NUTRITIONAL ASSESSMENT
INTRODUCTION:-
The word nutrition is derived from the word “nutricus” which
means to suckle at the breast. Nutrition is defined as combination of dynamic process by
which the consumed food is utilized for nourishment and structural and functional efficiency
of every cell of the body. It is the science of food and its relationship to health. The term food
refers to anything which nourishes the body. It includes solid, semisolids and liquids which
can be consumed and which help to sustain the body and keep it healthy. Food and nutrition
are different and having different meaning. Food is defined as what one feed on and is a
composite mixture of many nutrient substances ranging from a fraction of a gram in some
cases to hundred of grams in others. Food stuff is defined as anything which can be used for
food. Balanced and sufficient nutritional intake is most essential for children to promote
optimal growth and development to protect and maintain health. To prevent nutritional
deficiency conditions and various illness.
DEFINITION: -
Nutrition is defined as combination of dynamic process by which the
consumed food is utilized for nourishment, structure and functional efficiency of every cell of
body.
CRITERION MEASUREMENT:-
Nutritional assessment will be based on the
anthropometric measurement in different grades of nutrition by using different method of
classification.
1) GOMEZ ‘S CLASSIFICATION (1956) WEIGHT FOR AGE:
weight of child
Weight for age% = *100
Weight of child of same age (ICMR)
Normal nutritional status 90% to 110%
1st Degree malnutrition 75% to 89%
2nd Degree malnutrition 60% to 74%
3rd Degree malnutrition Under 60%
2) WATERLOW’S CLASSIFICATION (1977) DEFINES TWO GROUPS:
Weight for height(wasting%) = weight of child *100
Weight of child of same height (ICMR)
Height for age (shunting%) = height of child *100
Height of normal child of same age
Nutritional status Shunting Wasting
Normal >95 >90
Mild impairment 87.5-95 80-90
Moderate impairment 80-87.5 70-80
Severe impairment <80 <70
3) MALNUTRITION GRADING BY MID ARM HEAD CIRCUMFERENCE RATIO
BY KANAWATI AND MC LAREN (1970)
Healthy> 0.311, Mild 0.310-0.280, Moderate 0.279-0.250, Severe<0.250
The standards of Indian council of Medical Research (ICMR 1984) have been used for
referral value of all anthropometric measurements.
1) INTRODUCTION:
My patient Arushi has been admitted in Indus hospital on
16/5/2024 at 10 am with complaints of diarrhea, low grade fever and vomiting.
BIODATA
Name :- Arushi
Age :- 1yr
Sex :- Female
Religion :- Hindu
OPD no. :- 459950
IPD NO. :- 303232
Address :- House no. Q-36, murlipura, jaipur
Bed no :- 6
DOA :- 16/05/2024
Diagnosis :- Diarrhea
CHIEF COMPLAINT:
My patient Arushi is admitted in pediatric ward with chief
complaint of diarrhea, low grade fever and vomiting.
PAST HISTORY:
My patient has no any past history of illness.
PRESENT HISTORY:
My patient Arushi is admitted in pediatric ward with complaint
of diarrhea, low grade fever and vomiting.
FAMILY HISTORY:
There are 3 members in my patient’s family. Her mother, father and
her self.
BIRTH HISTORY:
Mother’s condition: - During antenatal period her mother’s condition
was good.
Mode of delivery: - My patient Arushi was born by normal vaginal
delivery at Indus hospital
Birth weight: -At time of birth her weight was 3.5kg
Dietary pattern: - Vegetarian
Immunization history: - Received all vaccine up to age of 1 yr
Developmental history is normal up to the corresponding age.
Congenital malformation: - She was normal healthy child and no any
congenital anomalies at the time of birth.
PHYSICAL EXAMINATION:
Temp. : 990F
Pulse : 120b/min
Resp : 28breaths/min
BP : 94/78mm of Hg
Skin : Dehydrated
Posture : Normal
Chest : Normal
Lungs : Bilateral air entry
Abdomen: Stomachache due to diarrhoea
Dependency level of patient: fully dependent.
Wt : 8.6kg
Ht : 74cm
Hc : 45cm
Cc : 46cm
1) GOMEZ ,S CLASSIFICATION (1956) WEIGHT FOR AGE:
weight of child
Weight for age % = *100
. Weight of child of same age (ICMR)
8.6kg *100
9.5
= 90.53%
2) WATERLOW’S CLASSIFICATION (1977) DEFINES TWO GROUPS:
Weight for height(wasting%) = weight of child *100
Weight of child of same height (ICMR)
= 8.6kg *100
11.8
= 72.88%
Height for age(shunting%) = height of child *100
Height of normal child of same age
= 74 *100
75
= 98.67%
Normal Observed
Head circumference 45cm 45cm
Chest circumference 47.5cm 46cm
REMARK:
Nutritional status of my child is normal according to Gomes’s classification
and waterlow`s classification wasting is moderately impaired but shunting is normal. My
patient’s head and chest circumference is appropriate according to age.
CLINICAL MANIFESTATION:
Growth retardation: Not observed
Muscle vesting with retention of subcutaneous fat: Not observed
Dullness & loss of appetite: Observed in my patient
Pitting edema over per orbital region: Not observed
Thin light colored hair: Not observed in my patient
Gross wasting of muscles with subcutaneous tissue: Not observed
Dry skin with prominent loose folds : Not observed
HEALTH EDUCATION:-
PERSONAL HYGIENE:
Advice to maintain personal hygiene like daily bath, hand washing before and after
meal, cutting nails etc
DIET:-
Instructed to take high protein & caloric diet.
Advice to take iron rich diet like gram, spinach, nuts.
Advice to improve dietary habit with locally available, low cost food items for
balanced diet.
MEDICATION:
Advice to take regular medicine if prescribed.
Immunization against vaccine preventable disease.
FOLLOW UP CARE:
Advice for follow up check up and to take medicine in time.
ENVIRONMENTAL SANITATION:
Teaching given on environmental sanitation.
BIBLIOGRAPHY:-
1) Vishwanathan J and Desai A b (1989) “Achar’s Textbook of pediatrics”, 3rd edition, by
orient longman, Pp-315,316.
2) Ghai OP,(1996),”text book of essesstial of pediatric”, by OP ghai, Pp-206,207
3) Datta Parul,(2007), “textbook of pediatric” , 1st ed, Jaypee brothers medical
publisher (p) ltd, Pp189,190,191.
4) Park K. Preventive and social medicine.20th edition. Jabalpur : Banarsidas
Bhunot;2009.p.575-576
5) Lal Sundar.Text book of community health nsg.2nd ed. Chennai:CBS
publisher;2009.p.145-147
