Phases of Nutritional Care

Nutritional care can be defined as:

The practice of providing nutritional assistance to an individual or group, being one of the main areas of activity of the nutritionist, as it aims to guide dietary behaviors to ensure healthy eating habits and promoting improvements in quality of life. of individuals, healthy or sick (AQUINO; PHILIPPI, 2009).

For Cintra (2003), the phases of nutritional care comprise:

a) Assessment of nutritional status: information obtained from the patient, family members or companions, relating to the patient’s nutritional status, eating habits and lifestyle; to compose an initial assessment. This information is contained in the nutritional anamnesis form.

b) Analysis: careful study of all data collected for correct interpretations.

c) Planning: establishment of diet therapy goals based on the nutritional problems detected in the analysis of the information.

d) Implementation: practical feasibility of dietary planning. It requires supervision and monitoring of the other professionals involved in this stage (nutrition technicians, butlers and even nurses, as they administer the diet) to ensure proper compliance with the planned diet.

e) Evolution and monitoring: constant verification and review, if necessary, of all nutritional care.

f) Preparation for discharge: provide nutritional guidance for discharge according to the patient’s clinical and nutritional needs, without forgetting the economic, social and cultural aspects that involve this process.

The Purpose of Malnutrition Therapy:

  1. Provides energy and nutrients for preventing and overcoming hypoglycemia.
  2. Prevent and treat dehydration.
  3. Prevent and overcome deficiencies in micronutrients, vitamins, minerals and electrolytes.
  4. Restore health conditions and improve nutritional status.

Basic Principles of Nutrition Therapy in Malnutrition Children:

  • Providing fluids and food (nutritional therapy) is done regularly (for 24 hours).
  • Gradually starting from the liquid form, pulverized and solid (easily absorbed) with small portions, often and low in sodium.
  • Through a phase of stabilization, transition and rehabilitation.
  • New weight gain was assessed after administration of F 100.
  • Always monitored and evaluated.

Determining Child Nutrition Therapy, Includes 3 (Three) Phases:

Stabilization Phase

The purpose of giving food (Formula 75) in this phase is so that the child’s condition is stable and not to gain weight. Formula 75 contains 75 kcal of energy for every 100 ml of solution.

  1. Energy is given 80-100 kcal / kg BW
  2. Protein 1 – 1.5 g / kg body weight
  3. Fluid
  • Without edema or +, ++ (130ml / kg BW)
  • With severe edema +++ (100ml / kg BW)

4. In the final stage of stabilization

F 75 intervals of 3 hours (if it can be spent) à replaced F100

Transition Phase

The purpose of giving food (Formula 100) in this phase is to prepare the child to receive more fluid and energy. Formula 100 contains 100 kcal of energy for every 100 ml of solution.

  1. Fluid: 150 ml / kg body weight
  2. Energy: 100-150 kcal / kg body weight
  3. Protein: 2-3 g / kg body weight

Rehabilitation Phase

The purpose of providing food at this phase is to pursue growth, given after the child can eat given Formula 100 plus baby / child food.

  1. Energy 150-220 kcal / kg BW
  2. Protein 4-6 g / kg body weight
  3. Fluid 150-200 ml / kg BW, Fat at least 40% of total energy
  4. The form of nutrient dense food, given according to BB
  • BW <7 kg, given nutrient dense baby food / mash.
  • BB ≥ 7 kg, given nutrient-dense / soft child food.

How to Make a Formula

  1. Material Composition F-75/1000 ml:

– Skimmed milk powder: 25 g

– Granulated sugar: 100 g

– Oil: 30 g

– Mineral mix: 20 ml

– Add water to 1000 ml

  1. Composition of ingredients F-100/1000 ml:

– Skimmed milk powder: 85 g

– Granulated sugar: 50 g

– Oil: 60 g

– Mineral mix: 20 ml

– Add water to 1000 ml

Steps:

  1. Mix sugar and vegetable oil, stir until smooth.
  2. Add electrolyte / mineral mix solution .
  3. Add skim milk little by little.
  4. Dilute with warm water little by little, while stirring until homogeneous until it becomes the desired amount of liquid.
  5. This solution can be drunk directly. Cook for 4 minutes, for infants with dysentery or persistent diarrhea.

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