The three-part nursing diagnosis statement is also called the PES format which includes the Problem, Etiology, and Signs and Symptoms. Updated International Dysphagia Diet Standardisation Initiative (IDDSI) information is included in the appendix. Health promotion nursing diagnoses are usually written as one-part statements because related factors are always the same: motivated to achieve a higher level of wellness though related factors may be used to improve the of the chosen diagnosis. Inconsistent carbohydrate intake (NI-5.8.4) Altered gastrointestinal function (NC-1.4) Disordered eating pattern (NB-1.5) RELATIONSHIPS Assessment Diagnosis Intervention Monitor/Eval Problem Etiology Signs/Symptoms Sample:Excessive Mineral(po4) intake related to overconsumption of a limited variety of Recent data demonstrate that dysphagia is mostly persisting and that its presence is independently associated with adverse patient-centered clinical outcomes. PES FORMAT. This article serves as a beginners guide on how to confidently conduct a thorough NFPE. 2J=_r=9j#"X)8Z%
-A >jlgsr2h"USZb 5"xN*s=M~IO`dHX~P[[m~L,?Hm3%+$e"Jy"#g#'yt[. (c;U *NOTE: the above PES statement includes "dysphagia" because it is officially documented in their medical history by a speech pathologist. It has been shown that PES can restore safe swallowing in orally intubated or tracheotomized ICU patients with neurogenic dysphagia following severe stroke. The goal of the intervention should be fixing the nutrition diagnosis, addressing the root cause (or etiology) of the nutrition diagnosis, AND reducing the signs/symptoms. Inadequate mineral intake (specify) (NI-5.10.1) Three substances that take an active role in production of gastric juices include: Enterochromaffin-like cells, G cells, Lq@FTY}X6xYp'"]JbnGmggGtAFbm! Zenker's Diverticulum. Stage in critical care specialists in principles of epidemiology in clinical assessment for the pes! Inability to manage self-care (NB-2.3) .U@5=exWtV=|X ze
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^-\OI\|u^+:7/&j'sZ7|Y!pc- h9B 2009, Humbert, McLaren et al. Dysphagia occurs as food and fluids enter into the airway. The E in the PES Statement stands for Etiology. Lets look an an example of a PES Statement: "Excessive Energy Intake (Problem) related to frequent consumption of high-calorie meals and snacks (Etiology), as evidenced by daily caloric intake exceeding estimated energy needs by 750 kcal and 16 lb weight gain in past 3 months (Signs/symptoms).". The PES statement is part of the Nutrition Care Process (NCP), a systematic approach to providing high-quality nutrition care. Posterior tongue retraction Brainstem disinhibition 3. Retrieved from: https://www.andeal.org/vault/2440/web/files/EAL/NCP_EAL_201711.pdf Accessed August 9, 2019. study was to assess the real-world effect of PES on dysphagia severity (assessed using the validated dysphagia severity rating scale, DSRS [ 4 , 6 ]) in patients with neurogenic dysphagia. Diabetic Diet: Does It Have a Place in Nursing Homes? Third, dysphagia severity was reduced in all groups suggesting that PES is effective in multiple different causes of neurogenic dysphagia. x[qSIlKReS)uC"?PW[I>P>R?7\qL osA?4ln{~y|pMiVjZo]eVMvn_6^O?G~Xn-]iaE:xM]/j vYQ:\7Cs4]&zyJ^y- e~;,mUwr"kjLuweFc}}G:rsK%Wa$y3'nqm?bd[m5mr7y!oFKZnnn;E-[-{z;mpO_\F2 =
~f]xcz\wMO1reMLY~0/j 1) Poor nutrition choices and intake related to dietary intake as evidenced by the dietary recall and high BMI. This category covers calorie/energy balance, fluid and nutrient intake, and intake of oral supplements, nutrition support, or bioactive substances. 97 0 obj
