1278 UNIT X / Promoting Physiologic Health
NURSING CARE PLAN Nutrition
ASSESSMENT DATA NURSING DIAGNOSIS DESIRED OUTCOMES*
Nursing Assessment
Mrs. Rose Santini, a 59-year-old homemaker, attends a commu-
nity hospital–sponsored health fair. She approaches the nutrition
information booth, and the clinical specialist in nutritional support
gathers a nutritional history. Mrs. Santini is very upset about her
9-kg (20-lb) weight gain. She relates to the nurse clinician that
since the death of her husband 1 month ago she has lost interest
in many of her usual physical and social activities. She no longer
attends YMCA exercise and swimming sessions and has lost con-
tact with her couple’s bridge group. Mrs. Santini states she is
bored, depressed, and very unhappy about her appearance. She
has a small frame and has always prided herself on her petite fig-
ure. She says her eating habits have changed considerably. She
snacks while watching TV and rarely prepares a complete meal.
Imbalanced Nutrition: More
than body requirements related
to excess intake and decreased
activity expenditure (as evi-
denced by weight gain of 20 lb,
triceps skin fold greater than
normal, undesirable eating
patterns).
Weight Control [1612] as evi-
denced by demonstrating
■Eats three meals each day
that result in a 500-calorie
reduction in intake.
■Develops a physical exercise
plan that engages her in 15
to 20 minutes of exercise by
day 5.
■Identifies eating habits that
contribute to weight gain by
day 2.
NURSING INTERVENTIONS*/SELECTED ACTIVITIES RATIONALE
Weight Reduction Assistance [1280]
Determine current eating patterns by having Mrs. Santini keep a
diary of what, when, and where she eats.
Set a weekly goal for weight loss.
Encourage use of internal reward systems when goals are accom-
plished.
Set a realistic plan with Mrs. Santini to include reduced food in-
take and increased energy expenditure.
Assist client to identify motivation for eating and internal and ex-
ternal cues associated with eating.
Encourage attendance at support groups for weight loss and/or
refer to a community weight control program.
Develop a daily meal plan with a well-balanced diet, reduced
calories, and reduced fat.
Increases awareness of activities and foods that contribute to ex-
cessive intake.
The desirable weight loss rate is 1–2 pounds per week.
Goal setting provides motivation, which is essential for a success-
ful weight-loss program.
A combined plan of calorie reduction and exercise can enhance
weight loss since exercise increases caloric utilization.
Awareness of factors that contribute to overeating will assist the
individual in planning behavior modification techniques to avoid
situations that prompt excess food consumption.
Overweight people are often nutritionally deprived. Intake must
be reduced by 500 calories per day to obtain a one-pound-per-
week weight loss.
Support groups can provide companionship, increase motivation,
and offer practical solutions to problems associated with dieting.
Physical Examination
Height: 162.6 cm (5′4′′)
Weight: 63.6 kg (140 lb)
Temperature: 37°C (98.6°F)
Pulse: 76 BPM
Respirations: 16/minute
Blood pressure: 144/84 mm Hg
Triceps skinfold: 21 mm
Small frame, weight in excess of
10% over ideal for height and
frame
Diagnostic Data
CBC normal, urinalysis negative,
chest x-ray negative, thyroid
profile within normal limits
Nutritional Counseling [5246]
Facilitate identification of eating behaviors to be changed.
Use accepted nutritional standards to assist Mrs. Santini in evalu-
ating adequacy of dietary intake.
Increases individual’s awareness of those actions that contribute
to excessive intake.
Comparing the individual’s dietary history with nutritional stan-
dards will facilitate identification of nutritional deficiencies and/or
excesses.
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