Imbalanced Nutrition Nursing Care Plan: 2 Sample Plans and Interventions

Imbalanced nutrition happens when a client takes in fewer nutrients than the body needs, or when intake does not match needs because of illness. It can slow healing, weaken muscles, and raise infection risk. Your priorities are finding the cause, tracking intake and weight, and helping the client meet nutrition goals safely.

A · AssessmentD · DiagnosisP · PlanningI · InterventionE · Evaluation

Each care plan below follows the nursing process (ADPIE).

CARE PLAN 1 · NURSING DIAGNOSIS

Imbalanced Nutrition: Less Than Body Requirements

Related to

Poor appetite from illness or medications
Difficulty chewing or swallowing
Increased needs from healing or infection

As evidenced by

Weight loss of 5% or more in 1 month
Eating less than half of meals
Low albumin or prealbumin
Muscle wasting and fatigue

PLANNING · EXPECTED OUTCOMES

Short-term goals

Client eats at least 75% of each meal within 1 week
Client has no further weight loss this week

Long-term goals

Client gains weight toward the target goal
Client chooses balanced meals at home

ASSESSMENT

Weight at least weekly, or daily if ordered
Percentage of meals eaten and calorie counts
Ability to chew and swallow
Albumin, prealbumin, and electrolytes
Food preferences and cultural needs

INTERVENTIONS AND RATIONALES

INTERVENTION	RATIONALE
Refer to a dietitian	A dietitian calculates calorie and protein needs and builds a plan.
Offer small, frequent meals and high-calorie, high-protein snacks or supplements	Small portions are easier to finish and still add up.
Give mouth care before meals and manage nausea or pain	A clean, comfortable mouth and less nausea improve appetite.
Sit the client upright and help with meals as needed	Upright position supports safe swallowing, and help increases intake.
Respect food preferences and allow family to bring food if allowed	Familiar foods encourage the client to eat more.

EVALUATION

Client eats at least 75% of meals
Weight is stable or rising
Client chooses protein foods from the menu

CARE PLAN 2 · NURSING DIAGNOSIS

Risk for Aspiration

Risk factors

Difficulty swallowing
Decreased level of consciousness
Tube feedings

PLANNING · EXPECTED OUTCOMES

Short-term goals

Client eats and drinks without coughing or choking during meals

Long-term goals

Client stays free of aspiration pneumonia

ASSESSMENT

Swallow screen per protocol before oral intake
Coughing, choking, or wet voice during meals
Lung sounds and temperature
Tube feeding placement and residual per protocol

INTERVENTIONS AND RATIONALES

INTERVENTION	RATIONALE
Complete a swallow screen and request a speech therapy evaluation as needed	This finds safe food and liquid textures.
Keep the head of the bed at least 30 degrees during tube feedings and upright for meals	Upright position helps prevent stomach contents from entering the lungs.
Use thickened liquids or modified diets as ordered	Thicker textures are easier to control while swallowing.
Check tube placement before feedings and medications per policy	Correct placement prevents feeding into the lungs.

EVALUATION

Client eats without coughing or choking
Lungs are clear and client is afebrile

Practice this in Everyday RN

Balance meal trays, swallow checks, and tube feedings during a full shift.

Play Everyday RN

Quick answers

Which lab best shows recent changes in nutrition status?

Prealbumin, because it changes within a few days. Albumin changes slowly and can be affected by fluid status and illness.

What is the first action before feeding a client after a stroke?

Complete a swallow screen. Feeding before checking the swallow can lead to aspiration.

For learning only. Individualize every care plan to your client, and follow your program, current guidelines, provider orders, and facility policy.