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PES FORMAT. The PES statement describes the nutrition problem, its root cause, and evidence for the diagnosis. There are approximately 70 of these nutritional diagnostic terms that cover three domains: FOOD AND/OR NUTRIENT INTAKE. PES Statements: Example P: Less than optimal enteral (or parenteral) nutrition composition or modality: The nutrient components or delivery is inconsistent with evidenced-based practices. The etiology describes the cause of the nutrition diagnosis in the PES statement. STATEMENTS PES FORMAT Problem(P)-some alteration in nutritional status Etiology(E)-cause or contributing risk factors "related to" Signs/symptoms(S)-defining characteristics of the problem " As evidenced by" The individualized nutrition care plan is based on information gathered by the comprehensive nutrition assessment and additional nutritional assessments. Inadequate mineral intake (specify) (NI- 5.10.1) inconsistent carbohydrate intake) are different from medical diagnosis (ex. This article explains the causes, symptoms and risk factors of refeeding syndrome, as well as information on how its typically treated. A PES statement is a nutrition diagnosis used in a clinical setting. Check out the blog archives for disease-specific PES statement examples. Nutrition intervention was defined as any type of intervention for children aged <5 years to improve their overall nutritional status. Title: Case 23 - Ischemic Stroke Instructions: Answer the questions below. PES Format The format of the PES statement is Problem (the nutrition diagnosis) related to Etiology (the root cause of the nutrition diagnosis) as evidenced by Signs and Symptoms (findings from the nutrition assessment that determine the nutrition diagnosis). It connects to the nutrition diagnosis by the words related to. %%EOF
Excessive fat intake (NI-5.5.2) NEW! Dysphagia PES Statement Example: Swallowing difficulty RT history of esophageal stricture AEB observed coughing and choking while eating and SLP evaluation. In these situations particularly those that pose a risk to the residents health or safety, such as the refusal of thickened liquids the nutrition care plan should identify the care or service being declined, the risk associated with that choice, and efforts made by the IDT to educate the resident and representative, if applicable. Interventions should be specific stating what, where, when, and how. Module 17 - Domain II: Determine Specific Feeding Needs, Nutrition Monitoring & Evaluation After reviewing Module 17 lecture, you should be able to: Determine specific feeding needs. Problem, Etiology, Signs and Symptoms=Nutrition Diagnosis, 1) Inadequate protein and energy intake related to increased nutrient needs as evidenced by impaired skin integrity, 2) At risk for weight loss and malnutrition related to frequent COPD exacerbations as evidenced by PO intake <50% of estimated nutrient needs, 3) Inadequate oral intake related to intakes less than 50% of estimated nutrient needs as evidenced by dislike of a prescribed mechanically altered diet, 4) Moderate malnutrition related to intakes meeting <50% of estimated nutrient needs x >7 days as evidenced by weight loss > 5% in 30 days, functional decline, and visual appearance of loss of subcutaneous fat and muscle wasting at temple and orbital regions, 5) Mild malnutrition related to a recent decline in PO intakes and difficulty swallowing as evidenced by 5.7% weight loss in 30 days, functional decline, and slight indentation at the temples, 6) Fluctuating blood sugars related to excessive carbohydrate intake as evidenced by inconsistent timing of meals and increased snacking, 7) Severe malnutrition related to intakes < 75% EEE for > 1 month as evidenced by 17% weight loss in 7 months, functional decline, and severe fat/muscle wasting at: temples, orbitals, triceps, and buccal fat pads, 8) Swallowing difficulty related to recent CVA as evidenced by a diagnosis of aspiration pneumonia, 9) Inadequate protein intake related to the increased need for high quality-protein as evidenced by CKD 4 diagnoses, 10) At risk for weight loss and malnutrition related to altered GI function as evidenced by frequent diarrhea and IBS diagnosis, 11) Excessive energy intake related to increased snacking as evidenced by weight gain of 12% in 180 days, (Numbers 2 and 10 are at risk PES Statements).
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