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Nursing 1160 Nursing Skills 1

Unit 12
Assisting with Nutrition

Threads: Decision Making and Patient Safety

Class Concepts: Safety, Asepsis (medical), Assessment, and Therapeutic Modalities

Competencies in the Context of Entry-level Registered Nurse Practice in British Columbia reflected in this
Learning Activity include, but are not limited to the following competencies. Please refer to the College of
Registered Nurses (www.crnbc.ca ) for a complete list of the updated entry level competencies.

Standards (2012) Competencies (2015)

Professional Responsibility
and Accountability; Self
Regulation
1. Is accountable and accepts responsibility for own actions,
decisions, and professional conduct.
25. Demonstrates quality assurance activities for continuing
competence and preparedness to meet regulatory requirements by:
assessing own practice and level of competence to identify
learning needs;
developing a learning plan using a variety of sources (e.g.,
self-assessment, literature, peer and client feedback);
seeking and using new knowledge that may enhance,
support, or influence competence in practice; and
implementing and evaluating the effectiveness of own
learning plan/and developing own future
learning/professional development plans to maintain and
enhance own competence as a registered nurse.

Knowledge-Based Practice 37. Uses appropriate assessment tools and techniques in

consultation with clients and the health care team, including
individuals, families, groups, communities and populations.

39. Collects information on individual client status using assessment

skills of observation, interview, history taking, interpretation of
laboratory data, mental status assessment, and physical
assessment.

42. Analyzes and interprets data obtained in client assessments to

draw conclusions about client health status.

68. Applies bio-hazard and safety principles, evidence-informed

practices, infection prevention and control practices, and appropriate
protective devices when providing nursing care to prevent injury to
clients, self, other health care workers, and the public.

71. Performs therapeutic interventions safely (e.g., positioning, skin

and wound care, management of intravenous therapy and drainage
tubes, and psychosocial interaction).
Ethical Practice 94. Promotes a safe environment for clients, self, health care
workers, and the public that addresses the unique needs of clients
within the context of care.

Created by W. Low 201410. Revised W. Low 201430, 201510, 201530, 201630.

Date of Implementation 201410 Date of Next Review 201720

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OVERVIEW

Adequate food and fluid intake are an important part of maintaining life. Factors such as
age, culture, health status, and socioeconomic status affect nutrition. In a health
promotion perspective, nurses assist with nutrition through teaching in various contexts
such as elementary schools, community care facilities, or hospitals. Usually, adults who
are in community care facilities or hospitals can provide self care activities such as
feeding themselves. At times, they are unable to feed themselves as related to their
health challenges. To help meet their nutritional need, nurses assist or feed individuals
and incorporate techniques to promote their appetite or eating, prepare food and/or
utensils for eating, and assist with menu planning. This learning activity focuses on the
assessment of clients who have swallowing and eating challenges, taking into account
positioning for meals and assisting with meals or feeding.

LEARNING OUTCOMES

1. To discuss the major foods and nutrients required for a healthy diet.
2. To describe physical, social, and psychological factors or changes that influence
individuals who require assistance with nutrition.
3. To apply the principles of assessing clients who need assistance to eat or be fed,
including a swallowing review.
4. To appraise normal/expected and abnormal/unexpected findings of individuals who
require assistance with nutrition.
5. To illustrate the process of preparation to completion for nurses who assist or feed
clients.
6. To apply nursing knowledge and skill for assisting or feeding, using the Critical
Components of a Skill.
7. To describe common therapeutic diets that may be prescribed to promote health and
healing.
8. To outline the documentation required after assisting or feeding clients.

IN PREPARATION

Class
1. Review the following:
a. Anatomy and physiology associated with the mechanics of swallowing and eating
and
b. Canada's Food Guide.

Created by W. Low 201410. Revised W. Low 201430, 201510, 201530, 201630.

Date of Implementation 201410 Date of Next Review 201720

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2. Read the following:

a. Weaver, K. (2014). Nutrition. In Potter, P., Perry, J., Ross-Kerr, J., Woods, M.,
Astle, B. and Duggleby, W. Canadian fundamentals of nursing (5th ed.). Toronto:
Mosby Elsevier.
Ch 42 Nutrition Assisting Patients with Feeding

b. Jarvis, C., Browne, A., MacDonald-Jenkins, J., & Luctkar-Flude, M. (2014).

