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Nutrition for Nurses

19.4 Evaluate Nutritional Strategies to Impact Musculoskeletal and Integumentary Wellness

Nutrition for Nurses19.4 Evaluate Nutritional Strategies to Impact Musculoskeletal and Integumentary Wellness

Learning Outcomes

By the end of this section, you should be able to:

  • 19.4.1 Evaluate a nutritional plan for its effectiveness on musculoskeletal and integumentary wellness.
  • 19.4.2 Modify a nutritional plan to promote musculoskeletal and integumentary wellness.

Evaluating the Client’s Compliance with the Meal Plan

Evaluation is an important part of the nursing process. After the client has integrated nutritional strategies into their eating habits, the nurse should go back and evaluate the effectiveness of the plan. This is accomplished through objective and subjective findings. Barriers to compliance may include a client’s inability to read, write, and perform simple math. Finances, resources, transportation, and support are also barriers to client nutritional compliance.

A client’s compliance with the meal plan can, to some degree, be evaluated through their improvement of symptoms related to the musculoskeletal and integumentary systems. Objective ways to evaluate compliance with a meal plan are monitoring client weight and laboratory test results. Other objective findings include improvement in wounds, fractures, injuries, and nail and hair quality. Radiology procedures showing regeneration of bone or no extension in bone loss are also objective findings.

Subjective data from the client or caregivers must also be considered in determining client nutritional compliance. In other words, the nurse needs to listen to the client and caregivers to determine if compliance is being met.

Evaluating the Effectiveness of a Nutritional Plan

The effectiveness of a nutritional plan can be determined by many factors such as weight variance, changes in pain and edema, alterations in muscle strength and tone, and absence or presence of fatigue. DEXA (dual x-ray absorptiometry) scans that measure bone density can be used as a follow up to the initial scan to determine if bone loss is stable or progressing. Continual monitoring of client labs is an effective way to evaluate whether the nutritional plan is working. Labs for the musculoskeletal and integumentary systems are outlined in Table 19.9.

Labs for Musculoskeletal and Integumentary Systems Indications
  • White blood count (WBC)
  • Erythrocyte sedimentation rate (ESR)
  • C-reactive protein (CRP)
  • Culture and sensitivity
  • Inflammation and infection
  • Inflammation
  • Infection
  • Vitamins A and D, and calcium
  • Fractures
  • Osteoporosis
  • Osteopenia
  • Paget’s disease
  • Antinuclear antibody (ANA)
  • Rheumatoid factor (RF)
  • Anti-cyclic citrullinated peptide (CCP)
  • Alanine aminotransferase (ALT)
  • Aspartate aminotransferase (AST)
  • Autoimmune disorders
  • Alkaline phosphatase (ALP)
  • Bone formation
  • Plasma histamine
  • Immune disorders
Table 19.9 Labs for Musculoskeletal and Integumentary Systems (source: Pagana & Pagana, 2023)

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