First of all, i am greatful to almighty god for establishing me to

complete this training.

I wish to express my sincere thanks to DR.shamshun nehar principle

of ranchi women’s college for providing the with all the necessary
facilities.

Special thanks to dietician Ghazala Matin chief dietician

head of department. For her encouragement and give me a chance to
complete this training her valuable suggestion constant
encouragement towards successful completion of training. I also
thanks to DR.renu kumara coordinator of clinical nutrition and
dietician department Miss Geeta kumara and Miss Arpita mishra
lecturer of CND . I am Also thankful to Nazia neha and Nigar Fatima
to her support.

Also,i want to like to thanks those who have help me

directly and indirectly in the training.

Date sign
22.11.22 Nisha raj
Day-1 and Day-2

NUTRITIONAL SCREENING

It is a process used quickly identify those who may be at risk of

malnutrition so that a full nutrition and appropriate nutrition intervention
can be provided. The purpose of nutritional screening is to rapidly
identify patient who are at high nutritional risk or have poor nutritional
status at hospital admission.
Nutritional screening is the brief evalution to complex process applied to
this subset to delineated further their nutritional status.
Nutritional assessment in A, B, C, D
A- Anthropometric measurement
B- Biochemical measurement
C- Clinical measurement
D- Dietary measurement
ANTHROPOMETRIC
Patient name
Age

Height

Weight
BMI
IBW
Body fat
Body water
HEIGHT
• The distance from the bottom of the feet to the top of the head.
Height can severe as an indicator of 2 key welfare components
namely nutritional quality and health.
• To measure height, first take of your shoes and socks.
• Stands as an upright as possible align with the wall on an even floor
ensure that your back and heel touch the walls.
• Slight a flag object like a book or cutting board along the wall until you can bring
it down to make fum contact with the top of your hand.
• Mark under the object where it lands.
• Use a tap measure to determine your height from the floor to the mark.

WEIGHT

• The weight of a person or things is how heavy they are measure in

units such as kg, pounds, and tuns.
• Use a digital scale.
• Remove shoes and heavy cloth& accessories.
• Stand with both feet in the centre of the scale.
• Record the weight to the nearest decimal fraction.

BMI (body mass index)

It is a valuable derived from the mass and height of a person the BMI is
defined as the body mass divided by the square of the body height and is
express in unit of kg/m

BMI – 2

RANGE OF BMI
Underweight – below 18.5
Normal – 18.5 – 24.9
Overweight Grade 1 – 25 – 29.9
 Grade 2 – 30 - 34.9
Grade 3 – 35 – 39.9
Obesity – more than 40

IBW (ideal body weight)

It is a clinical standard that in corporates biometric variable including
height gender and age.
Female – height in CM – 105
Male – height in CM – 100
BODY FAT
Generally refers to adipose tissue a complex connective tissue with
specific roles in metabolism and endocrine function, formula – (1.20×BMI )
+ (0.23×AGE ) – 16.2
BODY WATER
Body water is the water contain of an animal body that is contain in the
tissue blood, bones and else were. The ℅ of body water contains in
various fluid, compartment, add up to the total body water. This water
makes up a significant fraction of the human body. Both by wt and by
volume.
Body water formula –

CASE STUDY
Pt. Name: Basundhra Das
AGE: 19
HEIGHT: 150 CM
WEIGHT: 64
wt ∈kg
BMI : 2
ht ∈m
 64
=
( 1.50 )2
64
= 2.25

= 28.4 kg/m2

IBW = ht in CM – 105
= 150- 105
= 45
BODY FAT = (1.20×28.4) + (0.23×19) – 16.2
= 34.08 + 4.37 – 16.2
= 38.45- 16.2
= 22.25

BODY WATER
30
= 45 × 1000

= 1.35

DIFFERENT TEST IN DIFFERENT DISEASE CONDITION

I. Kidney function test (KFT) –

 Blood urea –20-40 mg/dl
 Serum creatinine –0.5 – 1.5 mg/dl
 Serum sodium (NA+) –135 – 145 mg/dl
 Serum potassium (k+) –3.6 - 5.5 mg/ dl
 Uric acid –3.0 - 8.2 mg/dl
II. Liver function test (LFT) -
 Billirubine–0.1 – 1.2 mg/dl
 Direct billirubine–0.1 –0.3 mg/dl
 Indirect billirubine–0.2 – 0.8 mg/dl
 SGPT –20 – 40 U/L
 SGOT –20 – 45 U/L
 Total protein –6.0 – 7.8 g/dl
 Albumin –3.5 – 5.5 g/dl
 Globulin –2.3 – 3.5 g/dl

