holistic assessment

Assessment Criteria

Assessment Findings / Data

Interpretation of Data for Nutritional Needs

Age and growth/development stage

Anthropometric: Height, Weight, BMI, Recent weight changes

Biochemical and Medications: (list any laboratory information available) No tests are required, but if available include. Include both prescription and over-the-counter drugs.

Clinical: Physical signs and symptoms of malnutrition observed in the patient

Dietary Data: Question present diet (see page 9 of text)

Medical-Psychosocial History: (see below)

24 hour diet recall

Allergies

Supplements (vitamins, minerals, herbal, or other)

Patient’s concerns about food or nutrition

Person preparing meals and food safety practices related to food preparation

Alcohol consumption

Economics related to food intake

Psychological factors affecting nutrition

Medical factors affecting nutrition

Social factors related to nutrition (culture, religion, barriers, knowledge base)

Nutritional Outcome or Goal #1

Interventions for outcome or goal #1

Nutritional Outcome or Goal #2

Interventions for outcome or goal #2

References