HIV/AIDS Nutrition Assessment Mind Map

FOOD AND NUTRIENT INTAKE (FH-1) 
Collect food intake records, 24-hour recall, food diary or food frequency questionnaire to estimate or assess:  
Energy intake determination (FH-1.1) 
·  Energy intake 
   -  Total energy estimated intake in 24 hours, approximate intake  

Food and beverage intake determination (FH-1.2) 
·  Fluid estimated intake from oral nutrition in 24 hours, high-energy beverages, liquid meal replacement, 
·  Nutritionally complete liquid supplement measured oral intake in 24 hours, 

·  Food intake 
   -  Amount of food, current dietary guidelines 
   -  Types of food, check for energy density of snacks, meals and desserts, check for fortified foods, keep in mind protein foods 
   -  Meal/snack pattern, check for missed meals, largest meal, frequency and timing of meals 


Bioactive constituent intake determination (FH-1.4) 
·  Alcohol intake  
   -   Alcohol intake in one week 
   -   Alcohol intake in 24 hours 
   -   Days per week alcoholic drinks consumed 
   -   Alcohol intake pattern on drinking days 
    -  Drink size/volume 
    -  Frequency 

Macronutrient intake determination (FH-1.5) 
Estimated intake is defined as the approximate intake. 
·  Fat intake 
   -  Estimated fat intake 
        -  Total fat estimated intake in 24 hours 
   -  Measured fat intake 
        -  Total fat measured intake in 24 hours, consider food preparation methods  
·  Protein intake 
   -  Estimated protein intake 
        -  Total protein estimated intake in 24 hours, satiety 
        -  High biological value protein estimated intake in 24 hours 
        -  Protein intake from supplements  
·  Amino acid intake 
   -  Estimated amino acid intake 
        -  Total amino acid estimated intake in 24 hours 
        -  Essential amino acid estimated intake in 24 hours 
·  Carbohydrate intake 
   -  Estimated carbohydrate intake 
        -  Total carbohydrate estimated intake in 24 hours 
  - Total carbohydrate intake 
·  Fiber intake 
   -  Estimated fiber intake 

Micronutrient intake determination (FH-1.6)  
·  Vitamin intake 
   -  Estimated vitamin intake 
        -  Multivitamin estimated intake in 24 hours 
·  Mineral/element intake 
   -  Estimated mineral intake 
        -  Calcium estimated intake in 24 hours 
        -  Iron estimated intake in 24 hours 


FOOD AND NUTRIENT ADMINISTRATION (FH-2) 
Diet history (FH-2.1) 
·  Diet History 
·  Diet experience 
   -   Previously prescribed diets  
        -  Adequacy, compliance, challenges 
·  Previous diet/nutrition education/counseling 
        -  Need for further nutrition education  
   -   Eating environment 
   -   Location 
   -   Atmosphere 
   -   Caregiver/companion 
   -   Eats alone 


MEDICATION AND COMPLEMENTARY/ALTERNATIVE MEDICINE USE (FH-3) 
Medications (FH-3.1) 
·  Prescription medication use, with nutrition-related side effects 
   -  Chemotherapy, such as busulfan, cisplatin, cyclophosphamide, cytarabine, doxorubicin, etoposide, l-asparaginase, melphalan, methotrexate, vincristine, 6-mercaptopurine 
   -  Corticosteroids, such as prednisone, dexamethasone  
   -  Antibiotics, such as amoxicillin/clavulanic, acyclovir 
   -  Pain-relief, such as morphine, codeine 
·  Over the counter (OTC) medication use 
·  Misuse of medication 

Complementary/Alternative Medicine (FH-3.2) 
·  Nutrition-related complementary/alternative medicine use 
·  Dietary supplements  


KNOWLEDGE BELIEF ATTITUDE DETERMINATION (FH-4) 
Food and nutrition knowledge (FH-4.1) 
·  Nutrition knowledge of community 
·  Nutrition knowledge of supportive individuals 
·  Nutrition knowledge of individual client 
   -  Principles of Nutrition Intervention for malnutrition 
   -  Connection between nutrition status and dietary intake  
   -  Energy balance concepts 
   -  Energy density of foods 
   -  Nutrient density of food  

Food and nutrition of skill (FH-4.2) 
·  Nutrition skill of community 
·  Nutrition skill of supportive individuals 
·  Nutrition skill of individual client 
   -  Selection/preparation of high-energy, high-protein meals and snacks 

