Page 29 - CLINICAL PRACTICE II

CikguOnline
CikguOnline

NUTRITION 1. VERY POOR 2. PROBABLY 3. ADEQUATE – 4.
Usual food – Never eats a INADEQUATE – Eats over half of EXCELLENT –
intake complete meal. Rarely eats a most meals. Eats Eats most of
pattern Rarely eats more complete meal a total of 4 every meal.
1NPO: than 1/3 of any and generally servings of Never refuses
Nothing by food offered. eats only about ½ protein (meat, a meal.
mouth. Eats 2 servings of any food dairy products) Usually eats a
2IV: or less of protein offered. Protein each day. total of 4 or
Intravenously. (meat or dairy intake includes Occasionally more servings
3TPN: Total products) per only 3 servings of refuses a meal, of meat and
parenteral day. Takes fluids meat or dairy but will usually dairy products.
nutrition. poorly. Does not products per day. take a Occasionally
take a liquid Occasionally will supplement if eats between
offered,
dietary take a dietary meals. Does
supplement, supplement OR is on a tube not require
feeding or TPN3 supplementati
OR is NPO1 OR receives less regimen, which on.
and/or than optimum probably meets
maintained on amount of liquid most of
clear liquids or diet or tube nutritional needs.
IV2 for more than feeding.
5 days.

1. PROBLEM- Requires moderate to 2. POTENTIAL 3. NO
FRICTION maximum assistance in moving. PROBLEM– APPARENT
AND SHEAR PROBLEM –
Complete lifting without sliding Moves feebly or Moves in bed
against sheets is impossible. requires and in chair
Frequently slides down in bed or minimum independently
chair, requiring frequent repositioning assistance. and has
sufficient
with maximum assistance. Spasticity, During a move, muscle strength
contractures, or agitation leads to skin probably to lift up
almost constant friction. slides to some completely
extent against during move.
sheets, chair, Maintains good
position in bed
restraints, or or chair at all
other devices. times.
Maintains
relatively good
position in chair
or bed most of
the time but
occasionally
slides down.

29 | P a g e