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NSG460
Nutritional Assessment Assignment
Mr T is an 83-year-old male who has been living in a nursing
home for the past 12 months since suffering a right middle
cerebral artery stroke. During this time he has had trouble
feeding himself and has lost 10 kg. He has a coccyx ulcer.
Patient height 180 cm; weight 55 kg [BMI= 17 kg/m2].
Mt. T. is not able to ambulate or get OOB without max assist of
2 staff. He does not like to turn in bed and lies in the same
position, on his back. most of the time.
He has dentures but since he has lost weight they do not fit
properly and this also hinders his ability to eat.
No one visits Mr. T. and he has shown signs of depression and
said he doesn’t want to live in this condition. He is now refusing
to eat most meals and is very weak. There has been a severe
decrease in food intake, he has lost about 6 pounds in the last 3
months, he is bed bound. He never eats a full meal.
Assignment
Review this case study and fill out the MNA tool I have
included.
NSG460
Nutritional Assessment Assignment
Mr T is an 83-year-old male who has been living in a nursing
home for the past 12 months since suffering a right middle
cerebral artery stroke. During this time he has had trouble
feeding himself and has lost 10 kg. He has a coccyx ulcer.
Patient height 180 cm; weight 55 kg [BMI= 17 kg/m2].
Mt. T. is not able to ambulate or get OOB without max assist of
2 staff. He does not like to turn in bed and lies in the same
position, on his back. most of the time.
He has dentures but since he has lost weight they do not fit
properly and this also hinders his ability to eat.
No one visits Mr. T. and he has shown signs of depression and
said he doesn’t want to live in this condition. He is now refusing
to eat most meals and is very weak. There has been a severe
decrease in food intake, he has lost about 6 pounds in the last 3
months, he is bed bound. He never eats a full meal.
Assignment
Review this case study and fill out the MNA tool I have
included.
Mini Nutritional Assessment
MNA®
Last name:
Sex:
First name:
Age:
Weight, kg:
Height, cm:
Date:
Complete the screen by filling in the boxes with the appropriate numbers.
Add the numbers for the screen. If score is 11 or less, continue with the assessment to gain a Malnutrition Indicator Score.
Screening
A Has food intake declined over the past 3 months due to loss
of appetite, digestive problems, chewing or swallowing
difficulties?
0 = severe decrease in food intake
1 = moderate decrease in food intake
2 = no decrease in food intake
B Weight loss during the last 3 months
0 = weight loss greater than 3kg (6.6lbs)
1 = does not know
2 = weight loss between 1 and 3kg (2.2 and 6.6 lbs)
3 = no weight loss
C Mobility
0 = bed or chair bound
1 = able to get out of bed / chair but does not go out
2 = goes out
J How many full meals does the patient eat daily?
0 = 1 meal
1 = 2 meals
2 = 3 meals
K Selected consumption markers for protein intake
• At least one serving of dairy products
yes
(milk, cheese, yoghurt) per day
• Two or more servings of legumes
yes
or eggs per week
• Meat, fish or poultry every day
yes
0.0 = if 0 or 1 yes
0.5 = if 2 yes
1.0 = if 3 yes
D Has suffered psychological stress or acute disease in the
past 3 months?
0 = yes
2 = no
E Neuropsychological problems
0 = severe dementia or depression
1 = mild dementia
2 = no psychological problems
N Mode of feeding
0 = unable to eat without assistance
1 = self-fed with some difficulty
2 = self-fed without any problem
F Body Mass Index (BMI) = weight in kg / (height in m)2
0 = BMI less than 19
1 = BMI 19 to less than 21
2 = BMI 21 to less than 23
3 = BMI 23 or greater
O Self view of nutritional status
0 = views self as being malnourished
1 = is uncertain of nutritional state
2 = views self as having no nutritional problem
12-14 points:
Normal nutritional status
8-11 points:
At risk of malnutrition
0-7 points:
Malnourished
For a more in-depth assessment, continue with questions G-R
Assessment
G Lives independently (not in nursing home or hospital)
1 = yes
0 = no
H Takes more than 3 prescription drugs per day
0 = yes
1 = no
I Pressure sores or skin ulcers
0 = yes
1 = no
References
1. Vellas B, Villars H, Abellan G, et al. Overview of the MNA® – Its History and
Challenges. J Nutr Health Aging. 2006; 10:456-465.
2. Rubenstein LZ, Harker JO, Salva A, Guigoz Y, Vellas B. Screening for
Undernutrition in Geriatric Practice: Developing the Short-Form Mini
Nutritional Assessment (MNA-SF). J. Geront. 2001; 56A: M366-377
3. Guigoz Y. The Mini-Nutritional Assessment (MNA®) Review of the Literature – What
does it tell us? J Nutr Health Aging. 2006; 10:466-487.
® Société des Produits Nestlé, S.A., Vevey, Switzerland, Trademark Owners
© Nestlé, 1994, Revision 2009. N67200 12/99 10M
For more information: www.mna-elderly.com
no
no
.
.
L Consumes two or more servings of fruit or vegetables
per day?
0 = no
1 = yes
M How much fluid (water, juice, coffee, tea, milk…) is
consumed per day?
0.0 = less than 3 cups
0.5 = 3 to 5 cups
1.0 = more than 5 cups
Screening score (subtotal max. 14 points)
no
.
P In comparison with other people of the same age, how does
the patient consider his / her health status?
0.0 = not as good
0.5 = does not know
1.0 = as good
2.0 = better
.
Q Mid-arm circumference (MAC) in cm
0.0 = MAC less than 21
0.5 = MAC 21 to 22
1.0 = MAC greater than 22
.
R Calf circumference (CC) in cm
0 = CC less than 31
1 = CC 31 or greater
Screening score
.
.
Total Assessment (max. 30 points)
.
Assessment (max. 16 points)
Malnutrition Indicator Score
24 to 30 points
Normal nutritional status
17 to 23.5 points
At risk of malnutrition
Less than 17 points
Malnourished
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