Domain 4. Activity-rest
Class 5. Self-care
Diagnostic Code: 00102
Nanda label: Feeding self-care deficit
Diagnostic focus: Feeding self-care
Feeding self-care deficit occurs when a person is unable to take in and digest food due to physical, emotional, mental, or cognitive limitations. This diagnosis is more common in infants and the elderly, but it can affect anybody at any age. For infants and the elderly, feeding self-care deficits often lead to malnourishment, inadequate caloric intake, poor health, and injury. In addition, people with feeding self-care deficits are often dependent on others for care and supervision. It is important that healthcare professionals help these patients identify the underlying cause of their deficit so they can provide quality care.
NANDA Nursing Diagnosis Definition
According to NANDA (North America Nursing Diagnosis Association), feeding self-care deficit is defined as “an impaired capacity to feed oneself as evidenced by inability to obtain or consume food in an age-appropriate manner.”
Defining Characteristics
Subjectives
*Verbalizations of difficulty feeding oneself
*Decreased interest in eating
*Demonstration of helplessness regarding feeding oneself
Objectives
*Decreased appetite
*Weight loss
*Malnourishment
*Inability to open containers
*Messy eating techniques
There are several factors related to feeding self-care deficit, including physical limitations, emotional issues, mental processing problems, and cognitive impairments. For example, physical limitations associated with musculoskeletal disorders such as cerebral palsy or muscular dystrophy can limit a person's ability to feed themselves. On the other hand, emotional issues such as depression or stress can affect one's motivation to feed themselves. Mental processing challenges can hinder one's ability to comprehend and follow verbal instructions, while cognitive impairments can make it difficult to learn new tasks.
Associated Conditions
Some associated conditions can worsen or even cause feeding self-care deficits, such as stroke, advanced age, dementia, mental illness, and endocrine disorders. Strokes are known to cause long-term physical impairments, which can make eating independently difficult. Advanced age can make access and manipulation of utensils harder, while dementia can lead to confusion and forgetfulness. Mental illnesses such as anxiety and depression can also disrupt a person's ability to eat on their own. Finally, endocrine disorders like diabetes can cause nutrient deficiencies which can affect how a person processes and digests foods.
Suggestions for Use
When caring for a patient with feeding self-care deficits, healthcare professionals should assess the patient's level of need and determine the root cause of the issue. Identifying the cause can help healthcare workers develop a plan of care tailored to the patient's needs. Additionally, healthcare professionals should be aware of the risks associated with feeding self-care deficits, such as aspiration, choking, dehydration, and malnutrition.
Suggested Alternative NANDA Nursing Diagnosis
Alternative nursing diagnoses for patients with feeding self-care deficits include: impaired swallowing, fluid volume deficit, impaired nutrition, and risk for aspiration. Impaired swallowing is a nursing diagnosis that relates to the patient's inability to swallow effectively, while fluid volume deficit is associated with dehydration from not drinking enough fluids. Risk for aspiration can occur if food or fluids enter the lungs instead of the stomach, while impaired nutrition is related to nutrient deficiencies.
Usage Tips
Feeding self-care deficits are best managed with a team approach. A team of professionals, such as nurses, doctors, dieticians, occupational therapists, and speech therapists, should collaborate to develop an individualized plan of care. It is important to assess the patient's physical, emotional, mental, and cognitive abilities when developing the plan. Health professionals should also coordinate with family members or caretakers to ensure a safe and healthy environment for the patient.
NOC Outcomes
The following NOC outcomes may be applicable when caring for patients with feeding self-care deficits: Activity Tolerance, Oxygen/Nutrient Exchange, Nutrition, Nutrition Metabolism, Safety Status, Speech, Swallowing and Cognitive Function. Activity tolerance is related to the patient’s ability to handle physical activities, such as eating. Oxygen/nutrient exchange is related to the patient’s ability to adequately process oxygen and nutrients. Nutrition and nutrition metabolism are both related to the quantity and quality of the food the patient is consuming. Safety status is associated with protecting the patient from falls and choking. Speech refers to the patient’s ability to communicate verbally. Swallowing is related to the patient’s safe ingestion of food and liquids. Finally, cognitive function indicates the patient’s ability to understand verbal instructions.
Evaluation Objectives and Criteria
When assessing a patient with feeding self-care deficits, healthcare professionals should evaluate the patient’s ability to independently perform self-care tasks related to eating. They should also assess the patient’s preferences in regards to food and eating. Healthcare workers should consider the patient’s underlying medical condition when assessing the patient's progress. These objectives should be evaluated in order to determine an appropriate plan of care for the patient.
NIC Interventions
The following NIC interventions may be applied to patients with feeding self-care deficits: Enteral Feeding, Nutrition Education, Basic Meal Preparation, Diet Instruction, Eating Techniques Instruction, Swallowing Exercises, Therapeutic Play, Fluid Management, and Nutritional Monitoring. Enteral feeding is administering food through a tube placed through the nose or mouth directly into the stomach. Nutrition education involves teaching the patient about healthy eating habits and proper nutrition. Basic meal preparation includes assisting a patient in preparing and serving meals. Diet instruction involves helping the patient understand what types of food to eat and how much to consume. Eating techniques instruction includes demonstrating proper use of utensils and mealtime etiquette. Swallowing exercises provide assistance to patients with impaired swallowing. Therapeutic play encourages the patient to interact with food in an engaging way. Fluid management is helping the patient stay hydrated and avoid dehydration. Finally, nutritional monitoring involves evaluation of the patient's food consumption, nutrient absorption, and body weight.
Nursing Activities
When caring for a patient with feeding self-care deficits, nurses should focus on promoting the patient's safety and independence. Nurses should provide guidance and assistance as necessary to ensure the patient is able to complete their self-care tasks. Additionally, nurses should assess the patient's tolerance of the self-care activity and provide feedback to other members of the care team.
Conclusion
Due to physical, emotional, mental, and cognitive limitations, some people are unable to safely and independently feed themselves. Feeding self-care deficits can lead to poor health, injury, and reliance upon others for care. Healthcare professionals should assess the patient’s level of need and underlying causes of the deficit in order to develop a plan of care that focuses on safety and independence. With the collaborative efforts of a team of healthcare professionals, patients with feeding self-care deficits can improve their health and quality of life.
FAQs
- Q: What is feeding self-care deficit?
A: Feeding self-care deficit is an impaired capacity to feed oneself as evidenced by inability to obtain or consume food in an age-appropriate manner. - Q: Who is most likely to experience feeding self-care deficit?
A: Infants and the elderly are more likely to experience feeding self-care deficits, however, anybody at any age can be affected. - Q: What are some accompanying conditions?
A: Stroke, advanced age, dementia, mental illness, and endocrine disorders can worsen or even cause feeding self-care deficits. - Q: How can healthcare professionals manage patients with feeding self-care deficits?
A: Healthcare professionals should assess the patient's level of need and determine the root cause of the issue. Additionally, healthcare professionals should be aware of the risks associated with feeding self-care deficits. - Q: What types of interventions may be indicated?
A: Potential interventions for patients with feeding self-care deficits include enteral feeding, nutrition education, basic meal preparation, diet instruction, eating techniques instruction, swallowing exercises, therapeutic play, fluid management, and nutritional monitoring.