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Ch5- Developing A
Nutrition Care Plan:
Putting It All Together
FNU 425-FAR
SPRING 1435-1436
19, 26/ 5/ 1436
Outline

Setting goals-broad & specific

Plan of action-factors for design

Tools for dietary assessment

Energy Determination
REE/ TEE

Physical Activity factor

Physical and Weight Assessment

Charting data

1


SOAP

ADIME
NCP integration
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Goal setting
“You fail to plan, you plan to fail”
Options tool
(eliciting ideas for change)
‫المدرسة‬
‫ضغط‬
‫الدم‬
‫الرياضة‬
‫األلياف‬
‫الكوليسترول‬
2
3
4
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Plan of Action-factors
1.
5
Investigate physical environment
Barrier vs. encouraging
2.
Examine social support (+,-)
Helping vs. hindering
3.
Review cognitive environment
“What are you saying to yourself not about the goal”
4.
Explain Positive coping talk
Change into a positive mind set if thinking negative
Plan of Action-factors-cont’d
5.
Modify goals if necessary
6.
Select a tracking technique
6
Client choose how to track goal
7.
Verbalizing the goal
After setting a SMART goal, ask client to verbalize it
8.
Write down the goal
“goals that are not written down are just wishes”
3
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Functions of Assessment
Data for dietary assessment
7
 Provide
baseline parameters
 Determine
health and nutrition risk
 Ascertain
feasible alternatives for diet
change/planning options
 Identify
 Set
strengths and roadblocks
priorities for making dietary changes
 Anticipate
appropriate outcomes
Dietary Assessment
Food intake data collection
1.

Self reported

By interview
Food data analysis
2.

Food group evaluation

Food component analysis
Interpretation of analysis
3.
4
general steps8

MyPyramid/ My Plate

DRIs

Diet plans (DASH, Mediterranean…etc.)
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Dietary Assessment-case
example
Dietary Assessment Tools
 Assessment
questionnaire and historical
data form
 Food
diary/daily food record
 24-hr
recall
 FFQ
 Usual
 Diet
5
diet
History interview
9
10
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Dietary Assessment Tools
summary
Portion size
6
11
12
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Portion size estimation
Portion estimation-cont’d
7
13
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Portion estimation-cont’d
Physical activity
15
16
 Sedentary (less than 60 minutes of physical activity per
week)

Light activity (30 minutes of physical activity 3 - 4
times per week)

Moderate activity (40 - 50 minutes of physical
activity 4 - 5 times per week)

8
Very active (training as an athlete)
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Energy Determination
17
 REE
(Resting Energy Expenditure)
The energy you need to sustain life
functions such as respiration, heart
beating, kidney functions over a 24-hr
period. Measured by energy
calculation equations.
Energy Determination-EER
9
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Physical Activity (PA) factor
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TEE = REE x PA
Physical and Weight
Assessment
 BMI
categories
 Weight-for-Height tables
 Waist Circumference
 Body
10
shape (Apple vs. Pear)
 Standard
for women = 88 cm
 Standard
for men = 102 cm
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Physical and Weight
Assessment
 Waist
Circumference
Physical and Weight
Assessment
 BMI
11
21
and WC risk estimation
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Why do Charting of data
23
“if its not documented, it didn’t happen”

Evidence of care

Accountability for meeting legal and professional
standards

Basis for evaluation and planning to ensure

Legal protection

Tool of communication with other health
professionals

Justification for health insurance reimbursemnt
SOAP
 Subjective
 Objective
 Assessment
 Plan
12
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13
Case study-Nancy
25
SOAP Documentation
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SOAP Documentation-cont’d
27
Sessions with your client
28