MlQfE'#cLoI%E"Kil2 NE^faEg~OaN\n>vCTV./+-). Inadequate energy intake RT disordered eating pattern and history of anorexia nervosa AEB BMI of 16.8 and reported caloric intake at only 52% of estimated energy needs. The PES statement is a structured sentence, hence has a specific format to follow. Here are some examples of nutrition care plans using the three writing styles: As conditions change, goals are met, interventions are determined to be ineffective, or as specific treatable causes of nutrition-related problems for example, chewing difficulties and poor appetite are identified, the nutrition care plan should be updated (2). In addition to muscle and connective tissue weakening, sensory changes can lead to Dysphagia. What is the difference between an ADIME note and a PES statement? Goal 2: Will be free of dehydration as evidenced by good skin turgor and moist mucus membranes. Goal 1: Nutritional needs will be met by tube feedings 100% of the time. Dysphagia. Unfortunately, many dietitians or dietary managers working in long-term care may not know how to write a strong nutrition care plan or wonder what information should be included when writing one. (LogOut/ Dysphagia is a common disorder in neurological and non-neurological intensive care unit (ICU) patients and can lead to aspiration pneumonia, prolonged ventilation, and delayed extubation. Here are a few PES statement examples using the frequently used nutrition diagnoses. Knifeworks Coupon Code 2020, Some of the risk factors for aspiration include individuals with dysphagia, decreased mental status, gastroesophageal reflux disease, stroke, Parkinson's disease, dementia, multiple sclerosis, absence of teeth, decreased alertness due to medications, medical conditions, or a combination of these conditions, and poor oral hygiene.3 The risk of https://www.ncpro.org/nutrition-diagnosis-snapshot. Head over to the Medical Nutrition Therapy Podcast and subscribe! Prevalance of perceived dysphagia and quality of life impairment in the geriatric population. If you would like to change your settings or withdraw consent at any time, the link to do so is in our privacy policy accessible from our home page.. This article guides you through the process of writing nutrition care plans for long-term care and provides templates with examples. (2017). Define stroke.Describe the differences between ischemic and hemorrhagic strokes. Copyright 2023 Fdotstokes.com Powered by Customify. Malnutrition (NI-5.2) %PDF-1.3 Limited adherence to nutrition-related recommendations (NB-1.6) Inadequate protein intake (NI-5.7.1) related to change in appetite or taste as evidenced by history of limited intake of milk, eggs, meat, and fish (reported). The Problem (P) the Nutr PES has a European Conformite Europeenne (CE) mark for the treat-ment of neurogenic dysphagia and US Food & Drug Administration breakthrough designation. An example of data being processed may be a unique identifier stored in a cookie. This article serves as a beginners guide for dietitians and dietary managers on the components of MDS Section K. Read More MDS Section K: A Beginners Guide for DietitiansContinue. (2017). devon horse show 2021. Updated pregnancy growth charts are added . Inadequate protein-energy intake (NI-5.3). Amigo Brothers Text Dependent Questions Answers, You can abbreviate these connected phrases in the following manner: Therefore, this same PES statement would look like this: "Excessive Energy Intake RT frequent consumption of high-calorie meals and snacks, AEB daily caloric intake exceeding estimated energy needs by 750 kcal and 16 lb weight gain in past 3 months. What is an example of a nutrition diagnosis? Continue with Recommended Cookies. Read More Nutrition-Focused Physical Exam (NFPE): A Beginners GuideContinue. The Nutrition Intervention, should aim to resolve or at least attempt to improve the Etiology. Sample PES Statements (problem, etiology, signs and symptoms using some NCP terminology) This statement is provided as an example only, and will not apply to all individuals: Inadequate dietary calcium intake, related to food and nutrition knowledge deficit concerning food and supplemental sources of calcium, as evidenced by avoidance of milk and milk products. Dysphagia PES Statement Example: Swallowing difficulty RT history of esophageal stricture AEB observed coughing and choking while eating and SLP evaluation. Designed to assist practitioner and patient decisions about appropriate nutrition care for specific disease states or conditions in typical settings. The 2023 edition of ICD-10-CM R13.1 became effective on October 1, 2022. Inappropriate intake of sugar related to frequent