Learning Outcomes
By the end of this section, you should be able to:
- 13.4.1 Evaluate a nutritional plan for its effect on pulmonary wellness.
- 13.4.2 Modify a nutritional plan to promote pulmonary wellness.
Evaluating the Client’s Compliance with the Meal Plan
Evaluation of nutritional strategies is imperative to verify a meal plan’s effectiveness and help the client achieve pulmonary wellness. An evaluation aims to measure understanding of the intervention and progress made for the specific interventions. Many clients cannot process large volumes of new medical information on the first exposure, and they only remember a minimal amount of what has been taught (Timmers et al., 2020). Clients and families will likely have questions requiring additional education and interval evaluation of each nutrition intervention. Each time the impact of a nutritional intervention is evaluated, education reinforcement should occur. Nursing nutrition interventions and evaluations vary based on organizational protocols and often involve a multidisciplinary approach.
Frequent tools used in the approach to evaluation of nutritional interventions include screening and diagnostic tools and anthropometric measures (skin-fold measurement, arm circumference, height, weight, BMI, and patterns of loss/gain), nutritional plan outcomes (appetite, eating difficulties, self-management strategies, pain with eating, oral/dental status, physical activity, and quality of life), diagnostics (labs and tests), and physical findings (appearance, muscle strength and function, muscle or fat wasting, swallow function, and affect) (van den Berg et al., 2021). When evaluating nutritional strategies and interventions with this approach, nurses can compare current findings with the previously recorded status to evaluate the success of the intervention on the client’s health and outcomes.
The Ability to Obtain Adequate Nutrition
The health care provider must determine the ability to adhere to a meal plan. Questions to consider:
- Can the client afford the recommended food items?
- Is nutritious food available and accessible to the client?
- Do the foods in the meal plan go against the client’s culture or religious beliefs?
These are all things that must be determined so the client can be adherent and avoid worsening obesity and exacerbated pulmonary illness. If the client’s answers present barriers to adequate nutrition or a source of possible nonadherence, attention must be given to supporting the client with adjusted recommendations, resources, or referrals to enable the client to follow the dietary guidelines and meal plan.
Case Study Conclusion
As noted in the case study, the client’s BMI was increasing, and she had moved from overweight to obese. The client needed instruction to achieve proper nutrition including:
- Understanding the physiologic changes associated with obesity that can worsen asthma and impact health during sports and play
- Using MyPlate as a model for adjusting food intake
- Focusing on a low-fat and high-protein diet with teaching about what foods fall into each food category
- Keeping a food log for review and education
- Removing medication (NSAID) use that would worsen asthma
The health care provider can give these instructions, enabling the client to adhere with the meal plan and optimal respiratory health.