Monitoring of Nutrition Therapy

Measuring the Effectiveness of the Nutritional Therapy

Monitoring a patient’s condition is crucial to achieve an optimal outcome and fast recovery. Proper monitoring with careful documentation and control can assess the effectiveness of the nutritional therapy. Patient status should be monitored by defined measurements and observations, such as recording of dietary intake, body weight and function and, when appropriate, laboratory parameters (e.g. blood parameters). Results of this monitoring can be useful to carry out adaptations of the nutritional therapy plan during patient’s hospitalization, if necessary.1,2

Monitoring and Follow-Up of Nutrition and Fluid Intake

Weight Monitoring

Regular patient monitoring should include weekly re-screening of weight gain and/or loss.2

Daily Nutrition Record

For patients who are given enteral or parenteral nutrition, daily nutritional record and fluid protocols should be maintained to monitor energy, protein and fluid intake2:

Laboratory Tests

As appropriate, blood parameters should be monitored to assess the patient’s nutrition status, to monitor substrate utilization and control adequacy of nutrition therapy.2,3 These parameters may include albumin, transferrin, prealbumin, and retinol-binding protein.3

Nutrition experts also recommend measuring hemoglobin, sodium, potassium, magnesium, calcium, phosphate, creatinine, blood urea nitrogen, triglycerides, coagulation, and blood glucose weekly. In severely malnourished patients it can even be appropriate to measure potassium, magnesium, and phosphate daily to monitor utilization and detect re-feeding syndrome as early as possible. Monitoring can also include the measurement of alkaline phosphatase, bilirubin and alanine aminotransferase (ALT).2

Determine the Need for Nutritional Supplementation

Results of the food and fluid protocol documentation and blood parameters can enable clinicians to calculate the required nutritional supplementation and fluid substitution needed by the patient.2

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