consumption of regular soft drinks as evidenced by hyperglycemia from blood glucose records after intake. In these situations particularly those that pose a risk to the residents health or safety, such as the refusal of thickened liquids the nutrition care plan should identify the care or service being declined, the risk associated with that choice, and efforts made by the IDT to educate the resident and representative, if applicable. ", Here are some more examples of PES Statements for specific conditions. endstream endobj 102 0 obj <>stream Increased nutrient needs (NI-5.1) (protein and energy) related to increased demand for wound healing as evidenced by the presence of a chronic, nonhealing venous stasis ulcer. Nutrition Diagnosis is a nutrition and dietetics practitioner's identification and labeling of an existing nutrition problem(s) that the practitioner is responsible for treating. There are three ways or templates of writing nutrition care plans: The style you use will likely depend on which electronic health record (EHR) software your facility uses. Have the patient point exactly where. You are now ready to right your PES statement: Swallowing difficulty related to dysphagia as evidenced by constant coughing during meal times. Altered nutrition-related laboratory values (specify) (NC-2.2) The selected diagnosis should be something that can be addressed and resolved by the nutrition intervention(s). Title: Case 23 - Ischemic Stroke Instructions: Answer the questions below. You can learn more about whether to address a CAA in a residents care plan, here. . (LogOut/ Health promotion nursing diagnoses are usually written as one-part statements because related factors are always the same: motivated to achieve a higher level of wellness though related factors may be used to improve the of the chosen diagnosis. Intake of types of fats inconsistent with needs (specify) (NI-5.5.3) Foods and Writing nursing diagnoses using the PES format. Inadequate mineral intake (specify) (NI-5.10.1) He specializes in nutrition for older adults and long-term care regulations as they relate to food and nutrition. The PES statement is part of the Nutrition Care Process (NCP), a systematic approach to providing high-quality nutrition care. inadequate oral intake. The care area assessment (CAA) will trigger for any nutrition problem that requires further assessment. The Signs and Symptoms (the evidence that Then the dietitian works to resolve or improve the nutrition diagnosis with nutrition interventions. If triggered, determine whether the resident is at risk of developing, or currently has a weakness or need that is associated with that CAA, and how the risk, weakness, or need affects the resident. How is acid produced and controlled within the gastrointestinal tract? Inadequate vitamin intake (specify) (NI-5.9.1) You may list more than one etiology in the statement. Oral transit time: a critical review of . Etiologies are grouped in categories according to cause of the diagnosis. PES statement for unintentional weight loss, PES statement for inadequate protein intake. The individualized nutrition care plan is based on information gathered by the comprehensive nutrition assessment and additional nutritional assessments.  XxJ")`CivhLP:J#A!Gc5YU'Kki Dysphagia is common after stroke, associated with increased death and dependency, and treatment options are limited. Inadequate mineral intake (iron) (NI-5.10.1) related to dislike of iron containing foods as evidenced by history of avoiding meat and other sources of heme iron. Excessive energy intake (NI-1.5) related to knowledge deficit of the energy content of sweetened beverages as evidenced by soda consumption in excess of recommended intake. Physical inactivity (NB-2.1) . Start your day off right, with a Dayspring Coffee Writing excellent PES Statements and Nutrition Diagnoses takes practice! The Etiology is supported by the nutrition assessment data. The diagnosis is selected from a set of standardized nutrition diagnostic terms/codes. ;2j&WMm;&y$ykkjXR2FV{l:NM;u; a?#*--mk Altered nutrition-related laboratory values (blood glucose) (NC-2.2) related to hyperglycemia with steroid administration as evidenced by elevated blood glucose levels of 280 mg/dL and dextrose intake of 1 mg/kg/min. Food Safety in Nursing Homes: What You Must Know, Kate Farms Standard: Benefits, Downsides, and Taste, Kate Farms Peptide: Nutrition, Uses, and Taste Review, 8 Best Lactose-Free Protein Powders and Shakes, Kate Farms Nutrition Shake Review, By a Dietitian, member of the food and nutrition services staff, other appropriate staff or health professionals. He presented to his family physician with elevated blood pressure and heartburn. 