Nurse's Pocket Guide

imbalanced NUTRITION: more than body requirements
• Discuss smart snacks (e.g., low-fat yogurt with fruit, nuts,
apple slices with peanut butter, low-fat string cheese, etc.) to
assist client in finding healthy options.
• Collaborate with physician/dietitian/nutrition team in
creating/evaluating effective nutritional program.
• Encourage involvement in planned exercise program of
client’s choice and within physical abilities.
• Monitor individual drug regimen (e.g., appetite suppressants,
hormone therapy, vitamin/mineral supplements).
• Provide positive reinforcement/encouragement for efforts
as well as actual weight loss. Enhances commitment to
program.
• Refer to bariatric specialist for additional interventions (e.g.,
extremely low-calorie diet, surgical weight loss procedures).
NURSING PRIORITY NO.3.To promote wellness (Teaching/Discharge
Considerations):
• Discuss reality of obesity and health consequences as well as
myths client/SO(s) may have about weight and weight loss.
• Assist client to choose nutritious foods that reflect personal
likes, meet individual needs, and are within financial budget.
• Encourage parent to model good nutritional choices (e.g.,
offer vegetables, fruits, and low-fat foods at daily meals and
snacks) to assist child in adopting healthy eating habits.
• Identify ways to manage stress/tension during meals. Promotes
relaxation to permit focus on act of eating and awareness of
satiety.
• Review and discuss strategies to deal appropriately with
stressful events/feelings instead of overeating.
• Encourage variety and moderation in dietary plan to decrease
boredom.
• Advise client to plan for special occasions (birthday/holidays) by
reducing intake before event and/or eating “smart” to redistribute/reduce
calories and allow for participation in food events.
• Discuss importance of an occasional treat by planning for
inclusion in diet to avoid feelings of deprivation arising
from self-denial.
• Recommend client weigh only once per week, same time/
clothes, and graph on chart. Measure/monitor body fat when
possible (more accurate measure).
• Discuss normalcy of ups and downs of weight loss: plateauing,
set point (at which weight is not being lost), hormonal
influences, and so forth. Prevents discouragement when
progress stalls.
Information in brackets added by the authors to clarify and enhance
the use of nursing diagnoses.
486 Cultural Collaborative Community/Home Care