Nutrition Care Process and Assessment
Nutrition Care Process and Assessment tests whether you can collect valid data, interpret it, and write a defensible nutrition diagnosis. The NCP has four steps-assessment, diagnosis, intervention, monitoring and evaluation-documented in ADIME format.
Core rules
- Nutrition assessment covers food/nutrition history, anthropometrics, biochemical data, clinical findings, and client history (the "ABCDs" plus history).
- A nutrition diagnosis uses PES: a single Problem from the intake, clinical, or behavioral-environmental domain; an Etiology linked by "related to"; and Signs/symptoms linked by "as evidenced by."
- The etiology must be a cause, not a second diagnosis; the signs must be measurable and change with intervention.
- Weight change percentage = (usual weight − current weight) / usual weight × 100.
- Albumin reflects inflammation and has a long half-life (~20 days); prealbumin (~2 days) also falls with inflammation. Neither is a stand-alone malnutrition marker.
- Malnutrition diagnosis (Academy/ASPEN) requires at least two of: insufficient energy intake, weight loss, loss of muscle mass, loss of subcutaneous fat, fluid accumulation, diminished functional status.
Worked example
A postoperative patient reports nausea and has eaten 25% of meals for three days, with 3% weight loss. A weak PES statement is "Malnutrition related to surgery." A stronger one is: "Inadequate oral intake related to postoperative nausea as evidenced by 25% meal consumption for three days and 3% weight loss." The problem is intake, the cause is nausea, and both signs are measurable.
Traps
Using a medical diagnosis (e.g., "diabetes") as the nutrition problem; putting another nutrition diagnosis in the etiology; citing albumin as proof of malnutrition; and writing "as evidenced by" with subjective, unmeasured statements.