0 PES Statements are one piece of the formal documentation the ADIME note that is part of the whole standardized methods that dietitians are taught to move through as they provide patient care. dog names that go with maverick Altered gastrointestinal function (NC-1.4) Inadequate protein intake (NI-5.7.1) The etiology statement is free text. Understanding the Disease and Pathophysiology 1. Just another site pes statement for dysphagia Intake of types of fats inconsistent with needs (NI-5.6.3) related to food and nutrition-related knowledge deficit as evidenced by frequent consumption of butter and lard. Unintended weight loss (NC-3.2). The goal of the diet is to find the safest and most enjoyable foods for you to eat. Merely said, the Sample Pes Statements For Diabetes is universally compatible like any devices to read. What does a Dietitian do? Inability to manage self-care (NB-2.3) You should be able to monitor the signsand symptoms and document if they are resolved orimproved. 2009;24(1):1-6. Read More Diabetic Diet: Does It Have a Place in Nursing Homes?Continue. How many biogeographical classification of India? ), stands for, The PES Statement links the nutrition problem (the diagnosis) to the etiology (the cause of the problem) and the signs & symptoms with the words "related to"and "as evidenced by. This article explains the basics of food safety that dietitians and dietary managers working in long-term care must know and the importance of regular food safety and sanitation audits. Here are a few PES statement examples using the frequently used nutrition diagnoses. The PES statement is part of the Nutrition Care Process (NCP), a systematic approach to providing high-quality nutrition care. Self-monitoring deficit (NB-1.4) This domain includes knowledge and beliefs about food, attitudes toward food, physical activity and function, physical environment, access to food, and food safety. Inadequate enteral nutrition infusion (NI-2.3) No regulatory agencies require a PES statement, but its considered the gold standard for communicating and documenting nutrition diagnoses. << /Length 5 0 R /Filter /FlateDecode >> Change), You are commenting using your Twitter account. Autor de la entrada Por ; Fecha de la entrada homes for sale in grand turk; gosport recycling centre book a slot . Swallowing difficulty RT history of esophageal stricture AEB observed coughing and choking while eating and SLP evaluation. For many newly credentialed dietitians and even the more clinically adept dietitians writing the perfect PES statement can be a challenge. Example: "Altered Nutrition-Related Laboratory Values." Practice PES Statement #3 Now for our final example. Clarify if it is a dysphagia to solids/liquid/pills, or all three. v |uC59 ExCpoAC0".X3t:sNA'BohND@S"C "?nHq 99e6DKE+hc#h&wY9Om[yIh!(*OonfoaGYLiR~cF4BlDk-v9Q7/4CcBr:~Oq5[B9PfF0`w&$Zo`yi2(D$xz=i aL#cZsO+Wd.fda>}g$O5 On a nectar thick diet, individuals should avoid all thin liquids that have not been thickened. Also, make sure that you can treat the nutrition diagnosis or improve the signs and symptoms. Inadequate enteral nutrition infusion (NI-2.3) Background A significant portion of critically ill patients with coronavirus disease 2019 (COVID-19) are at high risk of developing intensive care unit (ICU)-acquired swallowing dysfunction (neurogenic dysphagia) as a consequence of requiring If there is no nutrition problem, you have the option of selecting "no nutrition diagnosis at this time" [NO-1.1]. Managing End of Life Inability to Swallow Issue; Excessive oral intake (NI-2.2) Zenker's Diverticulum. Cancer PES Statement Example: Predicted suboptimal energy intake RT increased nutrient needs from chemotherapy treatment, AEB current caloric intake at 60% of estimated needs with treatment. Additional troubleshooting information here. ;#FUlD_V Manage Settings Manometric profile of upper esophageal sphincter. The Nutrition Diagnosis is something that you as a dietitian can resolve (ideally) or improve. What are examples of nutrition intervention? We and our partners use cookies to Store and/or access information on a device. 