Physical examination and health assessment (2nd Canadian ed.). Toronto:
Elsevier. Canada
Chapter 12 Nutritional Assessment and Nursing Practice

3. The schedule identifies the audio visual (AV) aids that must be watched PRIOR to
class.

4. Complete the following focus questions:

Focus questions from a learning activity created by Term 2 200610. Revised by S. Liversidge 200830, Dr. S. Ronaldson
201020, S. Liversidge 201130, and W. Low 201410.

a. Describe the major nutrients required for healthy nutrition.

b. Identify the group of individuals who are at most risk for a change in their
nutritional status. Explain.
c. Define:
i. basal metabolic rate (BMR),
ii. basal metabolic index (BMI),
iii. resting energy expenditure (REE),
iv. nutrient density,
v. nitrogen balance
vi. glucose,
vii. essential amino acids,
viii. anabolism,
ix. glycogenesis,
x. catabolism,
xi. gluconeogenesis,
xii. glycogenolysis,
xiii. ketones,
xiv. dysphagia,
xv. anorexia,
xvi. dehydration,
xvii. malnutrition,
xviii. obesity,
xix. xerostoma,
xx. diarrhea,
xxi. constipation,
xxii. functional assessment.
xxiii. aspiration.
Created by W. Low 201410. Revised W. Low 201430, 201510, 201530, 201630.

Date of Implementation 201410 Date of Next Review 201720

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d. Explain why a high level of cholesterol is considered to be a health risk.

e. Explain why water is considered to be a critical component of the body.
f. Identify the group of individuals who have the greatest and least amount of body
water.
g. Explain why hydration levels are affected by illness.
h. Identify the components and expected findings of a nutritional assessment.
i. Describe the normal age-related nutritional changes in the elderly.
j. Describe how food and fluid intake may be modified during the management of
illnesses.
k. Describe therapeutic diets.
l. Identify factors that may influence the client during a nutritional assessment and
assistance with a meal.
m. Describe the characteristics of individuals who are most at risk for aspiration.
n. Describe the components of a swallowing assessment.
o. Explain the preparation of clients and nurses before clients are assisted or fed
their meals.

5. Bring:
a. pudding for a snack,
b. juice or water, and
c. small towel.

ATI
N/A

IN CLASS/PRACTICE/NSC/D2L

Participate in class discussion about the assessment of clients who require assistance
with nutrition. In addition, discuss techniques used to assist or feed individuals to meet
their nutritional needs.

IN REFLECTION

Food fuels the body. Many individuals are able to feed themselves; some are unable to
do this activity of daily life. What assessment indicates that individuals required
assistance to eat?

What feelings did you experience when your peer-nurse fed you? What was helpful or
not helpful during the feeding? What is your take-home-message to support clients that
require assistance to maintain their nutritional needs?

Created by W. Low 201410. Revised W. Low 201430, 201510, 201530, 201630.

Date of Implementation 201410 Date of Next Review 201720

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REFERENCE

College of Registered Nurses of British Columbia. (2015). Competencies in the context

of entry-level registered nurse practice in British Columbia. Vancouver, BC:
Author.

College of Registered Nurses of British Columbia. (2012). Professional standards for

Registered nurses and nurse practitioners (Publication No. 128). Vancouver:
Author.

Jarvis, C., Browne, A., MacDonald-Jenkins, J., & Luctkar-Flude, M. (2014). Physical
examination and health assessment (2nd Canadian ed.). Toronto: Elsevier.
Canada

Potter, P., Perry, J., Ross-Kerr, J., Woods, M., Astle, B. and Duggleby, W. (Eds.)
(2014). Canadian fundamentals of nursing (Rev., 5th ed.). Toronto: Mosby
Elsevier.

Created by W. Low 201410. Revised W. Low 201430, 201510, 201530, 201630.

Date of Implementation 201410 Date of Next Review 201720