Description:

Form from HIS OpenVistA

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  1. 2/17/12
  2. 5/24/17
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May 24, 2017

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License:
Creative Commons BY-NC 3.0 Legacy
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HIS

  1. StudyEvent: HIS
    1. HIS
INTAKE
Hypermetabolism (Increased energy needs)
Hypometabolism (Decreased energy needs)
Inadequate energy intake
Excessive energy intake
Inadequate oral food/beverage intake
Excessive oral food/beverage intake
Inadequate intake from enteral/parenteral nutrition
Excessive intake from enteral/parenteral nutrition
Inadequate infusion of enteral/parenteral nutrition
Inadequate fluid intake
Excessive fluid intake
Inadequate bioactive substance abuse
Excessive bioactive substance intake
Excessive alcohol intake
Increased nutrient needs-(specify)
Evident protein energy malnutrition
Inadequate protein-energy intake
Decreased nutrient needs-(specify)
Imbalance of nutrients
Inadequate fat intake
Excessive fat intake
Inappropriate intake of food fats-(specify)
Inadequate protein intake
Excessive protein intake
Inappropriate intake of amino acids-(specify)
Inadequate carbohydrate intake
Excessive carbohydrate intake
Inappropriate intake of types of carbohydrates
Inconsistant carbohydrate intake
Inadequate fiber intake
Excessive fiber intake
Inadequate vitamin intake-(specify)
Excessive vitamin intake of:
Excessive dietary intake of vitamin A
Excessive dietary intake of thiamine
Excessive dietary intake of riboflavin
Excessive dietary intake of niacin
Excessive dietary intake of folate
Excessive dietary intake of vitamin C
Excessive dietary intake of vitamin D
Excessive dietary intake of vitamin E
Excessive dietary intake of vitamin K
Inadequate mineral intake of:
Calcium
Potassium
Iron
Zinc
Excessive mineral intake of:
Calcium
Potassium
Iron
Zinc
CLINICAL
Swallowing difficulty
Chewing (masticatory) difficulty
Breastfeeding difficulty
Altered GI function
Impaired nutrient utilization
Altered nutrition-related laboratory values
Food-medication interaction
Underweight
Involuntary weight loss
Overweight/obesity
Involuntary weight gain
BEHAVIORAL-ENVIROMENTAL
Food- and nutrition-related knowledge deficit
Harmful beliefs/attitudes about food-or
nutrition related topics(use with caution)
Not ready for diet/lifestyle change
Self-monitoring deficit
Disordered eating pattern
Limited adherance to nutrition related recommendations
Undesirable food choices
Physical inactivity
Excessive exercise
Inability or lack of desire to manage self-care
Impaired ability to prepare foods/meals
Poor nutrition quality of life
Self-feeding difficulty
Intake of unsafe food
Limited access to food
Nutritional Status
Nutritional Status (Comfort measures only - follow as needed)
FOOD AND/OR NUTRIENT DELIVERY
General/healthful diet
Modify distributions, type, or amount of food and nutrients within meals or at specified time
Specific foods/beverage or groups
Initiate enteral or parenteral nutrition
Modify rate, concentration, composition or schedule
Discontinue enteral or parenteral nutrition
Insert enteral feeding tube
Site Care
SUPPLEMENTS
Commercial beverage
Commercial food
Modified beverage
Modified food
Multivitamin / mineral
Vitamin
Thiamin
Riboflavin
Niacin
A
C
D
E
K
Folate
Multivitamin
Mineral
Calcium
Potassium
Iron
Zinc
Phosphorus
Magnesium
Multi-trace elements
Nutrition interventions
Initiate
Dose change
Form change
Route change
Administration schedule
Adaptive equipment
Feeding position
Meal set-up
Mouth Care
Lighting
Odors
Distraction
Table height
Table service / setup
Room temperature
NUTRITION EDUCATION
NUTRITION COUNSELING
Behavior modification
Cognitive-behavioral theory
Social learning theory
Transtheoretical
Strategies
Cognitive restructuring
Goal setting
Motivational interviewing
Problem solving
Rewards/reinforcement
Self-monitoring
Social support
Stimulates control / contingency management
Stress management
Phase
Involving
Exploring
Resolving
Closing
COORDINATION OF NUTRITION CARE
Team meeting
Referral to RD with different expertise
Collaboration/referral to other providers
Referral to community agencies / program
PES STATEMENTS
MONITOR & EVALUATION