NUTRITIONAL ASSESSMENT
INTRODUCTION:-
The word nutritional is derived from the word nutrias means to suckle at the breast. The
term food refers to anything which nourishes the body. It includes semisolid and liquid
which each be consumed and which help to sustain the body and keeps it healthy. Food
can be classified by chemical composition as protein, fats, carbohydrate, vitamins and
minerals. Balanced and sufficient nutritional is take most essential for children to
promote optimal growth and development to prevent and maintain health. Good
nutrition prevent malnutrition.
DEFINITION:-
Nutrition is define as combination of dynamic process by which the consumed food is
utilized for nourishment, structure and functional efficiency of every cell of the body.
1.GOMEZ’S CLASSIFICATION 196 WEIGHT FOR AGE:-
Weight for age = weight of child X 100
Weight of child of same age cm
Normal nutrition status 90% to 110%
1st degree malnutrition -95% to 89%
2nd degree malnutrition – 60% to 74%
3rd degree malnutrition – under 60%
2.WATER LOW’S CLASSIFICATION 1977
Define two groups-
S. NO. NUTRITIONAL STUNTING % WASTING % OF
STATUS OF Ht./ age Wt./Ht.
1. Normal >95% >90%
2. Mild impairment 87.5-95 80-90%
3. Moderate 80-87.5 70-80
4. impairment <80 <70.
Severe impairment
Weight for height wasting% = weight of child x100
Weight of child of same height
Height of age%= Height of child X 100
Height of normal child at same Age
1.Introduction of the patient.
My patient name is sudha. She was admitted in paediatric ward on with chief complain
of weakness dull lethargic feeling.
Biodata of patient.
Name - Ms.Sudha
Age - 5 year
Sex - Female
Date of admission - 10/12/2010
Address - Camp- 1, Supela Bhilai
I.P No. - 406903
Diagnosis - Anaemia.
Chief complain – My patient sudha is admitted in paediatric ward with chief complain
of weakness dizziness and dullness since 8 days.
Past History of illness – My patient on 22/2/ 28 with complain of fever since 5 days.
After all investigation she diagnosed as typhoid fever. She had taken treatment and after
that she was discharged.
Present History of illness – MY patient sudha is admitted in paediatric ward with
complain of weakness dizziness and dullness.
Birth History
Mother’s Condition:- During antenatal period her mother’s condition was good. She
was anaemic . She get T.T vaccination at that time.
Mode of Delivery:- My patient sudha was born by normal vaginal delivery at Distic
hospital, Durg.
Birth weight:- At the time of birth his weight was 2.9kg.
Congenital Malformation:- She was normal healthy child and no any congenital
anomalies at the time of birth.
Physical Examination
Temperature - 98.6’F
Pulse - 90/min
Respiration - 20/min
Weight -15.8kg.
Height - 108cm.
Lungs. - Clear
Abdomen - Soft
Criteria Measurement
Nutritional assessment will be based on the Anthropometric measurement.
1.Gomez’s classification 1956 for age.
Weight for age = weight of child X 100
Weight of child of same age cm
= 15.8 X 100 = 85.86%
18.4
Weight for height wasting%
= Weight of child X 100
Weight of child of same height
= 15.8 X 100 = 92.9%
17
Height of age% Stunting = Height of child X 100
Height of normal child at same Age
= 108 X 100
109.9
= 98.27%
Head & chest circumference
General Observed
Head circumference 47cm.
Chest circumference 54cm.
Remarks:-
1.According to Gomez’s classification my patient comes to under 1 st degree
malnutrition.
2.According to Water low’s classification
Shunting - Mild impairment
Wasting - Normal
Health education:-
1. Instructed to take high protein & caloric diet.
2. Advice to take iron rich diet like gram, ground nuts, palak bhaji etc.
3. Advice to maintain personal hygiene of patient.
4. Advice to take regular medicine.
5. Advice for follow up check up & to take medicine in time.
6. She should give medicine in time.
7. Teaching given about environment sanitation.
2.Introduction of my patient
My patient Pooja is admitted in paediatric ward with complaints of edema, periorbital
puffiness and reduce urine output.