Belief and attitude determination (FH-4.3) 
·  Nutrition priority of individual client (present/absent), values supporting change 
·  Nutrition priority of client's supportive individuals (present/absent), values supporting change 
·  Nutrition priority of client's supportive structures (present/absent), values supporting change 
·  Conflict with individual client's value system (present/absent) 
·  Conflict with client's supportive individuals' value system (present/absent) 
    -  Consider the importance of food-related activities 
·  Behavioral beliefs (motivation, control, norms, readiness) 
   - Perceived susceptibility to nutrition related health problems score 
     -  Self-rated, 1 = very low to 7 = very high perceived susceptibility 
   - Perceived severity of risk to health score 
     -  Self-rated, 1 = very low to 7 = very high perceived severity of risk 
  - Perceived benefit of nutrition-related change score 
     -  Self-rated, 1 = very low to 7 = very high perceived benefit 
   - Likelihood of performing nutrition-related behavior score 
     -  Self-rated, 1 = unlikely to perform behavior to 7 = very likely to perform behavior 
   - Perceived control over nutrition related behavior score 
     -  Self-rated, 1=very low to 7=very high perceived control 
   - Nutrition self-efficacy score (self-belief regarding achieving success)  
     -  Self-rated, 1=very low confidence to 7 = very high confidence in ability 
   - Perceived barrier to nutrition related behavior score (barriers to change) 
     -  Self-rated, 1=very low to 7=very high perceived barriers 
   - Readiness to change nutrition related behavior stage (readiness to change) 
      -  Precontemplation stage (present/absent) 
      -  Contemplation stage (present/absent) 
      -  Preparation stage (present/absent) 
      -  Action stage (present/absent) 
      -  Maintenance stage (present/absent) 
      -  Relapse stage (present/absent) 
   - Readiness to change nutrition related behavior score 
      -  Self-rated on scale of 1 to 10; 1 = not ready to 10 = fully ready to change 
  - Negative emotions about food and nutrition (present/absent), consider the impact of change, triggers to eating episodes   
  - Positive emotions about food and nutrition (present/absent) 
  - Unrealistic nutrition related goals (present/absent), weight gain expectations 
  - Unscientific nutrition beliefs/attitudes (present/absent) 
  - Body image disturbance (present/absent), anorexia nervosa 
   - Preoccupation with food (present/absent) 
  - Preoccupation with weight (present/absent) 
  - Preoccupation with body shape (present/absent) 
  - Negative nutrition self talk (present/absent), words used to describe lapses to self 
  - Positive nutrition self talk (present/absent) 
  - Preferences for food (yes/no) 
  - Preferences for beverages (yes/no) 


BEHAVIOR DETERMINATION (FH-5) 
Adherence behavior (FH-5.1) 
·  Self reported nutrition adherence score 
·  Nutrition encounter ratio 
    -  Nutrition visit attendance 
·  Ability to recall nutrition goals 
·  Nutrition self monitoring at agreed upon rate 
   -  Weight monitoring, dietary intake and physical activity logs  
·  Nutrition self management as agreed upon 


Eating behavior (FH-5.4) 
·  Meal duration 
·  Percent of meal time spent eating 
·  Preference to drink rather than eat 
·  Refusal to eat/chew 
·  Patient/client/caregiver fatigue during feeding process resulting in inadequate intake 
·  Willingness to try new foods 
   -  Including high-energy, high-protein foods and beverages 
·  Limited number of acceptable foods 
·  Rigid sensory preferences 
·  Changes in eating patterns, attitudes, and taste perceptions 

Social network behvaior (FH-5.5) 
·  Ability to build and utilize social network 


FACTORS AFFECTING ACCESS TO FOOD AND FOOD/NUTRITION-RELATED SUPPLIES (FH-6) 
Food and nutrition related supplies availability (FH-6.4) 
·  Access to food and nutrition related supplies 
·  Access to assistive eating devices 


PHYSICAL ACTIVITY AND FUNCTION (FH-7) 
Nutrition-related ADLs and IADLs (FH-7.2) 
·  Physical ability to complete tasks for meal preparation 
·  Physical ability to self-feed 
·  Receives assistance with intake 

Physical activity (FH-7.3) 
·  Physical activity history 
   -   Preferences 
   -   Recent changes 
   -   Limitations  
·  Consistency 
·  Frequency 
·  Duration 
·  Intensity 
·  Type of physical activity 
·  Strength 
·  TV/screen time 
·  Other sedentary activity time 

Factors affecting access to physical activity (FH-7.4) 
·  Perceived neighborhood safety 
·  Perceived walkability of neighborhood 
·  Perceived proximity to parks/green space 
·  Perceived access to physical activity facilities/programs 