III. Electrolyte test –

 Sodium –135 – 145 mg/dl
 Potassium – 3.6 –5.5 mg/dl
 Calcium – 8.7 – 11.0 mg/dl

IV. Thyroid test –

 Triodothyrionine(T3) - 60 – 180 mg/dl
 Thyroxine(T4) – 5 – 12 mg/dl
 Thyroid stimulating hormone(TSH) – 0.5 – 5.0 mg/dl
 Complex blood count (CBC)
 Haemoglobin (HB) – 12 -15g/dl (for female )
 13.5 – 17.0 g/dl (for male)
 Total leucocytes count (TLC) – 4000 – 11000/cum
 Neutrophils – 54 – 62%
 Lymphocytes – 1000 – 4800

V. Lipid profile Test (LPT) –

 Total cholesterol – 200mg/dl
 High density lipoprotein (HDL) – 55mg/dl
 Low density lipoprotein (LPD) – 150 mg/dl
 Triglycerides – 150mg/dl
 Very low density lipoprotein(VLDL) – 2-30 mg/dl
 VI. Sugar Test –
 Fasting – 70 – 110 mg/dl
 Post prandial(pp) – 140 mg/dl
 Random blood sugar(RBD) – 150 mg/dl
 HbA1C –
NORMAL – (below 6.0%)
Prediabetic – (6.0 – 6.4%)
Diabetic - (more than 6.5%)

VII. Fever
 WIDAL Test (for typhoid)
 Optimal Test (for malarial parasite)

VIII. Prothrombine Time

 Bleeding Time – 2 – 7 minutes
 Clotting Time – 4 – 10 minutes

DIET CODE –

1. N/D – Normal Diet

2. S/D – Soft Diet
3. L/D – Liquid Diet
4. D/D – Diabetic Diet
5. R/D – Renal Diet
6. D/R/D – Diabetic Renal Diet
7. NBM – Nil by mouth
8. L/C – Low cholesterol Diet
9. S/S – Semi Solid
10. S/D – Semi Diet
11.S/D/ - Soft Diabetic Diet
12.R/S/D – Renal Soft Diet

Diagnosis Diseases Introduction

 The process of identifying a disease, condition or injury from its sign and symptom
A Health history, physical, exam and test such as blood test, imaging test and
biopsis may be used to and make a health diagnosis.
Health care specialist carry out medical diagnostic and procedure to purpose
therapy prevent the recurance of the condition. One of the first slep diagnostic
procedure is to identify medical Indication patient Any variation from a patient
normal state is first identified.

Steps to Diagnosis
 Taking appreciate symptoms and collecting relevant data .
 Physical Examination :- Generating and differential diagnosis.
 Testing, Oduring, Reveing and acting on test result.
 Reaching a final diagnosis.
 Consultation ( refering to sick clasification this indicated)

Why do we diagnose a disease

Diagnosis helps workers screen for problems and manage client
safety. Accurate diagnosis is necessary for the research Foundation of
evidance based practice.

How to know diagnosis with lab test

Lab test and diagnostic procedure are test used to check if a person health is
normal
For example : a lab can test a sample of your blood test, urine test Or body tissue to
see if something is wrong.
A Diagnostic test , like blood pressure, testing. Can show, if you have high bp Or
low bp.

What is Creatining
Creatining is a waste product that comes from the normal Wear and tear on
muscle of the body.

What is Potassium test

 A potassium test measures the amount of k + in blood letium , the fluid part of your
blood. Potassium is a mineral that helps nerve and muscles communicate nutrients
move into cell and waste product used move out of cell .

What is Sodium test

A Sodium blood test is protein tell that may be used to check your general health. It
may be used to find and monitor condition that the balanced of fluid and acidity in
your body.

What is Urea test

Urea is a waste product that your kidney removed from your blood. Higher than
normal urea level will be a sign that your kidney are not working well.

What is urea acid test

This test measure the amount of uric acid in your blood or urine. Uric acid is a
normal waste product that made when the body breakdown the chemical called p-
urine

What is SGPD
The full form of SGPD is serum Glutamic Pyruvic transaminase. The SGPD is an
enzyme commonly found in animal. Many body tissue and mostly in liver.

What is SGOT
The fullform of SGOT is Serum Glutamic Ovaloacitic transaminase. SGOT is one
of the two liver enzyme it is also known as SGOT .

Glucose test
Many type of glucose test exist and they can be used to estimate blood sugar level
at a given time or over a longer period of time, to obtain average level how fast
body is able to normalize change glucose level .

What is pp test
Post predial test mean after a meal this test is done to see how your body
response to sugar and stratch after you eat a meal.

What is HbA1C test?

This test is also known as the haemoglobin A1C OR HbA1C is a sample blood test
that measure your average blood sugar level over the past three months . it is one
of the commonly used to test diagnosis prediabetic and diebatic and also main test
to help you and your health care and manage your diabetic .

What is HDL cholesterol test ?

HDL cholesterol test measures amount the high lipoprotein good cholesterol is your
blood. High HDL rate may lower your heart disease.

What is LDL?
A complete cholesterol test include the calculation of 4 types of fats in your blood.
Total cholesterol this is sum of your blood cholesterol contain low density of
lipoprotein. This is called bad cholesterol.