Biodata of Patient
Name - Ms.Pooja
Age - 4 year
Sex - Female
Date of admission - 12/02/2011
Address - Shanti Nagar Supela Bhilai
I.P No. - 67906
Diagnosis - Nephrotic Syndrome
Chief complain – My patient Pooja is admitted in paediatric ward with chief complain
of periorbital puffiness oedema and reduce urine out put.
Past History o – My patient has no any past history of illness.
Present History – MY patient Pooja is admitted in paediatric ward with complain on
swelling of face periorbital puffiness oedema and reduce urine out put.
Birth History
Mother’s Condition:- During antenatal period her mother’s condition was good.
Mode of Delivery:- My patient Pooja was born by normal vaginal delivery at Distic
hospital, Durg.
Birth weight:- At the time of birth his weight was 2.8kg.
Congenital Malformation:- She was normal healthy child and no any congenital
anomalies at the time of birth.
Physical Examination
Temperature - 98.6’F
Pulse - 100/min
Respiration - 24/min
Weight -13kg.
Height - 95cm.
Lungs. - Clear
Abdomen - Soft
Criteria Measurement
Nutritional assessment will be based on the Anthropometric measurement.
Gomez’s classification 1956 for age.
Weight for age = weight of child X 100
Weight of child of same age cm
= 13 X 100
16
= 81.25
Weight for height wasting% = Weight of child X 100
Weight of child of same height
= 13 X 100
15
= 86.6%
Height of age%= Height of child X 100
Height of normal child at same Age
= 95 X 100 = 94.05%
101.6
Nutritional status
Wasting -Mild impairment
Stunting - Mild impairment
Clinical feature observed
Edema Present
Muscular wasting Present
Hair change not present
Lethargy dullness Present
Loss of appetite Present
Growth retardation Not present
Remark
According to Gomez’s classification my patient comes under 1st degree
malnutrition.
According to Water low’s classification
Wasting - Mild impairment
Stunting - Mild impairment
Health education
1. Advice for high protein & low salt diet.
2. Explained her mother to give small-small amount of fluid.
3. Advised for personal hygiene to wash hand before meal & after defection.
4. To take regular medication.
5. Come for following check-up as advised by physician.
6. Teaching given about environment sanitation.
7. She should give medicine in time.
8. Instruction given to take balance diet.
3.Introduction of my patient
My patient Rekha Verma is admitted in paediatric ward with complaints of dyspnea,
feeding difficulty , pale ,dizziness & tachycardia.
Biodata of Patient
Name - Ms.Rekha Verma
Age - 2 years
Sex - Female
Date of admission - 2/02/2011
Address - kavardha
I.P No. - 67999
Diagnosis - VSD
Chief complain – My patient Rekha is admitted in paediatric ward with cheif complain
of dyspnea, feeding difficulty , pale ,dizziness & tachycardia.
Past History o – My patient has no any past history of illness.
Present History – MY patient Rekha is admitted in paediatric ward with complain on
swelling of face periorbital puffiness oedema and reduce urine out put.
Birth History
Mother’s Condition:- During antenatal period her mother’s condition was good.
Mode of Delivery:- My patient Rekha was born by normal vaginal dlivery at Distic
hospital, Durg.
Birth weight:- At the time of birth his weight was 2.5kg.
Congenital Malformation:- She was normal healthy child and no any congenital
anomalies at the time of birth.
Physical Examination
Temperature - 98.6’F
Pulse - 100/min
Respiration - 24/min
Weight -10.5kg.
Height - 79cm.
Lungs. - Clear
Abdomen - Soft
Criteria Measurement
Nutritional assessment will be bassed on the Anthropometric measurement.
1. Gomez’s classification 1956 for age.
Weight for age = weight of child X 100
Weight of child of same age cm
= 10.5 X 100 = 88.98%
11.8
Weight for height wasting%
= Weight of child X 100
Weight of child of same height
= 10.5 X 100 = 92.9%
Height of age% Stunting = Height of child X 100
Height of normal child at same Age
= 79 X 100
84.5
= 93.49%
Nutritional status
Wasting - Normal
Shunting -Mild impairment
Clinical feature observed
Edema Absent
Dyspnoea Present
Tachycardia Present
Feeding difficulty Present
Loss of appetite Present
Remark
According to Gomez’s classification my patient comes under 1st degree
malnutrition.
