation of fat in the body, especially around the waist and trunk.

On the other hand, the nutritional deficit is also possible when intake meets or exceeds physiological needs; this happens rarely, but it can be seen in people on prolonged starvation diets or the body’s inability to absorb nutrients properly. The latter is less common, but it can happen when a patient has an illness that damages the intestinal tract.

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How to Prevent Imbalanced Nutrition?

Prevention is always better than cure. So it would help if you avoided the possible causes of imbalanced nutrition before it happens. By good habits and following some precautions, one can easily prevent imbalanced nutrition:

*Drink plenty of clean water throughout the day- to prevent dehydration and flush out toxins better.

*Avoid meals on wheels- Most of them are processed foods, unhealthy, and lack nutrients.

* Ensure to eat as many fresh vegetables and fruits as possible- This will provide the most nutritional value for your body and keep you healthy.

* Get more essential fatty acids in your diet- Essential fats are a significant part of a balanced nutrition plan because they help regulate hormones and support your immune system. Also, they help prevent heart disease, cancer, depression, insomnia, and so much more. You can get them from nuts, avocados, and fish (mostly salmon).

* Get your vitamins from fresh vegetables and fruits- You can get the best nutrition from eating vegetables and fruits, so make sure you eat plenty of them.

What Causes Imbalanced Nutrition?

The most common causes of imbalanced nutrition are inappropriate diet and loss or deprivation in the body.

Inappropriate Diet

When a patient’s intake is less than recommended, it can lead to nutritional deficiency and ultimately malnutrition. It may be a result of illness, poor appetite, or lack of access to food. Unhealthy eating habits such as skipping meals, having eating disorders, or a person who does not eat sufficient amounts of vitamins and minerals may also lead to imbalanced nutrition.

Nutrient Loss

Some people may lose more nutrients through urine, fecal material, and sweat during exercise that they take in from food, which can cause deficiencies. Other causes of losing too much body fluid include diarrhea and vomiting.

Loss of muscle, fat, and water also causes loss in weight. Deficient protein intake makes the body use its proteins for energy, and this results in loss of body tissues.

Poor eating habits and lifestyles are responsible for many imbalances in our nutrition.

Signs and Symptoms of Imbalance Nutrition

Signs and symptoms can be observed in the body of a person who is experiencing imbalanced nutrition. A patient suffering from imbalanced nutrition may show one or more of the following signs:

  • Difficulty in chewing and swallowing
  • Decrease in personal hygiene and especially oral hygiene
  • Abdominal cramping
  • Abdominal pain
  • Weight loss due to the patient taking less than body requirements
  • Poor eyesight (in children)
  • Constipation
  • Loss of appetite
  • Changes in sleeping pattern (CDC)

Other signs and symptoms of imbalance nutrition include;

  • Change in vision,
  • Skin lesions,
  • Slow-healing wounds,
  • A general feeling of being run down  or tired all the time,
  • Low energy levels & weakness

Nursing Diagnosis for imbalanced Nutrition

(NANDA-I)

Weight loss- unexplained or excess.

The focus is on two main dimensions of imbalanced nutrition: insufficient quantity and poor quality. A single deficiency or excess of nutrients can cause health problems.  Insufficient amount of nutrients leads to deficient vitamin, mineral, and protein intake. This causes malnourished patients with weak immunity. Excess of nutrients leads to overload, such as high blood pressure, or can causes deficiency if the body cannot handle excessive nutrients.

-Risk for deficient Fluid Volume

-Deficient Knowledge (about nutrition)

-Malnutrition

-Imbalanced Nutrition

-Readiness for enhanced knowledge (about nutrition)

-Imbalanced fluid Volume Risk for deficient knowledge

Imbalanced Nutrition Nursing Care Plan

A comprehensive nutrition care plan is a vital component of nursing practice. It provides the framework for guiding patient-specific and outcome-based interventions to meet nutritional needs, address nutrient deficiencies or excesses, and help manage diet-related diseases.  

The first step in creating an Imbalanced Nutrition Care Plan is identifying the type of imbalance your patient suffers from (deficiency, excess, or disorder). Next, you need to identify any underlying causes such as malnutrition, chronic disease, or pregnancy.

Identifying the types of imbalanced nutrition is essential to guide your plan and decide which interventions you need to do to restore balance in your patient’s body. 