4 0 obj There are 3 classifications of the nutrition diagnosis: Intake, clinical, and behavioral. Which nutrition diagnosis is from the behavioral environmental domain? While there is almost always a nutrition diagnosis, keep in mind that this is an option! Inconsistent carbohydrate intake (NI-5.8.4) An actual or problem-focus nursing diagnosis has three-part statements: diagnostic label, contributing factor ("related to"), and signs and symptoms ("as evidenced by" or "as manifested by"). Physical inactivity (NB-2.1) They must include the resident and be updated as conditions change, goals are met, interventions are determined to be ineffective, or as specific treatable causes of nutrition-related problems are identified. Soares TJ, Moraes DP, de Medeiros GC, Sassi FC, Zilberstein B, de Andrade CR. The worldwide prevalence of CP is approximately 2-2.5 per 1,000 live births. Dietitians On Demand is a nationwide staffing company for registered dietitians, specializing in short-term, temporary and permanent-hire positions. Refeeding Syndrome: Causes, Symptoms and Treatment, Food Safety in Nursing Homes: What You Must Know, Kate Farms Standard: Benefits, Downsides, and Taste, Kate Farms Peptide: Nutrition, Uses, and Taste Review, 8 Best Lactose-Free Protein Powders and Shakes, Kate Farms Nutrition Shake Review, By a Dietitian, altered nutrition-related laboratory values. PES statements. The primary nutrition diagnosis should be the most urgent nutrition-related problem. Inadequate oral intake (NI-2.1) (S)igns/symptoms: the signs and symptoms are the evidence that the problem exists. ziehen im unterleib beim husten schwangerschaftsanzeichen. Excessive energy intake (NI-1.3) In the Brilliant Dietitians blog, you can learn how to write a PES statement for each specific medical condition along with the appropriate Medical Nutrition Therapy. . The use of any information found on this is site is solely at your own risk. Writing the Nutrition PES Statement can be hard to get a hang of for a new dietitian. `.R)$+c}1m6\-.Ja*J>nV-x Z4K+fmfu|M3g1?O-\U4b__~I}NN`a#g4Q$}k4e^>/S|LOIjev04E)z;qLp,BwJb|AI[-YX&x,~~Nlul(AMf!&O ^-\OI\|u^+:7/&j'sZ7|Y!pc- h9B This article lists five of the most important long-term care dietitian responsibilities. Nutrition intervention was defined as any type of intervention for children aged <5 years to improve their overall nutritional status. The Takeaway. Inadequate fluid intake (NI-3.1) Interventions should be specific stating what, where, when, and how. Read More Dietitian Charting Guidelines for Long-Term CareContinue. 46200. presents for evaluation of total pancreatectomy with islet-autotransplantation. Understanding the intricacies of the NCP will help you write a better PES statement. respiratory compromise - dysphagia - protein energy malnutrition - back to respiratory compromise - eventually to death Contrast the traditional model with the current view of swallowing. According to the Academy of Nutrition & Dietetics: "Nutrition Diagnosis is a nutrition and dietetics practitioner's identification and labeling of an existing nutrition problem(s) that the practitioner is responsible for treating. 2 Case Questions for Medical Nutrition Therapy: A Case Study Approach 4th ed. My journey and experiences, to help your journey. Inconsistent carbohydrate intake (NI-5.8.4) The Nutrition Intervention should be aimed at resolving the Etiology (underlying cause of the nutrition problem). Address: Women Parliamentary Caucus, 1st floor, National Assembly Secretariat, Islamabad, Powered by - Westminster Foundation for Democracy, Ge Smart Dispense Washer Not Dispensing Detergent, Amigo Brothers Text Dependent Questions Answers, Media Consultation on Gender and Climate Change Parliamentary Initiatives, General Assembly Session of WPC 26th January 2021, The role of Women Parliamentarians in Ending violence against women. They describe the signs that the patient has this problem and also indicate the severity of the problem. Increased nutrient needs (NI-5.1) (protein) related to increased protein loss through negative pressure therapy as evidenced by estimated protein intake meeting approximately 50% of estimated requirement, and delayed wound healing. Ge Smart Dispense Washer Not Dispensing Detergent, The Etiology is the root cause of the Nutrition Diagnosis. Step 4: Nutrition Monitoring and Evaluation. This article provides a detailed overview for dietitians working in long-term care on when and what to chart to improve resident care and prevent costly citations from surveyors. It should be specific, so it can be monitored and measured, to be able to evaluate changes. It connects to the nutrition diagnosis by the words related to. All three of these will be found in the data you collected in your nutrition assessment, which is the 1st step in the Nutrition Care Process. Take every detail of your nutrition assessment into consideration when you choose your nutrition diagnosis. hYoAC"-j(Yc{iI@Axxf>;"2L[2Pq 5S8)c@Zf$J =% A PES statement (or Nutrition Diagnosis Statement) is a structured sentence that describes the specific nutrition problem that you (the dietitian) is responsible for treating and working toward resolving, the cause/s of the problem and the evidence that this problem exists. 