According to Water low’s classification
Wasting - Normal
Stunting - Mild impairment
Health education
1. Advice for high protein & low salt diet.
2. When sneezing or coughing the child should cover his nose and mouth with
hanker chief.
3. Educate family members about the disease condition.
4. Explained her mother to give small-small amount of fluid.
5. Advised for personal hygiene to wash hand before meal & after defection.
6. To take regular medication.
7. Come for following check-up as advised by physician.
4.Introduction of my patient
My patient name is Mona. She is admitted in paediatric ward with complaints of fever
and breathlessness.
Biodata of Patient
Name - Ms. Mona
Age - 9 year
Sex - Female
Date of admission - 25/11/2010
Address - Durg.
I.P No. - 534408
Diagnosis - Asthma
Chief complain – My patient Mona is admitted in paediatric ward with chief complain
fever& breathlessness .
Past History o – My patient has no any past history of illness.
Present History – MY patient Mona is admitted in paediatric ward with complain on
fever & breathlessness.
Birth History
Mother’s Condition:- During antenatal period her mother’s condition was good.
Mode of Delivery:- My patient Mona was born by normal vaginal delivery at Distic
hospital, Durg.
Birth weight:- At the time of birth his weight was 3.1 kg.
Congenital Malformation:- He was normal healthy child and no any congenital
anomalies at the time of birth.
Physical Examination
Temperature - 100.6’F
Pulse - 110/min
Respiration - 26/min
Weight -26kg.
Height - 127cm.
Lungs. - Clear
Abdomen - Soft
Criteria Measurement
Nutritional assessment will be bassed on the Anthropometric measurement.
1.Gomez’s classification 1956 for age.
Weight for age = weight of child X 100
Weight of child of same age cm
= 26 X 100
28.5
= 91.2%
Weight for height wasting%
= Weight of child X 100
Weight of child of same height
= 26 X 100 = 98.11%
26.5
Height of age% Stunting = Height of child X 100
Height of normal child at same Age
= 126.5 X 100
132.2
= 95.68%
Nutritional status
Wasting -Normal
Shunting -Normal
Clinical feature observed
Edema Absent
Dyspnoea Absent
Fever Present
Breathing difficulty Present
Loss of appetite Present
Remark
According to Gomez’s classification my patient comes under normal nutrition
status.
According to Water low’s classification
Wasting - Normal
Stunting - Normal
Health education
1. Advice the patient and relatives important of personal hygiene.
2. Advice to avoid extreme heat and cold.
3. Advice to keep the child away from allergen.
4. Health education given to the parents about nutritious food.
5. Instructed the mother to take early intervention for unusual shortness of breath.
6. Advice the parents to inform physician if any complication occurs.
7. Teaching given about environment sanitation.
8. Advice given to mother that she should not give cold of water ice cream etc.
9. She should give medicine in time.
10.Advice given for follow up care and she should do regular check upp to her
child.
5.Introduction of my patient
My patient name is Zahid. He is admitted in paediatric ward with complaints of cough,
cold &fever.
Biodata of Patient
Name - Mr. Zahid
Age - 1 year
Sex - Male
Date of admission - 1/12/2010
Address - Aditya Nagar Durg.
I.P No. - 67955
Complain - cough cold & fever
Chief complain – My patient Zahid is admitted in paediatric ward with cheif complain
cough, cold & fever.
Past History o – My patient has no any past history of illness.
Present History – MY patient Rekha is admitted in paediatric ward with complain on
cough,cold and fever.
Birth History
Mother’s Condition:- During antenatal period her mother’s condition was good.
Mode of Delivery:- My patient Zahid was born by normal vaginal dlivery at Distic
hospital, Durg.
Birth weight:- At the time of birth his weight was 3 kg.
Congenital Malformation:- He was normal healthy child and no any congenital
anomalies at the time of birth.