Imbalanced Nutrition Nursing Interventions

Nursing interventions for this disorder include short term and long term treatments for imbalanced nutrition. Short term treatment focuses on maintaining the patient’s current health status until long-term nutritional rehabilitation is established. Long-term treatment focuses on establishing a healthy state of the body by providing proper diet and lifestyle modification.

The nursing interventions required are:  

Working on the underlying disease, if any

– Consider heart failure, diabetes, kidney disease, Alzheimer’s, etc. 

-Monitoring the patient for any side effects.  

-Checking the performance of liver and kidney functions-Checking levels of urea, creatinine, potassium. 

  -Measuring Height and Weight.  

Nursing assessment

-The nurse should assess the patient’s nutritional status by measuring vital signs, skin turgor, body mass index, and analyzing eating habits.

 -The nurse should analyze the patient’s fluid status and determine if there is a pattern of drinking too much water or not enough. 

-The nurse should assess if there is a pattern by talking to the patients and family about food preferences, cooking patterns, etc. 

Make diet history

– A diet history is critical for the nurse to assess the nutritional intake of the patient. By talking to the individual or their family, it is possible to assess the pattern the person generally consumes every day. The information from this assessment will help make necessary changes that would benefit the patient’s health.

Obtain a 3-day food diary to get detailed nutrition profile/history.  

-Provide meal planning based on the patient’s physical condition & cultural background & special diet if any  

-Providing teaching about food preparation, timing, & portion size (adequate amount)

-Discuss with the patient the health benefits of fruits and vegetables

-Providing education about diet and lifestyle changes to the individual as well as their family members and friends

The Patient should have small frequent meals that are nutritious and well balanced (contain all food groups) in vitamins, minerals, carbohydrates, protein, and fat. Suggest that the patient eat lots of fruits and salad vegetables. Increase whole grains like brown rice, bread, oats, or barley at least twice a day and make it three times if possible.

Use salt substitute (potassium chloride) to reduce potassium deficiency from salt intake. Limit alcohol and caffeine so that the patient’s metabolism improves. 

Do physical assessment

– In some cases, the nurse may need to do a physical assessment of the patient. This is extremely important during acute care or when there are signs of malnutrition such as; -Loss of subcutaneous tissue -Gastric ulcer -Edema, and weight loss

Do laboratory test

-It is important to note that the nurse may suggest specific lab tests to assess the electrolytes in the blood, magnesium level, and liver enzymes. Such tests like CBC (complete blood count) and liver function tests (LFT) are good indicators of nutrition.

The health care provider may also prescribe specific lab tests to diagnose various deficiencies or excesses in nutrients, such as blood gas analysis.

Referring patient to a dietitian

-The nurse may refer the patient to a dietitian for supervised nutritional rehabilitation.  The dietitian may perform administrative duties such as creating meal plans and teaching patients and families about nutrition.  The nurse must track how well the patient follows through with this plan by communicating with the dietitian and the patient’s family.

The nutritional rehabilitation of the patient should be based on anthropometric (body measurement), biochemical, laboratory results such as CBC (complete blood count), LFT (liver function tests), electrolytes, magnesium levels, etc.

-Work on patient’s activity, rest & sleep routines.  

Complications of Imbalanced Nutrition

Complications may be Acute or Chronic.

Acute Malnutrition- Severe complications include a high risk for infection, poor wound healing, dehydration, and electrolyte imbalances. The patient is more at risk for acute infections like pneumonia, bronchitis, or gastroenteritis (gastroenteritis, enteritis).

Chronic Malnutrition -Complications of chronic malnutrition are: Stunted growth, shorter height, underweight status, and delayed sexual maturity. Other complications are dehydration, anemia, and electrolyte imbalance. 

Treatment

Ultimate treatment involves giving the right amount and type of food based on each patient’s individual needs.

If there is no improvement with oral feeding, a nasogastric or gastrostomy may be inserted to administer the nutrition directly into the stomach. 

The type of tube and method of feeding depends on the health and age of the patient and may include: Tube feeding through NG (nasogastric) tube or G-Tube (gastrostomy) given with pureed food or liquids. A gastric tube may also feed directly into the stomach and is a temporary substitute while the patient is waiting for improvement in functional capacity.

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