Case study – 02
 Patient Name – Rekha devi
 Age – 42
 Sex – Female
 Height – 152 cm
 Weight – 52 kg
 B.M.I – 22.07kg/m2
 I.B.W – 47kg
 Body fat – 17.54gm
 Body water – 1.41L
 Chief complain – pain in abdomen,vomiting,nausea
 Diagnosis – cholelithiasis
 Diet - liquid diet after N/B/M for 6hr
 Biochemical report –
Haemoglobin – 12.2 gm/dl
Platelets counts – 2.33 cell/cu.mm (1,50,000-4,00.000)
 Consultants – DR. AJIT KUMAR
 SL.NO MEDICINE NAME MECH. Of action

1. Inj. PANTOP/PAN 40 It is used to control gases.

2. ONDEM It is reduce vomiting.

3. Inj. DILONA It is use in pain,swelling.

4. Inj.Neomit It is used for nausea, vomiting due to

certain medical conditions like
sromach upset.

5. Inj.Amikacin (500mg) it is use to treat serious bacterial

infections.

 Diet prescribed – Liquid diet (every 3 hourly)

# ONE DAY MENU PLAN

TIME MENU AMOUNT
6.00 AM MILK 200ml
9.00 AM Fruit juice (pomegranate) 200ml
12.00 AM Coconut water 200ml
3.00 AM Dal water 200ml
6.00 AM Clear veg (beans,cabbage,carrot, 200ml
Arrow powde).
9.00 AM milk 200ml
Case Study – 03
 Patient Name – klan Ansari
 Age – 50
 Sex – male
 Height – 162cm
 Weight – 50 kg
 B.M.I – 19.08kg/m2
 I.B.W – 62kg
 Body fat – 17.27gm
 Body water – 1.86L
 Chief complain – blurry vision,inability to see in dim light or loss
 Diagnosis – cataracts (motiyabind)
 Date of admission – 12/11/22
 Date of discharge – 14/11/22
 Biochemical Report –
Blood pressure – 120/80
Sugar – 98.0mg/dl
Non diabetic

# MEDICINE INTAKE
Serial no. Medicine name MECH. OF action

1. Tablet combiflame It reduce pain,fever,

inflammation
2. Tablet ciplox (500mg) It helps in control eye
Infections.
3. E/D Teargrade It is use as a lubricant
For dry eyes.
4. E/D Quadmox-Dx it is used to treat
bacterial
infections of the eye.

#Diet
 Diet prescribed –soft diet
ONE DAY MENU PLAN
TIME MEAL MENU AMOUNT
7.00A Early Tea 1 cup+biscuit(2pc) 50ml+12.5gm
M morning
8.00A Breakfa Toasted bread(4slice) 100gm+5gm+200ml
M st +butter+milk(1bowl)

10.00 Mid Fruits(boiled apple-1pc) 100gm

morning
1.00P Lunch Rice (1bowl)+dal+veggies(papaya) 100gm+25gm+200g
M +paneer m
+100gm
3.30P Evening Tea 1 cup+biscuit(2pc) 50ml+12.5gm
M tea
5.00P Snacks Veg soup(1bowl) 50gm veggies
M time
9.00P Bed milk 150ml
M time

After O.T precautions should taken by the eye patient are:

 Preventation from dust,gases and smoke.
 Soft diet for 1 week (blend food)
 No pressure to eye, no alcohol.
 No electric gadgets for 3 weeks.
 No bathing,oiling,no shaving(males)for 3 weeks.
 No long journey for 3 weeks.
 Bed rest for 3 weeks.
 Do not sleeping on the operated side of eye.
 5 min gap between every eye drops use.
RYLES TUBE FEEDING –

R.T feeding procedure to provide food to those patient who are either unable to
obtain food direct by mouth or are not in a condition to feeding swallow the food
safely so, the procedure of providing the entire food using a feeding tube is termed
as ryle’s tube feeding.
DALIYA MILK MIXTURE
Amount –
Daliya milk mixture – 100 ml
Daliya – 50 gm
Milk – 150 ml
Sugar – 5 gm
It should be cooked well and clear.

Ryle’s tube feed (100ml 3rd hourly)

Time Menu Amount
6.00 am milk 100 ml

9.00am Clearly veg soup Veg-10g beans+20g cabbage+5g arrow

powder+200ml water
12.00pm mix khichadi liquid Rice(50gm)+dal(25gm)+veggies(50gm)+
Soyabean(10gm)+oil (10ml)+salt(4 mg)
3.00pm Daliya milk Daliya(50gm)+milk(150ml)+sugar(5gm)
6.00pm Clearly veg soup Veg-10 g beans+20g+cabbage+5g arrow
Powder+200ml
9.00pm Mix khichadi liquid Rice 50gm+dal 25 gm +veggies 50 gm
+soyabean 10 gm +salt 4 mg