Nutrition Care for Individuals and Groups
The Nutrition Care Process
Use the four NCP steps in order: nutrition assessment, nutrition diagnosis (written as a PES statement-Problem, Etiology, Signs/Symptoms), intervention, and monitoring/evaluation. Screening comes before assessment: screening is a brief, validated risk check any trained staff member can complete, while assessment is a comprehensive review done by the RDN or the DTR under supervision. A frequent distractor swaps these two roles.
Assessment data
Organize findings as anthropometric, biochemical, clinical, and dietary (the “ABCDs”), plus food and nutrition history, medication and supplement use, and psychosocial and economic factors. Percent weight change over time, usual body weight, and edema status drive many interpretations.
DRI terms
EAR assesses adequacy of groups; RDA covers about 97–98% of individuals; AI is used when an EAR cannot be set; UL flags toxicity risk; AMDR gives acceptable macronutrient ranges.
Interventions and education
“If the gut works, use it”-enteral nutrition is preferred over parenteral when the GI tract functions. Know the stages-of-change model (precontemplation through maintenance) and use teach-back to verify learning, writing materials at roughly a sixth-grade reading level.
Traps
Do not confuse the DTR's implementation role with diagnosing or prescribing, and do not substitute headcount for assessment data when calculating needs.
Worked example
A 1.2 kcal/mL formula delivered at 1,200 mL/day supplies 1.2 × 1,200 = 1,440 kcal; at 50 g protein per liter, that is 0.05 × 1,200 = 60 g protein. Always multiply concentration by volume.