Imbalanced Nutrition More Than Body Requirements Nursing Diagnosis and Nursing Care Plan

Imbalanced Nutrition More Than Body Requirements Nursing Care Plans Diagnosis and Interventions

Imbalanced Nutrition More Than Body Requirements NCLEX Review and Nursing Care Plans

The prevalence rate of people who are overweight and obese is significantly increasing worldwide. These conditions can occur when caloric intake is greater than caloric expenditure.

Imbalanced Nutrition: More Than Body Requirements typically involves obesity, which is a significant risk factor in the development of cardiovascular disorders, type 2 diabetes mellitus, sleep disorders, and infertility in women. It can also aggravate musculoskeletal problems and decrease life expectancy.

Causes of  Imbalanced Nutrition: More Than Body Requirements

 Imbalanced Nutrition: More Than Body Requirements occurs when the daily energy intake is greater than energy expenditure, thus resulting in excessive weight gain. Other causes of obesity include physical inactivity, insomnia, endocrine disorders, medications, consumption of excess carbohydrates, and slow metabolism.

Related Factors to  Imbalanced Nutrition: More Than Body Requirements

Several factors are associated with  Imbalanced Nutrition: More Than Body Requirements, including:

  • genetics
  • ethnicity
  • sedentary lifestyle
  • emotional factors associated with dysfunctional eating, culture or ethnic influences on eating
  • medical conditions such as diabetes mellitus, severe hypertension, and Cushing’s syndrome
  • race – researchers found that African Americans and Hispanic individuals have higher chances of being overweight than Caucasians

Signs and Symptoms of Imbalanced Nutrition: More Than Body Requirements

 Imbalanced Nutrition: More Than Body Requirements is quantified by measuring the size of the waist, waist-to-hip ratio, and body mass index (BMI). The BMI is calculated by dividing the person’s weight in kilograms by their height in meters squared. A patient having a BMI of greater than or equal to 25 is considered overweight, while a BMI of more than 30 is considered obese.

Diagnosis of Imbalanced Nutrition: More Than Body Requirements

  • Physical assessment – essential in identifying potential problems related to imbalanced nutrition. In the diagnosis of obesity, it is important to note the patient’s exact weight, waist circumference, and BMI to obtain an accurate diagnosis. A patient having a BMI of greater than or equal to 25 is considered overweight, while a BMI of more than 30 is considered obese. Waist to hip ratio of more than 1:1 in men and more than 0:8 in women also indicate obesity.  It is also vital to acquire a thorough patient history to know if they are qualified for the nursing intervention of weight management. Adults without major health problems requiring therapy are the most appropriate patients.
  • Mental health assessment – evaluation of the patient’s psychological status in accordance with weight control and assessment of possible complications is also necessary. It is important to gauge the patient’s knowledge of a nutritious diet and assess the need for dietary supplements to develop a personalized teaching plan based on the patient’s condition.
  • Comprehensive nutritional assessment – includes the patient’s daily food intake (i.e., type and amount of food), estimated caloric intake, emotions at time of eating, activity at time of eating, location of meals, snaking patterns, meals skipped, and social/familial considerations. Assessment can be done by employing 24-hour recall, maintaining a food diary, or recording food frequency using typical food groups.

Treatment for Imbalanced Nutrition: More Than Body Requirements

Imbalanced Nutrition: More than Body Requirements can be managed through dietary modifications, behavioral interventions, medications, and surgical intervention if necessary.

However, it is worth noting that the health provider must first treat the underlying secondary causes of obesity and focus on controlling comorbidities. Maintaining a low-calorie diet which may be carbohydrate or fat restricted can be recommended. Anti-obesity medications are also available and can be administered in patients whose BMI is greater than or equal to 30 or BMI of greater than or equal to 27 with comorbidities.

An indication for surgical intervention such as gastric bypass is indicated for patients whose BMI is greater or equal to 40 or a BMI of more than 35 with severe comorbidities.

Nursing Diagnosis for Imbalanced Nutrition More Than Body Requirements 

Imbalanced Nutrition More Than Body Requirments Nursing Care Plan 1

Hypothyroidism

Nursing Diagnosis: Imbalanced Nutrition: More Than Body Requirements  related to greater intake than metabolic needs as evidenced by decreased appetite, sedentary activity level, and weight gain.

Desired Outcome: The patient will maintain a stable weight and take necessary nutrients.

