Imbalanced Nutrition: More Than Body Requirements [Nursing Care Plan]


Imbalanced Nutrition Care Plan

NANDA-I Definition: Intake of nutrients that exceeds metabolic needs 

Related To…

  • Excessive eating compared to nutritional needs 
  • Eating in response to emotional cues or external stimuli 
  • Poor dietary habits 
  • Lack of exercise 
  • Lack of knowledge about appropriate portion size and food preparation 

Subjective Data: patient’s feelings, perceptions, and concerns. (Symptoms)

  • Impaired perception of weight 
  • Lack of knowledge about preparing healthy food 
  • Report joint and muscle aches 
  • Sedentary lifestyle 
  • Eating as a coping method 

Objective Data: assessment, diagnostic tests, and lab values. (Signs) 

  • Past medical history of comorbidities: diabetes mellitus, obesity, hypertension
  • A1C level of 6.5% or higher 
  • Fasting blood sugar of 126 or higher 
  • BMI over 30
  • Bodyweight is more than healthy for height 

Expected Outcome

  • The patient will verbalize willingness to lose weight 
  • The patient will demonstrate necessary measures and lifestyle modifications to lose weight 
  • The patient will be able to name and prepare healthy meal options 

Assessment and Interventions 

Obtain baseline body measurements, such as weight, height, and waist circumference. 

Measurements of height and weight allow for calculating the BMI( Body mass index). According to the MayoClinic, a BMI above 30 is considered obese. Baseline measurements will allow for accurate tracking of weight loss. 

Assess the patient’s overall condition and for possible comorbidities acquired secondary to obesity. 

Health care staff needs to address health conditions that arise from obesity at the same time. Some conditions might improve or resolve with weight loss. Comorbidities that can arise from obesity might be diabetes mellitus, hypertension( high blood pressure), deterioration of the joints, difficulty breathing, and heart disease. 

Assess for the patient’s willingness to lose weight. 

The patient has to agree to the treatment plan to be successful. Results will be more consistent and long-lasting if the patient wants to change his or her lifestyle. 

Evaluate if any obstacles could prevent the patient from participating in a weight loss plan. 

There could be many reasons why the patient is not willing to participate in the treatment plan. Shame, Ignorance, or lack of motivation are only a few reasons to mention why the patient might not cooperate. It might just be a particular part of the treatment plan that the patient rejects. For example, the patient might agree to make dietary changes but not agree to an exercise plan.

Evaluate the patient’s dietary habits and perform a nutrition assessment. 

Caloric food intake 
Type of food Triggers to food consumption 
Availability of food and supplies 
Physical activity 
Knowledge about food and nutrients 
Medication intake 
Eating and snacking patterns 
Appetite 
Swallow function 

An in-depth nutrition assessment provides a baseline and exposes problems that the healthcare team can include in the care plan. 

Assess the patient’s mental makeup and collaborate with the appropriate department. 

The reason for overeating can be psychological. Depression or other mental illnesses might contribute to inappropriate eating habits. Binge eating might be an eating habit that is caused by mental issues. In that case, the patient needs further evaluation by specialized staff.

Encourage the patient to start a food diary. 

A food diary is an excellent tool to track the amount of food eaten and eating patterns. The patient can also include feelings, environmental circumstances, and time of the day with each meal or snack. With persistent tracking of food intake, the diary might reveal specific triggers or behaviors contributing to overeating. 

Help the patient learn how to read food labels correctly.

Food labels contain essential information about the calorie amount and serving size. To know the relation between calories and serving size of food, the patient has to read food labels. Have the patient pay attention to total fat and total sugars on food labels. 

Help establish behavioral patterns and methods to avoid overeating:

Avoiding to eat out, instead preparing food at home 
Increasing daily fruit and vegetable intake 
Substituting sweet and sugary fluids with water
Keeping a food diary and keeping track of progress 
Buying only healthy food to avoid temptation
Avoiding situations that cause boredom leading to overeating
Planning and preparing meals each day or weekly

Changing eating habits and identifying triggers causing overeating can help control temptation and, therefore, weight loss. 

