Nutrition Nursing Diagnosis for Cirrhosis
Nursing Diagnosis of Imbalanced Nutrition Less Than Body Requirements for Cirrhosis
Related to:
- Inadequate diet; inability to process / digest food
- Anorexia, nausea, vomiting, not eating, easy satiety (acites)
- Impaired metabolism of protein, fat, glucose and vitamin storage disorders.
Possible evidenced by:
- Changes in body weight
- Changes sounds and bowel function
- Poor muscle tone / muscle use
- Imbalance in nutrition examination
Nursing Interventis Imbalanced Nutrition Less Than Body Requirements for Cirrhosis:
1. Measure the daily dietary input, with the number of calories
Rationale: Provides information about the input requirements / deficiencies.
2. Measure body weight as indicated. Compare changes in fluid status, history of weight, triceps skin size.
Rational: It may be difficult using weight as a direct indicator of nutritional status because there is a picture edema / ascites. Triceps skin fold is useful in assessing changes in muscle mass and subcutaneous fat deposits.
3. Help and encourage patients to eat, explain why the type of diet. Feed the patient when fatigue or let someone nearby to help patients. Consider the selection of preferred food.
Rational: Proper diet is important for healing. Patients may eat better if the family is involved and preferred food as much as possible.
4. Encourage patients to eat all the foods / food additives.
Rationale: Patients may only eat a little, because it lost interest in food and experiencing nausea, general weakness, malaise.
5. Give eat little but often
Rationale: The poor tolerance to eat a lot may be associated with increased intra-abdominal pressure / ascites.
6. Provide additional salt if permitted; avoid that contain ammonium
Rational: Additional salt enhance the flavor of food and help to increase appetite; ammonia potential risk of encephalopathy.
7. Limit input caffeine, foods that produce gas or spicy and too spicy or too cold
Rationale: Helps in reducing gastric irritation / diarrhea and abdominal discomfort that can interfere with oral intake / digestion.
8. Give refined foods, avoid rough foods as indicated.
Rationale: Bleeding from esophageal varices may occur in severe cirrhosis.
9. Give mouth care frequently and before eating
Rationale: Patients tend to experience injury and / or bleeding gums and bad taste in the mouth which adds to anorexia.
10. Increase the period of uninterrupted sleep, especially before eating
Rationale: Energy storage lowers metabolic demands on the liver and increase cellular regeneration.
11. Advise to stop smoking if clients smoke.
Rational: Reduce excessive stimulation and the risk of gastric irritation / bleeding.
12. Supervise laboratory tests (eg, serum glucose, albumin, total protein, ammonia)
Rationale: Glucose decreased due to impaired glycogenesis, decreased glycogen deposits or entries not adequate.
Protein dropped because of metabolic disturbances, decreased hepatic synthesis, or loss to the peritoneal cavity (ascites). Elevated levels of ammonia necessary protein intake restrictions to prevent serious complications.
13. Maintain the status of fasting when indicated
Rationale: At first, the relaxation of GI is required to reduce demand on the liver and the production of ammonia / urea GI
14. Consult with dietitian to provide a diet high in calories and simple carbohydrates, low fat and high in protein are; limit sodium and fluids if necessary. Give extra fluids as indicated.
Rational: Foods high in calories are needed in most patients with limited revenue, carbohydrates provide energy ready for use. Fat is absorbed poorly due to liver dysfunction and may aggravate abdominal discomfort. Protein is needed on improving the levels of serum proteins to reduce edema and to improve the regeneration of liver cells.
Note: Protein and foods high in ammonia (eg gelatin) is restricted if ammonia levels rising atai patients had clinical signs of hepatic encephalopathy. In addition this individual can tolerate vegetable protein better than animal protein.
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