Imbalanced Nutrition More Than Body Requirments Nursing InterventionsRationale
1. Evaluate the patient’s weight.Patients with hypothyroidism may gain weight due to excess fluid volume and low basal metabolic rate.
2. Evaluate the patient’s appetite.Patients with hypothyroidism have a decreased appetite. Weight gain and decreased appetite are common manifestations of hypothyroidism.
3. Create a food diary with the patient.A 24-hour food recall provides a baseline for a personalized nutritional plan in accordance to the patient’s metabolic needs.
4. Educate the patient and family regarding body weight changes in hypothyroidism.This allows the patient and the family to understand the inverse relationship between appetite and weight gain in hypothyroidism.
5. Coordinate with a dietician to determine the patient’s caloric needs.This is necessary so that the appropriate caloric requirements to maintain nutrient intake and achieve a stable weight can be calculated.
6. Encourage the patient to eat six small meals throughout the day.This ensures that the patient with decreased energy levels has adequate nutrient intake.
7. Offer assistance as needed during mealtime.This ensures that the patient has adequate nutrient intake despite decreased energy levels.
8. Encourage the patient to eat high-fiber foods.Hypothyroidism causes constipation by decreasing gastrointestinal motility.
9. Encourage the patient to adopt a diet low in cholesterol, calories, and saturated fat.Hypothyroidism makes it difficult for the body to metabolize and remove bad cholesterol from the body. Additionally, since the patient has slow metabolism, he/she requires fewer calories to support metabolic needs.  

Imbalanced Nutrition More Than Body Requirments Nursing Care Plan 2

Binge Eating Disorder

Nursing Diagnosis: Imbalanced Nutrition: More Than Body Requirements to inadequate food intake, self-induced vomiting, or chronic/excessive laxative use secondary to binge eating disorder as evidenced by a body weight 15% (or greater) below or within the accepted range, excessive hair loss, pale conjunctiva and mucous membranes, poor skin turgor/muscle tone, amenorrhea, hypothermia, bradycardia, cardiac irregularities, and hypotension.

Desired outcomes include: 

  • The patient will express understanding of nutritional needs
  • The patient will establish a dietary pattern with a caloric intake enough to adequately regain/maintain an appropriate weight.
  • The patient will demonstrate weight gain that is within the individually expected range.
Imbalanced Nutrition More Than Body Requirments Nursing InterventionsRationale
1. Monitor the patient during mealtimes and for a specified period after meals (usually one hour after meals).This would prevent vomiting episodes during or after eating.
2. Distinguish the patient’s elimination patterns.This would prevent the patient’s self-induced vomiting
3. Assess the patient’s suicide potentialWarning signs to look out for include having comorbid psychiatric symptoms and a history of sexual abuse.
4. Identify the patient’s risk of laxative, emetic, and diuretic abuseAbuse of these medications may be observed in bulimic patients.
5. Establish a minimum goal weight and daily nutritional requirementsAdequate nutrition improves the patient’s cognitive capacity. Malnutrition may influence the patient’s mood and can lead to depression, agitation, and altered mental status.
6. Maintain a consistent therapeutic approach and stimulate a pleasant environment and record intake.Maintaining a consistent approach will help in establishing rapport with the patient. This can be achieved by structuring meals and avoiding discussions about food to reduce power struggles and manipulation with the patient. Additionally, avoid any comment that may come out as coercion because the patient might detect urgency and react to pressure.
7. Provide smaller meals and supplemental snacks if necessary.This is to prevent gastric dilation which may occur if refeeding is administered too rapidly after a period of fasting or starvation dieting.

Imbalanced Nutrition More Than Body Requirments Nursing Care Plan 3

Obesity

Nursing Diagnosis: Imbalanced Nutrition: More Than Body Requirements  related to food intake that exceeds body needs, psychosocial factors, and socioeconomic status as evidenced by a weight of greater than or equal to 20% from the normal body weight, reported dysfunctional eating patterns, and a surplus of body fat as determined by skinfold measurements.

Desired outcomes include:

  • The patient will be able to identify inappropriate behaviors and consequences related to overeating or weight gain.
  • The patient will be able to establish eating pattern changes and participation in a personalized exercise program.
  • The patient will be able to display weight loss with optimal maintenance of health.
Imbalanced Nutrition More Than Body Requirments Nursing InterventionsRationale
1. Evaluate the patient’s cause of obesity.This allows the formation of an individualized choice of interventions. 
2. Record and review daily food diary indicating caloric intake, types and amounts of food, and eating habits.This provides the patient an overview of the amount of the food ingested and subsequent eating habits.
3. Investigate and discuss emotions and events associated with eating.This helps the patient differentiate if he/she is eating to satisfy an emotional need or physiological hunger.
4. Come up with a meal plan with the patient while taking note of the patient’s height, body build, age, gender, and individual patterns of eating, energy, and nutrient requirements.Maintaining a reducing diet which still contain foods from basic food groups
5. Highlight the significance of avoiding fad diets.Total elimination of essential body components can lead to metabolic disturbances. Excessive cut-off of carbohydrates from the diet can lead to fatigue, instability, headache, metabolic acidosis, and interference with the weight loss program.

