NUTRIONAL

ASSESSMENT
MODULE 3
 course CLO#1: Identify the role of
the essential nutrients in

learning
1
healthy nutrition

outcomes 2
CLO#2: Describe the factors
affecting food safety and
risk for a client

CLO#3: Discuss assessment

3 procedures with its normal
and abnormal finding

CLO#4:Show beginning skills

in anthropometric
4
measurements for
nutritional assessment
CLO#1: Identify the
role of the essential
nutrients in healthy
nutrition
 1. Carbohydrates

Carbohydrates are a primary source of energy

for the body. When carbohydrates are
consumed, they are broken down into
monosaccharides, which are absorbed into the
bloodstream and converted into glucose. This
2.
glucose is essential for producing ATP
(adenosine triphosphate), the energy currency
of cells, ensuring that the body has the energy
needed for daily activities and metabolic
processes
 Functions of
Carbohydrates:

1. Essential for producing energy

2. Provides dietary intakes
3. Vital for brain function
4. Play a critical role in preventing the overuse
of proteins and lipids for energy
 2. Proteins

Proteins are known as the building blocks of life;

they are made up of amino acids, with nine
essential amino acids that must be obtained from
the diet. Complete proteins, found in animal
products while incomplete proteins are found in
plant-based foods. All necessary to provide all
2.
essential amino acids.
 Functions of Proteins:

Proteins are Protein serve as Proteins play a Proteins are

fundamental enzymes, which significant role vital
for the growth, are biological in regulating components of
repair, and catalysts that various the immune
maintenance of facilitate physiological system.
body tissues. biochemical processes.
reactions in the
body.
 3. Fats/Lipids

Fats or lipids encompass a variety of

compounds, such as triglycerides,
cholesterol, phospholipids, and fat-
soluble vitamins. They are a vital
2. of energy, providing over
source
twice as many calories per gram as
carbohydrates or proteins. They can
be classified as either saturated or
unsaturated
Difference of Saturated and
Unsaturated Fats:
 4. Vitamins
Vitamins are organic molecules
that are essential for normal
metabolism and must be obtained
through the diet, as the body
cannot produce them in sufficient
quantities. They exist in minute
2. in food and are crucial
quantities
for various bodily functions. There
are two types fat solubles and
water solubles
 Fat-soluble vitamins Water soluble vitamins

Fat-soluble vitamins Water-soluble vitamins

(A, D, E, and K) are (the B vitamins and vitamin C)
absorbed along with dietary are absorbed with water and
fats and can be stored in are typically excreted in urine,
the body for long periods, meaning they need to be
which can lead to toxicity if consumed more regularly.
2. in excess.
consumed
4.
Most vitamins function as coenzymes, which
are necessary for the activity of enzymes that
facilitate biochemical reactions in the body.

For example, B vitamins are involved in energy

metabolism, while vitamin C is essential for
collagen synthesis and immune function. Each
vitamin has specific roles, such as vitamin A for
vision and skin health, vitamin D for calcium
absorption, and vitamin K for blood clotting.

B vitamins C vitamins Vitamin D Vitamin K

 5. Minerals

Minerals are inorganic nutrients that are crucial for

normal metabolic functions. They constitute about
4–5% of total body weight and must be obtained
through the diet, as the body cannot produce them.
Minerals play a variety of important roles in the
body, including: Establishing resting membrane
potentials and generating action potentials in nerve
2.
and muscle cells. Adding mechanical strength to
bones and teeth, coenzymes, buffers, or regulators
of osmotic pressure for maintaining fluid balance
and proper cellular function.
 Minerals are divided into two categories:
macrominerals and trace minerals.

Macrominerals are required in greater

quantities and include calcium, phosphorus,
magnesium, sodium, potassium, chloride,
and sulfur.

Trace minerals are needed only in small

concentrations and include iron, manganese,
copper, iodine, zinc, cobalt, fluoride, and
selenium.
 Some important minerals and their functions
include:

Calcium: Essential for bone and teeth formation, blood clotting, muscle
activity, and nerve function.

Iron: A component of hemoglobin, crucial for oxygen transport and energy

production.

Magnesium: Involved in coenzyme functions, bone formation, and muscle and

nerve function.

