Nursing Assessment of Nutritional & Gastrointestinal Status

Lesson Transcript
Instructor: Sarah Lawson

Sarah has taught nursing courses and has a master's degree in nursing education.

Nurses conduct an assessment of a patient's gastrointestinal status and health through lengthy conversation in the form of an examination. Learn how the health and nutritional history of a patient is collected to assess their nutritional and gastrointestinal status. Updated: 11/23/2021

Health History Assessment

Nursing is a very diverse field of work. Nurses are able to work in many different settings, including hospitals, doctor's offices, schools, clinics, and in the community. No matter in what setting a nurse chooses to work, they need to be knowledgeable in assessment skills. In this lesson, you will learn about obtaining health information from patients through health history and nutritional and gastrointestinal assessments.

A health history assessment is an interview with the patient about their past and current lifestyle and is used to determine their health status. It is important to assess the psychosocial, ethnic, and cultural background of the patient while obtaining a health history. The physical environment and activities of daily living, including details about lifestyle, are discussed. The nurse also assesses current health problems, medical history, and family history. This is a great time to get to know a patient. Patients that trust their healthcare providers and know they truly care about them are much more likely to give thorough and truthful information.

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  • 0:05 Health History Assessment
  • 1:06 Nutritional Assessment
  • 4:33 Gastrointestinal Assessment
  • 6:37 Lesson Summary
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Nutritional Assessment

Good nutrition is important to everyone's health, and nutrition is thus an important part of the health history assessment. Many disorders can be caused by nutritional deficiency, overeating, or eating unhealthy meals. These behaviors can lead to major illnesses, such as heart disease, cancer, and stroke. The nutritional assessment focuses on examining a patient's nutritional status and providing information about obesity, weight loss, malnutrition, deficiencies in specific nutrients, metabolic abnormalities, effects of medications on nutrition, and other specific problems affecting the patient.

During the nutritional assessment, it is important to visually assess the appearance of the patient. Certain signs and symptoms are suggestive of nutritional deficiency, such as muscle wasting and poor skin integrity. Other signs may indicate other conditions; for example, truncal obesity may be a sign of an endocrine disorder called Cushing's disease.

Information that is necessary to obtain during the nutritional assessment includes body mass index (BMI), waist circumference, biochemical measurements, clinical examination findings, and dietary data.

The body mass index (BMI) is a ratio based on the patient's body weight and height. A patient's BMI can be calculated using the following formula: BMI = 703 * weight in pounds / (height in inches)^2. Typically, a BMI of 18 to 24 is considered normal, 25 to 29 is overweight, 30 to 39 is obese, and 40 and above is extremely obese.

Biochemical assessment is the study of a patient's nutritional status by examining their blood and urine. Specific studies include the serum (albumin, transferrin, retinol-binding protein, electrolytes, hemoglobin, vitamin A, carotene, vitamin C, and total lymphocyte count). The urine study includes creatinine, thiamine, riboflavin, niacin, and iodine. Abnormalities in these values can reflect protein deficiency, inadequate liver or kidney function, or other diseases or infections.

Clinical examination findings are the patient's general appearance during a health history or examination. Signs of good nutrition include a normal body weight with respect to height and the appearance of health in the person's body tissues. This includes their hair, skin, teeth, gums, mucous membranes, abdomen, extremities, and thyroid gland. Examples of findings from poor nutrition include poor skin turgor (this could indicate dehydration), edema or swelling, dryness of skin and hair, poorly healing wounds, under- or overweight, bruises, and lack of muscle tone.

Dietary data is used to determine if the patient's dietary intake is adequate and appropriate. This data is obtained through the dietary history. For some patients, a 24 hour recall of their diet is all the information that is needed. For patients who are having more severe problems or symptoms, a more detailed history may be needed. Some are instructed to record everything they consume for several days before their appointment or hospitalization. This information is necessary to determine if a certain food is causing problems, such as an allergy or intolerance, or to determine if a deficiency is present.

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