title = "Nutritional Assessment and Dietary Support"

content = """
Nutrition directly affects wound healing, immune function, medication metabolism, energy for
rehabilitation, and recovery from surgery or illness. Malnutrition is prevalent in home health
populations — particularly the elderly, those with chronic disease, and patients recently discharged
from hospital — yet it is frequently under-identified.

**Nutritional Risk Indicators**
The clinical team uses OASIS and clinical observation to identify patients at nutritional risk:
- Unintentional weight loss of more than 5% body weight in the past month or 10% in six months
- BMI below 18.5 (underweight) or above 35 (morbid obesity affecting mobility and wound healing)
- Poor appetite, difficulty swallowing, nausea, vomiting, or diarrhea that limits intake
- Chronic conditions known to affect nutritional status: diabetes, chronic kidney disease, COPD,
  heart failure, cancer, Crohn's disease
- Dependence on others for meal preparation, with inadequate informal support

**Dysphagia and Swallowing Concerns**
Patients with a history of stroke, Parkinson's disease, head and neck cancer, or neurological
conditions may have dysphagia (difficulty swallowing), placing them at risk for aspiration pneumonia.
If the clinical team identifies swallowing difficulties, an SLP evaluation should be ordered. In
the interim, ensure the care plan notes any diet texture modifications recommended by the physician.

**Coordination Responsibilities**
- When the RN identifies a patient at nutritional risk, confirm an MSW or dietary referral is in
  the care plan.
- For diabetic patients, ensure the care plan includes physician-ordered dietary education and that
  the RN is monitoring blood glucose trends in relation to meals.
- If the patient lacks access to adequate food (food insecurity), coordinate with the MSW to
  connect the patient with Meals on Wheels, food pantry programs, SNAP benefits, or community
  nutrition programs.
- Document any unplanned weight changes of more than 3 pounds in a visit cycle and notify the
  physician using the SBAR format.

**Oral Health**
Poor oral health affects nutritional intake and is frequently overlooked in elderly patients.
Encourage the care team to assess dental status and refer to dental services if oral pain, poorly
fitting dentures, or oral infections are limiting the patient's ability to eat.
"""

version = "0.0.1"