Potassium: Important for muscle and nerve function,

Zinc: Necessary for enzyme function and protein metabolism (RDI: 11 mg).
 6. Water

Water is crucial for maintaining the health of

cells and body fluid compartments. It
facilitates the movement of nutrients and
waste products, regulates osmotic pressure,
and supports cellular functions. Adequate
2. ensures proper fluid balance,
hydration
essential for physiological processes like
digestion, temperature regulation, and
electrolyte balance.
Functions of water:
1. Water acts as a solvent for various nutrients and
electrolytes, facilitating their transport across cell
membranes.

2. Water helps regulate the balance of fluids in the

body

3. Water is vital for maintaining the integrity and

function of cells, hydration of the body and for
thermoregulation.

4. Water intake is essential for the kidneys to filter waste

products from the blood and excrete them through urine.
 CLO#2: Describe the
factors affecting food
safety and risk for a
client
the factors affecting food
safety and risk for a client
1. FOOD POISONING
Food Poisoning is an occurrence that occurs when an
individual consumes contaminated food.
Contamination happens when it is infected by a toxic
agent or organism such as bacterium, fungus,
2.
parasite, or virus, in which the byproducts of these
organisms cause food poisoning. It is an acute form of
gastroenteritis brought on by consuming food or
liquid that has been tainted by live bacteria, their
toxins, inorganic chemicals, or poison that has been
transferred from plants or animals.
 Common contaminants
include:

SALMONELLA E. COLI NOROVIRUS Hepatitis A

Found in Present in raw Linked to raw fruits, Transmitted through

undercooked vegetables and leafy greens, fresh fruit, shellfish,
eggs, poultry, undercooked meat, undercooked shellfish, or contaminated
beef, pork, producing a toxin and food handled by water/ice, affecting
vegetables, and that irritates the infected individuals, the liver but not
processed foods. small intestine. causing stomach flu. chronic.
symptoms
Common symptoms include:
Nausea
Vomiting
Diarrhea
Abdominal pain
Usually, these symptoms show up hours to days
after consumption. Most cases are mild and resolve
on their own, but more serious cases can need
medical care.
Clients at Risk for
Food Poisoning
Treatment
Immunocompromised Hydration: Drink fluids like fruit juice or coconut
people water for electrolytes. Avoid caffeine and try
herbal teas like peppermint or chamomile for
comfort.

Pregnant women OTC Medications: Pepto-Bismol and loperamide

(Imodium) help with nausea and diarrhea. Consult
a doctor before use, as they may delay
necessary care.
Older adults
Prescription Medications: Antiparasitics (e.g.,
albendazole) and antibiotics (e.g., azithromycin
for Campylobacter) are used for specific
Young children infections.
the factors affecting food
safety and risk for a client
2. Food Allergies
Food Allergy is an immunological response
that occurs shortly after consuming a
particular food. A small quantity of the food
that causes the allergy can cause symptoms
2. hives, enlarged airways, and
including
stomach issues. Food allergies in certain
individuals can result in severe symptoms or
even anaphylaxis, a potentially fatal
reaction.
 Most food allergies are triggered
by certain proteins in:

Crustacean
Peanuts Cow's milk Chicken eggs
shellfish

A food allergy occurs when a person's immune system incorrectly perceives a

particular food or ingredient in food as harmful. The immune system reacts by
stimulating cells to create immunoglobulin E (IgE), an antibody that identifies
the food or dietary substance—also known as an allergen—that causes the
allergy.
symptoms
•Skin Reactions: Hives, swelling of the lips, face, or tongue, and itchy
rashes.

•Respiratory Issues: Wheezing, difficulty breathing, throat tightness,

and coughing.

•Gastrointestinal Symptoms: Abdominal pain, nausea, vomiting, and

diarrhea.

•Systemic Reactions: Dizziness, lightheadedness, or loss of

consciousness.
Clients at Risk for
Food ALLERGY
Treatment
Clients with a family history
For mild allergic reactions, antihistamines—either
of an allergy prescribed or available over-the-counter—can help
reduce symptoms like itching or hives. Nonetheless,
these medications are not suitable for treating severe
People with existing food allergies allergic reactions.
or other allergic conditions
In the event of a severe allergic reaction, an
emergency injection of epinephrine may be required,
along with a trip to the emergency room. Many
Children, especially infants
individuals with allergies carry an epinephrine auto
and toddlers injector (such as Adrenaclick or EpiPen), which delivers
a single dose of medication when pressed against the
thigh.

