Nutrition Care for Individuals and Groups
The Nutrition Care Process
Four interlocking steps: assessment, nutrition diagnosis, intervention, and monitoring/evaluation, documented as ADIME. Assessment covers food and nutrition history, anthropometrics, biochemical data, nutrition-focused physical findings, and client history. The diagnosis is written as a PES statement - Problem (standardized term) related to Etiology as evidenced by Signs/Symptoms. The etiology drives your intervention; the signs and symptoms are what you monitor.
Intervention and counseling
Match strategy to setting: food and nutrient delivery, education, counseling, coordination of care. Know the behavior-change frameworks - transtheoretical stages (precontemplation through maintenance), motivational interviewing, self-efficacy, health belief model, social cognitive theory - and that the stage of readiness determines the approach, not a single standardized handout.
MNT anchors
Diabetes: individualized consistent carbohydrate with weight and activity emphasis. CKD: protein, sodium, potassium, phosphorus, and fluid tailored to stage and labs. Cardiac: DASH-style eating with sodium and saturated fat reduction. Dysphagia: standardized texture and liquid levels. Nutrition support: use the gut when it functions; monitor phosphate, potassium, and magnesium for refeeding risk in the malnourished.
Traps
Diagnosing a medical condition rather than a nutrition problem. Writing an intervention into the etiology slot. Omitting a time frame for weight change, which makes the finding uninterpretable.
Rule of thumb
Percent weight change = (usual weight − current weight) ÷ usual weight × 100. Involuntary loss exceeding 5% in 1 month, 7.5% in 3 months, or 10% in 6 months is clinically significant. Example: 160 lb falling to 152 lb = 8 ÷ 160 = 5%, which matters if it occurred within a month.