24/06/1436 1 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 2 24/06/1436 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 24/06/1436 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 24/06/1436 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.) 24/06/1436 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 24/06/1436 Dietary Assessment Tools summary Portion size 6 11 12 24/06/1436 Portion size estimation Portion estimation-cont’d 7 13 14 24/06/1436 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) 24/06/1436 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 18 24/06/1436 Physical Activity (PA) factor 19 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 20 24/06/1436 Physical and Weight Assessment Waist Circumference Physical and Weight Assessment BMI 11 21 and WC risk estimation 22 24/06/1436 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 24 24/06/1436 13 Case study-Nancy 25 SOAP Documentation 26 24/06/1436 14 SOAP Documentation-cont’d 27 Sessions with your client 28
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