Physical Examination
Temperature - 100.6’F
Pulse - 110/min
Respiration - 26/min
Weight - 8kg
Height - 72cm.
Lungs. - Clear
Abdomen - Soft
Criteria Measurement
Nutritional assessment will be based on the Anthropometric measurement.
1.Gomez’s classification 1956 for age.
Weight for age = weight of child X 100
Weight of child of same age cm
= 8 X 100
9.5
= 84.21%
Weight for height wasting%
= Weight of child X 100
Weight of child of same height
= 8 X 100 = 88.8%
9
Height of age% Stunting = Height of child X 100
Height of normal child at same Age
= 72 X 100
75
= 96%
Nutritional status
Wasting -Mild impairment
Shunting - Normal
Clinical feature observed
Edema Absent
Dyspnoea Absent
Fever Present
Feeding difficulty Present
Loss of appetite Present
Remark
According to Gomez’s classification my patient comes under 1st degree
malnutrition.
According to Water low’s classification
Wasting - Mild impairment
Stunting - Normal
Health education
1. Instruction given to take balance diet. Diet should include 22gm protein
100cal/kg.
2. Advised for immunization according to age or schedule.
3. Teaching given about environment sanitation.
4. Advice given to mother that she should not give cold of water ice cream etc.
5. She should give medicine in time.
6. Advice given for follow up care and she should do regular check up to her child.
Introduction of my patient
My patient name is Zahid. He is admitted in paediatric ward with complaints of cough,
cold &fever.
Biodata of Patient
Name - Mr. Zahid
Age - 1 year
Sex - Male
Date of admission - 1/12/2010
Address - Aditya Nagar Durg.
I.P No. - 67955
Complain - cough cold & fever
Chief complain – My patient Zahid is admitted in paediatric ward with cheif complain
cough, cold & fever.
Past History o – My patient has no any past history of illness.
Present History – My patient Rekha is admitted in paediatric ward with complain on
cough,cold and fever.
Birth History
Mother’s Condition:- During antenatal period her mother’s condition was good.
Mode of Delivery:- My patient Zahid was born by normal vaginal dlivery at Distic
hospital, Durg.
Birth weight:- At the time of birth his weight was 3 kg.
Congenital Malformation:- He was normal healthy child and no any congenital
anomalies at the time of birth.
Physical Examination
Temperature - 100.6’F
Pulse - 110/min
Respiration - 26/min
Weight -9.5kg.
Height - 73cm.
Lungs. - Clear
Abdomen - Soft
Criteria Measurement
Nutritional assessment will be bassed on the Anthropometric measurement.
1.Gomez’s classification 1956 for age.
Weight for age = weight of child X 100
Weight of child of same age cm
= 15.8 X 100 = 85.86%
18.4
Weight for height wasting%
= Weight of child X 100
Weight of child of same height
= 15.8 X 100 = 92.9%
17
Height of age% Stunting = Height of child X 100
Height of normal child at same Age
= 108 X 100
109.9
= 98.27%
2. Gomez’s classification 1956 for age.
Weight for age = weight of child X 100
Weight of child of same age cm
Nutritional status
Wasting
Shunting
Clinical feature observed
Edema Absent
Dyspnoea Absent
Fever Present
Feeding difficulty Present
Loss of appetite Present
Remark
According to Gomez’s classification my patient comes under ......... degree
malnutrition.
According to Water low’s classification
Wasting
Stunting
Health education
1. Instruction given to take balance diet. Diet should include 22gm protein
100cal/kg.
2. Advised for immunization according to age or schedule.
3. Teaching given about environment sanitation.
4. Advice given to mother that she should not give cold of water ice cream etc.
5. She should give medicine in time.
6. Advice given for follow up care and she should do regular check upp to her
child.
SANDIPANI ACEDEMY
PENDRI (MASTURI) BILASPUR C.G.
M.Sc. NURSING 1ST YEAR
SUBJECT :- CHILD HEALTH NURSING
NUTRITIONAL ASSESSMENT
SUBMITTED TO :- SUBMITTED BY:-
MRS R. S. RAMYA RUBINA RASHMI MASIH
M.Sc. NURSING 1st YEAR
