imbalanced Nutrition: Less than Body Requirements | Nursing Care Plan for Inflammatory Bowel Disease

Nursing diagnosis: imbalanced Nutrition: Less than Body Requirements related to

Altered absorption of nutrients

Hypermetabolic state

Medically restricted intake; fear that eating may cause diarrhea

Possibly evidenced by

Weight loss, decreased subcutaneous fat and muscle mass, poor muscle tone

Hyperactive bowel sounds, steatorrhea

Pale conjunctiva and mucous membranes

Aversion to eating

Desired Outcomes/Evaluation Criteria—Client Will

Nutritional Status

Demonstrate stable weight or progressive gain toward goal with normalization of laboratory values and absence of signs of malnutrition.

Nursing intervention with rationale:

1. Assess weight, age, body mass, strength, and activity and rest levels. Ascertain stage of disease process and its effects on client’s nutritional status.

Rationale: Provides comparative baseline.

2. Inspect oral mucosa.

Rationale: May reveal ulcerations and/or provide information about the integrity of the entire GI tract, affecting ability to eat and absorb nutrients.

3. Evaluate client’s appetite.

Rationale: Appetite may be suppressed because of altered taste, early satiety, meal-related cramping, diarrhea, or a combination of these factors.

4. Weigh frequently.

Rationale: Provides information about dietary needs and effectiveness of therapy.

5. Encourage bedrest or limited activity during acute phase of illness.

Rationale: Decreasing metabolic needs aids in preventing caloric depletion and conserves energy.

6. Recommend rest before meals.

Rationale: Quiets peristalsis and increases available energy for eating.

7. Provide oral hygiene.

Rationale: A clean mouth can enhance the taste of food.

8. Serve foods in well-ventilated, pleasant surroundings, with unhurried atmosphere and congenial company.

Rationale: Pleasant environment aids in reducing stress and is more conducive to eating.

9. Avoid or limit foods that might cause or exacerbate abdominal cramping and flatulence—milk products, foods high in fiber or fat, alcohol, caffeinated beverages, chocolate, peppermint, tomatoes, and orange juice.

Rationale: Individual tolerance varies, depending on stage of disease and area of bowel affected.

10. Provide nutritional support, for example: Enteral feedings, such as Ultra Clear Plus via nasogastric (NG) tube, percutaneous endoscopic gastrostomy (PEG), or J-tube

Rationale: Many clinical studies have shown early enteral feeding is beneficial in reducing the effects of malabsorption and providing essential nutrients. Although elemental enteral solutions cannot provide all needed nutrients, they can prevent gut atrophy.