People with asthma

the factors affecting food
safety and risk for a client
3. Food Intolerance
Food intolerance is often referred to as food sensitivity,
highlighting the nuanced relationship between the body
and the foods consumed. Individuals with food
2.
sensitivities may find that their bodies react negatively to
particular ingredients. When an individual experiences a
food intolerance, it signifies that their digestive system
struggles to properly process certain foods.
symptoms
Symptoms of a food intolerance
include:
Abdominal (belly) pain.
Diarrhea.
Gas and bloating.
Headaches or migraines.
Heartburn.
Nausea.
Upset stomach.
 CAUSES
Individuals who experience food
intolerances frequently lack sufficient
amounts of specific enzymes that are
essential for the digestive system to
effectively break down certain foods or
ingredients. This enzymatic deficiency can
lead to various digestive issues and
discomfort after consuming problematic
foods.
Clients at Risk for
Food INTOLERANCE Treatment
Certain gastrointestinal
Elimination Diet: Remove suspected trigger foods and
conditions reintroduce them gradually to identify intolerances,
ideally with professional guidance.

Avoidance: Avoid foods that trigger symptoms,

Individuals with Celiac disease including reading labels and asking about food
preparation.

Medications: OTC options like antacids or lactase

Those with Inflammatory
supplements can help relieve discomfort.
Bowel Disease (IBD)
Dietary Modifications: Incorporate small amounts of
tolerated foods and use lactose-reduced products to
manage symptoms.
Individuals with Crohn’s
disease
CLO#3: Discuss
assessment
procedures with its
normal and abnormal
finding
 GENERAL STATUS/ APPEARANCE
Apparent State of Health Level of Consciousness

Normal Findings: The patient Normal Findings: The patient is

appears weak-nourished, healthy, and awake, alerts, and responsive to
free from sign of illness. stimuli.
Abnormal Findings: Patient may look Abnormal Findings: The patient
frail, weak, malnourished, or showing appears lethargic, confused,
signs signs of acute or chronic illness weak, or unresponsive.

Skin and Breathing Signs of Distress

Normal Findings: The patient’s skin is intact, Normal Findings: The patient is calm
with no visible lesions or bruises, and their and comfortable without visible
breathing is normal and unlabored. distress.
Abnormal Findings: The patient has pale skin, Abnormal Findings: The patient
wounds, pressure injuries, and having difficulty exhibits agitation, anxiety, pain, signs
in breathing. of respiratory or cardiac distress.
 GENERAL STATUS/ APPEARANCE
Dress, Grooming, and hygiene Posture and Motor Activity

Normal Findings: The patient is clean, well- Normal Findings: The patient maintains
groomed, and dressed appropriately with no a relaxed posture with smooth,
noticeable odors. coordinated movements.
Abnormal Findings: Patient may appear Abnormal Findings: The patient has
unkempt, wear inappropriate clothing, or have tense posture, slouched appearance,
noticeable body or breath odors. tremors, or uncoordinated movements .

Facial Expression and Mood

Normal Findings: The patient displays appropriate facial expressions,

maintains eye contact, and cooperates well.
Abnormal Findings: The patient may show paranoia, sudden mood
changes, anxiety, or facial expressions that do not match their emotions
 Normal Findings
Normal body proportional, bilateral
BODY BUILD
muscles are firm and well developed, Naturally slim and lean,
equal distribution of fat with some with little muscle or fat.
subcutaneous fat, body parts are Has long limbs and
intact and appear equal without narrow shoulders, often
obvious deformities (Weber & Kelly, making them appear
2018, p. 231). taller.
Fast metabolism, which
Abnormal Findings makes it harder to gain
Lack of Subcutaneous fat with weight.
prominent bones is seen in the In healthcare, being
undernourished, abdominal ascites is extremely thin might be a
seen in starvation and liver disease, sign of malnutrition or an
abundant fatty tissues is noted in underlying health issue
obesity (Weber & Kelly, 2018, p. 231). that needs attention.
 BODY BUILD
Naturally muscular and Naturally rounded body shape
well-proportioned, with a higher fat percentage and
making it easier to build a wider waist.
strength. Broad shoulders Tends to have a slower
and a narrow waist, metabolism, making it easier to
gain weight and harder to lose it.
giving an athletic look.
Often hereditary, but lifestyle
Gains muscle easily and
choices like diet and activity level
usually stays fit with
play a big role.
minimal effort.
Shorter limbs and a stockier build
Generally healthy, but too
give them a naturally strong
much muscle can
frame.
sometimes hide issues
Prone to weight-related health
like high blood pressure
risks, such as heart disease,
or joint strain.
diabetes, and high blood
pressure.
Anthropometric measurements