Educate about healthy nutrition and proper portion sizes:

Advise the patient to eat at least 2 to 3 cups of vegetables per day 
Instruct the patient to eat at least 1 ½ to 2 cups of fruits 
Encourage water intake and avoid beverages containing sugars such as fruit juices and energy drinks 
Men should drink 15.5 cups and women 11.5 cups of water per day 
Encourage the patient to aim for a balanced intake of all food groups such as dairy, fiber, grains, fruits, vegetables, and protein
Help distinguish between healthy and unhealthy foods

Knowledge about portion sizes and calories about different food will help the patient permanently change diet habits and his or her perception of healthy eating.

Assist the patient with creating a meal plan: 

Introduce the patient to weekly meal planning and preparation 
Help set up a realistic meal plan that fits into the patient’s lifestyle 
Assist the patient in creating a menu and learning how to meal prep

The patient is more likely to follow through with health changes if they are personalized. Healthcare staff has to provide the patient with the necessary means and skills to realize lifestyle changes. By increasing the patient’s knowledge and skill level, long term commitment is much more likely. 

Collaborate with a dietitian to provide education and resources. 

A variety of factors require attention and consideration when it comes to establishing a meal plan. With a thorough assessment and nutritional knowledge, dietitians can provide valuable information by considering the type of diet and the amount of calories needed to lose weight for a specific individual. Dietitians will be able to integrate ethnic foods into the meal plan and further personalize the meal plan. 

Educate the patient about the benefits of losing weight slowly.

By losing weight gradually, the patient will be able to keep the weight off long term. According to the CDC, it is healthiest to lose 1 to 2 pounds per week. Steadily losing weight emphasizes a permanent lifestyle change rather than a diet. 

Provide resources such as apps and websites to help educate about healthy nutrition and weight loss.

Choosemyplate.gov is an excellent online resource to learn about healthy eating. Following these guidelines ensures information accuracy because the information is research-based. Using apps to track food intake and weight loss keeps the patient motivated and ensures accuracy of documentation. 

Assess the patient’s willingness and ability to engage in an exercise plan. 

There may be many reasons for lack of exercise. The patient might be physically unable to exercise, mentally not stable enough, or too ashamed to engage in an exercise plan. Once the healthcare team has identified why the patient is not exercising, the care plan can be adjusted to meet the patient’s needs. 

Recommend the patient engage in various exercises:

Walking 
Swimming 
Running 
Weight lifting 
Cardio 
Yoga 
Pilates 
Cycling 

A variety of different exercises keep the patient interested and motivated to continue to exercise. Different workouts provide a variety that keeps the patient engaged long term. 

Educate the family and caregiver about nutrition and necessary lifestyle adjustments. 

The patient’s environment has to be supportive of lifestyle changes and eliminate temptations of previous habits. The patient is more likely to be successful if the entire family engages in healthy lifestyle changes.

Education/ Discharge Planning/Continuity of Care at Home

Educate the patient about the possible health risks of overeating and obesity.

According to the CDC, health risks include but are not limited to hypertension, diabetes, elevated cholesterol, coronary artery disease, sleep apnea, bone, and joint damage. 

Educate about the benefits of weight loss. 

Patients and families might be more likely to comply if they know the reason behind necessary lifestyle changes.

Recommend the patient uses healthy eating as a lifestyle change rather than dieting. 

Results might be more promising and long-lasting if the patient includes dietary changes and physical changes such as exercising. 

Remind the patient to weigh regularly and record progress. 

The patient might be more consistent in the weight loss process when seeing constant progress. 

More Care Plans:

Knowledge Deficit Care Plan

Ineffective Health Maintenance Care Plan

Impaired Home Maintenance [Care Plan]

Readiness for Enhanced Nutrition [Care Plan]

References:

Ackley, B., & Ladwig, G. (2014). Nursing diagnosis handbook (10th ed.). Maryland Heights: Mosby Elsevier.

Gulanick, M., & Myers, J. (2014). Nursing care plans (8th ed.). Elsevier.

The Health Effects of Overweight and Obesity | Healthy Weight, Nutrition, and Physical Activity | CDC. Cdc.gov.[Link]

Healthy Weight Loss. Centers for Disease Control and Prevention. [Link]

Diabetes Testing. Centers for Disease Control and Prevention. [Link]

Obesity – Symptoms and causes. Mayo Clinic. [Link]

CDC Press Releases. CDC.[Link]

How much water do you need to stay healthy?. Mayo Clinic.[Link]

Obesity – Symptoms and causes. Mayo Clinic. [Link]

The 8 Best Exercises for Weight Loss. Healthline. [Link]

Recent Posts