7.3 Implement Nutritional Strategies to Impact Endocrine Wellness

Holistic Nursing Assessment of the Client’s Readiness to Learn

A holistic nutritional evaluation of the client involves assessing not only the client's physical symptoms and medical history, but also their educational, emotional, social, and spiritual needs. Socioeconomic conditions, cultural norms, and religious beliefs affect a person’s nutritional intake and learning ability.

Assessing a client’s readiness to learn involves identifying the client’s strengths and barriers relative to learning as well as their motivation to learn and receptiveness to the instruction. Health literacy is a fundamental consideration when teaching clients. Health literacy refers to how well an individual can find, understand, and use information to make informed health-related decisions (Centers for Disease Control and Prevention, 2023c). Education goals and strategies should be formulated consistent with the client’s health literacy level.

Client Teaching

Effective education helps clients improve their overall health, manage chronic diseases, and lower the risk for complications (Ardoin, 2022). Teaching clients how to follow their prescribed diet requires time, client engagement, and a variety of resources and strategies (Agency for Healthcare Research and Quality, 2023). Once the nurse has assessed the client’s education needs, the nurse needs to work with the client to set learning goals and objectives and select appropriate learning resources (National Library of Medicine, 2021). Client education should be structured around the methods of learning best suited for the client. Examples of educational resources include written materials, models, and videos. Be realistic regarding the amount of content that needs to be covered and respect the client’s limits. Use an organized but flexible approach to be able to adjust to the client’s response. If possible, involve family members or caregivers in the process as these individuals can provide additional support to the client.

The nurse should cover the following items as part of monitoring carbohydrate intake for clients with diabetes (CDC, 2023a):

• Clients with diabetes should track their carbohydrate intake to better manage their blood glucose levels.
• Keeping blood glucose levels stable and as close to normal as possible will help the client feel well and prevent or delay the development of diabetes-related complications.
• There are three types of carbohydrates:
  • Sugars: naturally found in fruit or milk, or added to many foods (added sugars are identified on the food label)
  • Starches: grains and starchy vegetables such as corn or potatoes
  • Fiber: indigestible part of plants that do not elevate blood glucose levels
• Carbohydrates are measured in grams and listed on food labels or found in resources listing nutritional information for nonpackaged food items.
• One serving of carbohydrates = 15 g of carbohydrates.
• The client should follow their prescribed diet indicating how many servings of carbohydrates to consume.
• The client should try to consume a consistent amount of carbohydrates at each meal to maintain consistent blood glucose levels.