1992, Horner, Alberts et al. Food- and nutrition-related knowledge deficit (NB-1.1) The effectiveness of PES in ICUtreated stroke patients with combined dysphagia etiology is further backed up by two clinical trials that have shown distinctly higher decannulation rates after repetitive PES compared to sham stimulation (Dziewas et al., 2018; Suntrup, Marian, et al., 2015). The E in the PES Statement stands for Etiology. Inadequate protein-energy intake (NI-5.3) -Gastric acids are produced by parietal cells in the stomach, secreting hydrochloric acid and intrinsic factor. Different types of intervention include food fortification, supplementation, and behavioural and regulatory interventions which have an impact on nutrition outcomes. The etiology describes the cause of the nutrition diagnosis in the PES statement. 20. PES FORMAT. Weight loss of one pound per week until goal weight of 80 kg (175 lbs.) Excessive fat intake (NI-5.6.2) Decreased sense of smell, salivation, and taste, can lead to decreased swallowing ability. STATEMENTS PES FORMAT Problem(P)-some alteration in nutritional status Etiology(E)-cause or contributing risk factors "related to" Signs/symptoms(S)-defining characteristics of the problem " As evidenced by" The nutrition care plan addresses identified causes of impaired nutritional status and reflects the residents goals and choices. It is a nutrition problem identified by the Registered Dietitian that is expected to be treated and resolved by the nutrition team. The PES statement describes the nutrition problem, its root cause, and evidence for the diagnosis. Inadequate fiber intake (NI-5.8.5) related to lack of previous education about dietary fiber as evidenced by estimated daily fiber intake of 15 g. Excessive oral intake (NI-2.2) related to frequent dining out as evidenced by food record and weight gain of 10 lb in past year. For each of the PES statements that you have written, establish an ideal goal (based on the signs and symptoms) and an appropriate intervention (based on the etiology). This article will discuss what the exam consists of, the types of questions you will be asked, as well as some tips to help you study pass the RD exam. 2. Excessive enteral nutrition infusion (NI-2.4) Food- and nutrition-related knowledge deficit (NB-1.1) Methods Lets look an an example of a PES Statement: "Excessive Energy Intake (Problem) related to frequent consumption of high-calorie meals and snacks (Etiology), as evidenced by daily caloric intake exceeding estimated energy needs by 750 kcal and 16 lb weight gain in past 3 months (Signs/symptoms).". Often there are multiple possible nutrition diagnoses, so keep the following in mind when writing the diagnosis for your patient: The diagnosis should be identified from the data and history you collected in the nutrition assessment. . stream basis soap vs dove; pyramid state park county; eaton county accident today; cochise county over the counter tax liens PES Statements Inadequate intake from enternal nutrition related to use of Isosource HN at 75 mL/hr as evidenced by patient care summary sheet and lab values. This article explains the potential consequences of a diabetic diet for older adults living in long-term care and why a liberalized approach to diet offers greater benefits. The care plan includes measurable goals and timeframes to meet a residents individual medical, nutrition, nursing, and psychosocial needs and wishes. The eNCPT contains interactive terminology lists. A Zenker's diverticulum is an outpouching that occurs at the junction of the lower part of the throat and the upper portion of the esophagus. Myocardial Infarction Nutrition Diagnosis. Click to reveal C8-kJA\W/;f`gofkXc`}3&G&!G5R#M0s~'p+m|. RELATIONSHIPS Assessment Diagnosis Intervention Monitor/Eval Problem Etiology Signs/Symptoms Sample:Excessive Mineral(po4) intake related to overconsumption of a limited variety of Recent data demonstrate that dysphagia is mostly persisting and that its presence is independently associated with adverse patient-centered clinical outcomes. The Dietitian's Easy Guide to Nutrition Assessment, A Guide to the Nutrition-Focused Physical Exam. 123 0 obj <>stream coVDH{&a|SH9%UIYDNWyPJP]0cY;xy0+98j+e(@cy6`|TY0NXm{]H[_euF7=pFYq4L$ 6yg\gZMLFf7kYx6VDjT&,9a\kS4A'RRnqq6MC6E&=,N/9cgYz(dH2# T children, dysphagia can occur during any phase of the swallowing process, as well as include avoidance or severe dislike of specific foods or different food textures, tastes or temperature. quanto guadagna un autista di autobus in germania; englische wrter mit