Conduct a nutritional assessment upon admission, with each condition change change and when a pressure ulcer is not healing. Refer all residents with pressure ulcers to the dietitian for early assessment and intervention.
Determine residents’ weigh history and identify any significant weight loss from usual body weight (>5 percent change in 30 days or >10 percent in 180 days}
Assess the Ability to eat independently. Provide assistance and/or special feeding devices when resident is impaired.
Assess total nutrient intake (food, fluid, oral supplements, enteral/parenteral feedings).
Provide sufficient calories. In general; a person with a pressure ulcer requires 30 to 35 Kcalories/kg body weight. Modify any dietary restrictions that are causing the resident to decrease food and fluid intake. Provide enhanced foods or oral supplements between meals if needed.
Provide enough protein. Offer 1.25 to 1.5 grams protein/kg body weight for residents with pressure ulcers (when compatible with goals of care) Assess renal function to ensure that high levels of protein are appropriate.
Encourage Hydration Monitor residents for signs and symptoms of dehydration, which include: Changes in weight, skin turgor, urine output, elevated serum sodium or calculated serum osmolality.
Residents with elevated temperature, vomiting, profuse sweating, diarrhea or heavily draining wounds need additional fluid.
Encourage a balanced diet that includes good sources of vitamins and minerals. Offer vitamin and mineral supplements when dietary intake is poor or deficiencies are suspected or confirmed.