Modification of levels of nutrients

Elimination of specific foods

An individual’s nutritional care consists of the following four essential elements: assessment, planning, implementation, and evaluation. All of these elements are necessary for the successful provision of effective health care. Assessment provides the health care team with an estimate of the patient’s nutritional status upon admission and provides a basis for planning diet therapy during hospitalization. Dietary implementation and monitoring guide the health care team in evaluating and adjusting both optimal calorie and nutritional intake. These contribute to the patient’s total care by reducing tissue healing time, decreasing susceptibility to infection, and providing for an optimal physical and biochemical status.

To summarize briefly, the overall objectives of planned and implemented diet therapy are to:

Prevent nutritional deficiency

Improve and maintain the very best nutritional status

Aid the maintenance and re-establishment of a positive state of well-being in persons with a medical or physical problem

Identify problems associated with over nutrition and undernutrition and decide when these problems put a patient at a high nutritional risk.

THE MEDICAL PATIENT

For purposes of this discussion, the term medical patient will be considered as any person who is receiving diagnostic, therapeutic, and supportive care for a condition that is not managed by surgical, orthopedic, psychiatric, or maternity-related therapy. This is not to infer that patients in these other categories are not treated for medical problems. Many surgical, orthopedic, psychiatric and maternity patients do have secondary medical problems that are treated while they are undergoing management for their primary condition. Although many medical problems can be treated on an outpatient basis, this discussion will address the hospitalized medical patient. It should be noted that the basic principles of management are essentially the same for both the inpatient and outpatient.

The medical management of the patient generally consists of laboratory and diagnostic tests and procedures, medication, food and fluid therapy, and patient teaching. Additionally, for many medical patients, particularly during the initial treatment phase, rest is a part of the prescribed treatment.

TEST AND PROCEDURES

A variety of laboratory and diagnostic tests and procedures are commonly ordered for the medical patient. Frequently, the hospital corpsman is assigned to prepare the patient for the procedure, collect the specimens, or assist with both the procedure and specimen collection. Whether a specimen is to be collected or a procedure is to be performed, the patient needs a clear and simple explanation about what is to be done and what the patient can do to assist with the activity. Often the success of the test or procedure is dependent upon the patient’s informed cooperation. When collecting specimens, the hospital corpsman must complete the following:

Collect the correct kind and amount of specimen at the right time.

Place the specimen in the correct container.

Label the container completely and accurately. This often differs somewhat for each facility and local policies should be consulted.

Complete the laboratory request form accurately.

Record on the patient’s record and other forms, as appropriate, the date, time, kind of specimen collected, the disposition of the specimen, and anything unusual about the appearance of the specimen or the patient during the collection.

When assisting with a diagnostic procedure, the hospital corpsman must understand the sequence of steps of the procedure and exactly how his or her assistance can best be provided. Since many procedures terminate in the collection of a