These help assess an individual’s body size,

composition, and nutritional status. These
measurements are commonly used in
clinical and community health settings to
2.
monitor growth, detect malnutrition, and
assess the risk of various health conditions.
Measuring
Height
measuring height determines an individual's vertical
length from the base of their feet to the top of their head.
It is useful for assessing growth in children and overall
health in adults.
Procedure:
1. Ensure the patient is barefoot and standing on a flat
surface.
2. The back, buttocks, shoulders, and head should be
against the stadiometer or a wall.
3. Position the head in the Frankfort horizontal plane (the
imaginary line from the lower eye socket to the top of the
ear canal should be parallel to the floor). Assessment Tool:
4. Lower the measuring bar gently onto the top of the head. Wall-mounted stadiometer
5. Record height in centimeters (cm) or meters (m). or a portable height rod
Measuring
Weight
Weight measurement is used to assess an individual's
body mass, which is crucial for evaluating nutrition
and health status.

Procedure:
1. Use a calibrated weighing scale on a flat, level
surface.
2. Ensure the patient removes shoes and heavy
clothing before stepping onto the scale.
3. Instruct the patient to stand upright and still. Assessment Tool:
Digital or mechanical
4. Record weight in kilograms (kg) or pounds (lbs). weighing scale
Determining Ideal Body Weight
(IBW) and Percentage of IBW
Ideal Body Weight (IBW) estimates a person’s Assessment Tool:
optimal weight based on height and sex, while
Height and weight scale
Percentage of IBW helps assess whether they are
underweight, normal weight, or overweight. for IBW calculations

Procedure:
Ideal Body Weight (IBW) is estimated using
formulas based on height, gender, and body
frame.
A common formula for IBW in adults is:
For women: 45.5 kg + 2.3 kg for each inch
over 5 feet.
For men: 50 kg + 2.3 kg for each inch over 5
feet.
Determining Waist
Circumference
Waist circumference helps assess abdominal fat,
which is a key indicator of metabolic and
cardiovascular risk.

Procedure:
1. Measure at the narrowest part of the abdomen,
usually just above the navel.
2. The patient should stand straight and breathe
normally.
3. Wrap a non-stretchable measuring tape around Assessment Tool:
Measuring tape
the waist, ensuring it is parallel to the floor.
4. Record the measurement in centimeters (cm).
Measuring Body Mass
Index (BMI)
BMI is a calculation that helps Normal Findings:
categorize individuals based on 18.5–24.9 kg/m²
Abnormal Findings:
their weight relative to height.
Underweight: BMI < 18.5
Overweight: BMI 25–29.9
Procedure: Obesity: BMI ≥ 30
Formula: BMI = weight (kg) ÷
Assessment Tool:
height (m²) BMI Chart or
Calculator
Determining Waist-to-Hip
Ratio (WHR)
WHR measures fat distribution and helps assess the
risk of cardiovascular diseases.

Procedure:
Measure the waist circumference at the
narrowest point and the hip circumference at
the widest point around the buttocks.
WHR is calculated as: WHR
=Waist circumference (cm) mHip circumference Assessment Tool:
(cm) Measuring tape
WHR=Hip circumference (cm)Waist circumference
(cm)
Measuring Mid-Arm
Circumference (MAC)
MAC is used to assess muscle and fat mass,
particularly in malnutrition screening.

Procedure:
1. Locate the midpoint between the
shoulder (acromion) and elbow
(olecranon).
2. Wrap a non-stretchable tape around the
upper arm. Assessment Tool:
3. Record measurement in cm.
Measuring tape
Measuring Triceps Skinfold
Thickness
This measures subcutaneous fat,
providing an estimate of overall body fat
percentage.

Procedure:
1. Use calipers to pinch the skin at the
midpoint between the shoulder and
elbow.
Assessment Tool:
2. Measure thickness in millimeters Skinfold calipers
(mm).
Calculating Mid-Arm Muscle
Circumference (MAMC)
MAMC is an indicator of muscle mass and is used to assess
nutritional status, particularly in cases of malnutrition or
muscle wasting.

