Imbalanced Nutrition: Less than Body Requirements | Nursing Care Plan for Tuberculosis

Nursing diagnosis: imbalanced Nutrition: Less than Body Requirements related to fatigue; frequent cough and sputum production; dyspnea; anorexia; insufficient financial resources

Possibly evidenced by

Weight 10% to 20% below ideal for frame and height

Reported lack of interest in food, altered taste sensation

Poor muscle tone

Desired Outcomes/Evaluation Criteria—Client Will

Nutritional Status

Demonstrate progressive weight gain toward goal with normalization of laboratory values and be free of signs of malnutrition.

Initiate behaviors or lifestyle changes to regain and to maintain appropriate weight.

Nursing intervention with rationale:

1. Document client’s nutritional status on admission, noting skin turgor, current weight and degree of weight loss, integrity of oral mucosa, ability to swallow, presence of bowel tones,

and history of nausea, vomiting, or diarrhea.

Rationale: Useful in defining extent of problem and appropriate choice of interventions.

2. Ascertain client’s usual dietary pattern and likes and dislikes.

Rationale: Helps to identify specific needs or strengths. Consideration of individual preferences may improve dietary intake.

3. Monitor intake and ouput (I&O) and weight periodically.

Rationale: Useful in measuring effectiveness of nutritional and fluid support.

4. Investigate anorexia, nausea, and vomiting. Note possible correlation to medications. Monitor frequency, volume, and consistency of stools.

Rationale: Affects dietary choices and can identify areas for problem-solving to enhance intake of nutrients.

5. Encourage and provide for frequent rest periods.

Rationale: Helps conserve energy, especially when metabolic requirements are increased by fever.

6. Provide oral care before and after respiratory treatments.

Rationale: Reduces bad taste left from sputum or medications used for respiratory treatments that can stimulate the vomiting center.

7. Encourage small, frequent meals with foods high in protein and carbohydrates.

Rationale: Maximizes nutrient intake without undue energy expenditure from eating large meals.

8. Encourage SO to bring foods from home and to share meals with client unless contraindicated.

Rationale: Creates a more normal social environment during mealtime and helps meet personal and cultural preferences.

9. Refer to dietitian for adjustments in dietary composition.

Rationale: Provides assistance in planning a diet with nutrients adequate to meet client’s metabolic requirements, dietary preferences, and financial resources postdischarge.

10. Consult with respiratory therapy to schedule treatments 1 to 2 hours before or after meals.

Rationale: May help reduce the incidence of nausea and vomiting associated with medications or the effects of respiratory treatments on a full stomach.