NUTRITION RELATED CLIENT CENTERED MEASURES (FH-8) 
Food and/or nutrition quality of life (FH-8.1) 
·  Nutrition quality of life responses

Nutrition focused anthropometric measurements (AD-1)

Body composition/growth/weight history (AD-1.1) 
·  Height 
  -  Measured height (lb, oz, kg, g) 
·  Weight 
  -  Measured weight (lb, oz, kg, g) 
  -  Stated weight (lb, oz, kg, g) 
  -  Stated peak weight (lb, oz, kg, g) 
  -  Usual stated body weight (lb, oz, kg, g) 
  -  UBW percentage (%) 
·  Frame 
  -  Frame size (small/medium/large) 
·  Weight change 
  -  Weight gain (lb, oz, kg, g) 
  -  Weight loss (lb, oz, kg, g) 
  -  Weight change percentage (%) 
  -  Specify time frame 
  -  Weight change intent 
  -  Lowest weight/time 
  -  Highest weight/time 
·  Body mass 
  -  Body mass index (BMI) (kg/m²) 
  -  Body mass index prime ratio (BMI prime) (actual BMI to the upper limit BMI of 25) 
·  Body compartment estimates 
  -  Body fat percentage (%) 
  -  Body surface area (m²) 
  -  Bone age (years) 
  -  Bone mineral density t score 
  -  Bone mineral density z score 
  -  Mid arm muscle circumference (in/cm)⁽³⁾ 
        -  <19.0 cm — Severe malnutrition 
        -  19.0 to 22.0 cm — no clinical complications, moderate malnutrition 
  -  Mid arm muscle circumference percentile 
  -  Triceps skin fold thickness 
        -  Calf circumference measured to 0.1cm — 31 cm determines malnutrition risk⁽⁴⁾ 
        -  Corrected arm muscle area — Malnutrition risk: men 21.4 cm² , women 21.6 cm^{2 (5)} 
  -  Triceps skinfold percentile  
  -  Mid upper arm circumference 
  -  Mid upper arm circumference left arm 
  -  Mid upper arm circumference z score

Nutrition focused biochemical data, tests and procedures (BD-1)

Acid base balance (BD-1.1) 
·  Arterial pH 
·  Arterial bicarbonate 

Electrolyte and renal profile (BD-1.2) 
·  BUN 
·  Creatinine 
·  BUN: creatinine ratio 
·  Glomerular filtration rate 
·  Sodium (Na) 
·  Chloride (Cl) 
·  Potassium (K) 
·  Magnesium (Mg) 
·  Calcium, serum (Ca) 
·  Calcium, ionized (Ca) 
·  Phosphorus (P) 

Gastrointestinal profile (BD-1.4) 
·  Alanine aminotransferase (ALT) 
·  Asparate aminotransferase (AST) 

Glucose/endocrine profile (BD-1.5) 
·  Glucose, fasting 
  -  (4.0-6.1 mmol/L) (indicator of inflammatory response) ⁽⁶⁾ 

Inflammatory profile (BD-1.6) 
·  C reactive protein (CRP) 

Metabolic rate profile (BD-1.8) 
·  Resting metabolic rate, measured (RMR) 
·  Respiratory quotient, measured (RQ) 

Mineral profile (BD-1.9) 
·  Zinc (Zn), serum or plasma 
·  Selenium (S), serum or urinary 

Nutritional anemia profile (BD-1.10) 
·  Hemoglobin 
·  Hematocrit 
·  Iron, serum 
·  Total iron binding capacity 
·  Transferrin saturation 

Protein profile (BD-1.11) 
·  Albumin, interpret with caution ⁽⁶⁾ 
·  Prealbumin, interpret with caution ⁽⁶⁾ 
·  White blood-cell count  
·  Nitrogen balance 
·  Tumor markers 

Vitamin profile (BD-1.13)  
·  Vitamin A, serum or plasma retinol 
·  Vitamin C, plasma or serum 
·  Vitamin D, 25 hydroxy 
·  Vitamin E, plasma alpha-tocopherol 
·  Vitamin B6, plasma or serum pyridoxal 5' phosphate concentration 
·  B group vitamins including folic acid, B6, B12

Nutrition focused physical exam (PD-1)