Procedure:
1. Measure Mid-Arm Circumference (MAC):
Locate the midpoint between the shoulder (acromion)
and elbow (olecranon process).
Wrap a non-stretchable measuring tape around the
arm and record the measurement in centimeters (cm).
2. Measure Triceps Skinfold Thickness (TSF): Assessment Tool:
Use calipers to pinch the skin at the midpoint of the Measuring tape for MAC
upper arm. Skinfold calipers for TSF
Measure the skinfold thickness in millimeters (mm). Calculator for applying the
3. Apply the MAMC Formula: formula
4. MAMC = MAC − (0.314 × TSF)
Hydration Status

Hydration status is an important sign of a person's overall

health, but it can sometimes be overlooked or mistaken for
changes in nutrition. In healthcare, it's important to
regularly check a patient's hydration levels to determine if
they are dehydrated (low on fluids) or overloaded with
2.
fluids. This helps guide the appropriate care and treatment
for the patient.
Factors that can be used in
assessing hydration status:

Body Mass
Changes in body mass over a short period of time can be used to
quantify water gain or loss, as 1 ml of water has a mass of 1g.
Observe the changes in the body mass of the client. Clients that

2.
gained body mass over a short period of time assumed to be
hydrated, which is normal, while clients that lost some of their body
mass over a short period of time assumed to be dehydrated, and is
abnormal.
Factors that can be used in
assessing hydration status:

Blood:
Blood is easily sampled and contains fluid in red blood cells (intracellular)
as well as in plasma (extracellular). Changes in blood volume and
composition reflect changes in hydration status. Compare clients the
2.
hemoglobin concentration, hematocrit concentration, sodium
concentration, and osmolality (the measure of solute of concentration) to
the normal count reference
Factors that can be used in
assessing hydration status:

Urine:
According to some studies, the color of the urine is the best hydration
status indicator. Urine is easily sampled, although 24-hour urine
collections can be onerous for subjects. Urine color is determined mostly
2.
by the amount of urochrome present in the urine. When a large volume of
urine is expelled and the urine is diluted, it has a very light color, whereas
when a small volume of urine is produced and the urine is concentrated, it
has a dark color.
CLO#4: Show beginning
skills in anthropometric
measurements for
nutritional assessment
The The Beginning skills in
Anthropometric
Measurements for
Nutritional Assessment

The essential elements of

anthropometric measurements include
height, weight, head circumferences, all
of which are crucial for evaluating
nutritional status and body composition.
The following are the essential skills and
techniques for performing these
measurements:
 Growth charts monitor children's growth by comparing their
Growth measurements to standardized benchmarks. They help identify
potential growth or nutritional issues early, ensuring accurate
charts assessment with the appropriate chart.

Measuring head circumference helps assess brain and skull

development in young children. For accuracy, take two Head
measurements around the largest part of the head within 0.2
cm (0.25 inches), average them, and check for developmental circumference
concerns.

Accurate height measurement requires standing straight with

the back, heels, and shoulders touching the stadiometer or wall.
HEIGHT The stadiometer bar should gently touch the top of the head,
ensuring precise tracking of growth, BMI, and health trends.

Weight should be measured on a calibrated scale while standing still

and upright for accuracy. This measurement helps assess overall
health, body composition, and BMI. Maintaining a healthy weight can
Weight
prevent conditions like diabetes, high blood pressure, and heart
disease.
BMI is a basic calculation that
assesses whether a person’s Body
weight is appropriate for their
height using the formula: BMI = mass
kg/m². While useful for identifying
potential health risks, it should be index
paired with other assessments
since it doesn’t account for muscle
(BMI)
mass or fat distribution. Limb measurements assess
growth and body
BMI = kg/m2 proportions, helping detect
(BMI = weight in kilograms / [height in meters
x height in meters) malnutrition or
abnormalities. Leg and arm
lengths are measured from
key points, while mid-upper
arm circumference is taken
Limb at the midpoint. Accurate
measurements technique ensures reliable
results.
Waist Skinfold
circumference measurements

Set Small Goals: Break

large tasks into smaller,
Waist circumference helps assess central Skinfold measurements
manageable parts. estimate
fat, which is linked to health risks like body fat by measuring the thickness
diabetes and heart disease. It is of pinched skin at areas like the
measured by wrapping a tape around the triceps, thigh, belly, and chest.
waist at the level of the belly button, Accurate results depend on proper
ensuring a snug but not tight fit. A higher technique and consistency. This
waist measurement indicates increased method is often combined with other
health risks and is an important indicator assessments for a more complete
of body fat distribution. evaluation of body fat.