Imbalanced Nutrition More Than Body Requirments Nursing Care Plan 4

Hypertension

Nursing Diagnosis: Imbalanced Nutrition: More Than Body Requirements  related to food intake that exceeds body needs and sedentary lifestyle secondary to hypertension evidenced by a weight of greater than or equal to 20% from the normal body weight, reported dysfunctional eating patterns, and a surplus of body fat as determined by skinfold measurements.

Desired outcomes include:

  • The patient will be able to identify the relationship between hypertension and imbalanced nutrition.
  • The patient will be able to establish eating pattern changes and participation in a personalized exercise program.
  • The patient will be able to display weight loss with optimal maintenance of health.
Imbalanced Nutrition More Than Body Requirments Nursing InterventionsRationale
1. Evaluate the patient’s cause of being overweight.This allows the formation of an individualized choice of interventions. 
2. Record and review daily food diary indicating caloric intake, types and amounts of food, and eating habits.This provides the patient an overview of the amount of the food ingested and subsequent eating habits.
3. Refer to the dietitian as required.A dietitian can provide expert advice on reducing weight in relation to hypertension and overeating.
4. Create a meal plan with the patient while taking note of the patient’s height, body build, age, gender, and individual patterns of eating, energy, and nutrient requirements.Maintaining a weight-reducing diet which still contains foods from basic food groups.
5. Highlight the significance of a low fat diet.Total elimination of essential body components can lead to metabolic disturbances. Excessive cut-off of carbohydrates from the diet can lead to fatigue, instability, headache, metabolic acidosis, and interference with the weight loss program.
6. Create a physical activity plan with the patient, including exercise.To ensure that the client will have a more active lifestyle.

Imbalanced Nutrition More Than Body Requirments Nursing Care Plan 5

Depression

Nursing Diagnosis: Imbalanced Nutrition: More Than Body Requirements to inadequate food intake, secondary to depression as evidenced by a body weight 15% (or greater) below or within the accepted range, verbal report of overeating, sedentary lifestyle, and low mood

Desired outcomes include: 

  • The patient will express understanding of nutritional needs.
  • The patient will understand the relationship between imbalanced nutrition/ overeating and depression.
  • The patient will establish a dietary pattern with a caloric intake enough to adequately regain/maintain an appropriate weight.
  • The patient will demonstrate weight gain that is within the individually expected range
Imbalanced Nutrition More Than Body Requirments Nursing InterventionsRationale
1. Monitor the patient during mealtimes and for a specified period after meals (usually one hour after meals).To observe the patient’s behavior of overeating as well as his/her food choices.
2. Allow the patient to discuss the reason behind depression and overeating.To understand the patient’s situation and establish rapport.
3. Discuss food choices and appropriate food amounts per food group.To educate the patient about proper food choices and the food amounts that can help lead to weight loss.
4. Talk to the patient about cognitive behavioral therapy and referral to a therapist.Cognitive behavioral therapy can help the patient to commence weight-control behaviors.
5. Establish a minimum goal weight and daily nutritional requirementsAdequate nutrition improves the patient’s cognitive capacity. Malnutrition may influence the patient’s mood and can lead to depression, agitation, and altered mental status.
6. Maintain a consistent therapeutic approach and stimulate a pleasant environment and record intake.Maintaining a consistent approach will help in establishing rapport with the patient. This can be achieved by structuring meals and avoiding discussions about food to reduce power struggles and manipulation with the patient. Additionally, avoid any comment that may come out as coercion because the patient might detect urgency and react to pressure.

Nursing References

Ackley, B. J., Ladwig, G. B., Makic, M. B., Martinez-Kratz, M. R., & Zanotti, M. (2020). Nursing diagnoses handbook: An evidence-based guide to planning care. St. Louis, MO: Elsevier.  Buy on Amazon

Gulanick, M., & Myers, J. L. (2017). Nursing care plans: Diagnoses, interventions, & outcomes. St. Louis, MO: Elsevier. Buy on Amazon

Ignatavicius, D. D., Workman, M. L., Rebar, C. R., & Heimgartner, N. M. (2018). Medical-surgical nursing: Concepts for interprofessional collaborative care. St. Louis, MO: Elsevier.  Buy on Amazon

Silvestri, L. A. (2020). Saunders comprehensive review for the NCLEX-RN examination. St. Louis, MO: Elsevier.  Buy on Amazon

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Please follow your facilities guidelines, policies, and procedures.

The medical information on this site is provided as an information resource only and is not to be used or relied on for any diagnostic or treatment purposes.

Nursing Stat Facts
Nursing Stat Facts

This information is intended to be nursing education and should not be used as a substitute for professional diagnosis and treatment.

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