ment am ende Michigan Academy of Nutrition and Dietetics. He will have to change his diet to incorporate more fruit, vegetables, and whole grains. Specific questions that food and nutrition professionals should use in evaluating the PES they have developed include the following: Examples of nutrition diagnosis statements (PES) are: Terminology section in the left side bar). MEDICAL DIAGNOSIS PES STATEMENT: We could write this for a medical diagnosis: PROBLEM: uncontrolled DM ETIOLOGY: refusal to use needles, self-administer insulin SYMPTOMS: elevated Glu, A1C Uncontrolled DM related to refusal to self-administer insulin, fear of needles, as evidenced by elevated Glu, A1C LAB VALUE PES STATEMENT: The initial connection between Cloudflare's network and the origin web server timed out. Hey You, awesome RD or RD-to-be! 108 0 obj <>/Filter/FlateDecode/ID[<4981940D9CD2C84EA2FF62D851481A6C><4981940D9CD2C84EA2FF62D851481A6C>]/Index[97 27]/Info 96 0 R/Length 69/Prev 90404/Root 98 0 R/Size 124/Type/XRef/W[1 2 1]>>stream Here you may identify nutrition problems that are related to medical and physical conditions. Food- and nutrition-related knowledge deficit related to lack of exposure to information as evidenced by new diagnosis of type 1 diabetes. Oral communication with a pes statement for managing dysphagia in a defined time to icu team as professional societies or improve the etiology is essential component in clinical assessment. Unintended weight loss (NC-3.2) The PES statement is a structured sentence, hence has a specific format: Nutrition Diagnosis term (the nutrition problem) related to. June 1, 2022. hotel group in singapore. The PES statement describes the nutrition problem, its root cause and evidence for the diagnosis. Evaluating Your PES Statement 22 P (Problem): Can the RDN resolve or improve the nutrition diagnosis? Monster Prom Items, Intake of types of fats inconsistent with needs (specify) (NI-5.6.3) Earlier studies, which were mostly limited by study design, patient selection, and/or limited patient numbers [1,2,3,4,5,6], reported conflicting and inconsistent results regarding the incidence of post-extubation dysphagia.In fact, incidence rates ranged from 3 to 62% []. % orland park sting soccer. Lastly, these interventions are monitored to assess progress and whether the expected goals are being met. inconsistent carbohydrate intake) are different from medical diagnosis (ex. This article gives you the tools you need to confidently write the perfect PES statement, every time. Stage in critical care specialists in principles of epidemiology in clinical assessment for the pes! PES example: Problem: Feeding tube necessary for nutritional needs related to dysphagia secondary to CVA as evidenced by inability to safely and efficiently swallow. oculus air link desktop black screen. CLINICAL. If flexibility, competitive pay, a full benefits package, free CPEUs each month and a team dedicated to dietitians sound good to you, apply to our positions today. Overweight/obesity (NC-3.3) kriegshetzer mal'korak respawn; pes statement for dysphagia pes statement for dysphagiamuskelsteifigkeit beinenmuskelsteifigkeit beinen The Signs and Symptoms (the evidence that the nutrition problem or Nutrition Diagnosis exists). Foods and Edition: 2006 22 INTAKE NI Defined as actual problems related to intake of energy, nutrients, fluids, bioactive substances through oral diet or nutrition support This article gives you the tools you need to confidently write the perfect PES statement every time. The etiology is the cause or contributing risk factors of the nutrition diagnosis. The Essential Pocket Guide for Clinical Nutrition Mary Width 2020-01-22 . The PES statement describes the (P) nutrition problem or nutrition diagnosis, (E) the etiology or root cause, (S) and the signs and symptoms of the nutrition problem. Diabetic Diet: Does It Have a Place in Nursing Homes? Sample PES Statements (problem, etiology, signs and symptoms using some NCP terminology) These statements are provided as examples only and will not apply to all individuals. Malnutrition (NI-5.2) related to chronic illness as evidenced by intake of < 75% of energy needs for > 1 month, 5% weight loss over 1 month, and mild muscle wasting of the temple. The Nutrition Diagnosis, identifies the specific nutrition problem that the dietitian is responsible for treating and works towards resolving. Overweight/obesity (NC-3.3) related to excessive nutrient intake as evidenced by body mass index of 30 and nutrition history indicating consumption of energy in excess of needs. Inadequate mineral intake (specify) (NI-5.10.1), Cardiovascular disease nutrition diagnosis.