Nutrition-focused physical findings (PD-1.1) 
·  Overall findings 
  -  Underweight, change in how clothes fit  
·  Adipose finding 
  -  Atrophy of orbital fat 
  -  Loss of subcutaneous fat ^(6,7) 
  -  Loss of subcutaneous triceps fat 
  -  Loss of subcutaneous biceps fat 
  -  Loss of subcutaneous fat overlying the ribs 
· Cardiovascular-pulmonary system finding
  -  Dyspnea 
  -  Signs of circulatory collapse, such as cold hands and feet, weak radial pulse or diminished consciousness ⁽⁸⁾ 
·  Digestive system finding 
  -  Abdominal distension 
  -  Anorexia 
  -  Ascites 
  -  Bowel function  
  -  Decrease in appetite 
  -  Early satiety 
  -  Nausea 
  -  Loose stool 
  -  Retching 
  -  Vomiting 
·  Edema finding
  -  Ankle edema 
  -  Starvation edema/nutritional edema - local or generalized fluid accumulation that may mask weight loss (extremities, vulvar/scrotal edema or ascites) ⁽⁹⁾ 
·  Eyes finding
  -  Sunken eyes 
·  Hair ⁽⁴⁾ finding 
  -  Alopecia 
  -  Dry hair 
  -  Hair lacks luster 
  -  Increased loss of hair 
  -  Nutritional hair color change 
·  Hand and nails ⁽⁷⁾ finding
  -  Nail changes 
  -  Discoloration  
  -  Spooning  
·  Mouth finding 
  -  Cracked lips, dryness 
  -  Cheliosis ⁽⁷⁾ 
  -  Gingivitis, tongue changes such as glossitis 
  -  Swollen gums 
·  Muscles finding 
  -  Muscle atrophy ⁽⁷⁾ 
  -  Muscle weakness 
     -  Impaired bility to sit upright 
     -  Hand-grip strength — use to document a decline in physical function ⁽⁶⁾ 
     -  Impaired mobility ⁽¹⁰⁾ 
  -  Quadriceps muscle atrophy 
  -  Deltoid muscle atrophy 
  -  Gastrocnemius muscle atrophy 
  -  Gluteal muscle atrophy 
  -  Interosseous hand muscle atrophy 
  -  Pectoral muscle atrophy 
  -  Temporalis muscle atrophy 
  -  Trapezius muscle atrophy 
  -  Latissiumus dorsi muscle atrophy 
·  Nerves, cognition, and feelings finding
  -  Clouded consciousness 
  -  Depressed mood 
  -  Dizziness 
  -  Feels cold 
  -  Flat affect 
·  Skin finding
  -  Pale complexion 
  -  Impaired wound healing ⁽⁷⁾ 
  -  Pressure injury (specify) 
  -  Scaling skin 
  -  Stasis ulcer 
  -  Yellow skin 
·  Teeth finding
  -  Dental caries 
  -  Edentulous ⁽⁷⁾ 
  -  Impaired dentition 
·  Tongue finding 
  -  Glossitis 
·  Vital signs 
  -  Blood pressure, systolic 
  -  Blood pressure, diastolic 
  -  Pulse rate

NUTRITION DIAGNOSIS ETIOLOGY CATEGORY IDENTIFICATION (EY-1) 
The Etiology Categories are located in the Nutrition Assessment. However, these terms are used in the Nutrition Diagnoses section.  
The Nutrition Diagnoses Etiology Matrix from the Academy of Nutrition and Dietetics is available here.

Beliefs attitudes etiology (EY-1.1)

Cultural etiology (EY-1.2)

Knowledge etiology (EY-1.3)

Physical function etiology (EY-1.4)

Physiologic metabolic etiology (EY-1.5)

Psychological etiology (EY-1.6)

Social personal etiology (EY-1.7)

Treatment etiology (EY-1.8)

Access etiology (EY-1.9)

Behavior etiology (EY-1.10)

INTERVENTION GOAL STATUS (EV-1) 
The Nutrition Diagnosis Status' are located under Nutrition Assessment. 
These terms are used to evaluate the progress towards meeting goals set in the course of Nutrition Intervention. 

New goal identified (EV-1.1)

Goal achieved (EV-1.2)

Goal discontinued (EV-1.3)

Goal not achieved (EV-1.4)

Some progress toward goal (EV-1.5)

Some digression away from goal (EV-1.6)

NUTRITION DIAGNOSIS STATUS (EV-2) 
The Nutrition Diagnosis Status' are located under Nutrition Assessment. 
These terms are used in the Nutrition Diagnoses section to clearly evaluate the status/progress of a nutrition diagnosis. 

New nutrition diagnosis (EV-2.1)

Active nutrition diagnosis (EV-2.2)

Resolved nutrition diagnosis (EV-2.3)

Discontinued nutrition diagnosis (EV-2.4)