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Part II Nutrition Assessment, Consequences, and Implications

BOX 15.2 cont. Recommendations from the National Pressure Ulcer Advisory Panel 2014 Guidelines for Prevention and Treatment of Pressure Ulcers Nutrition Screening

Hydration

1. Provide and encourage adequate daily fluid intake for hydration for an individual assessed to be at risk of or with a pressure ulcer. This must be consistent with the individual’s comorbid conditions and goals. (Strength of Evidence = C; Strength of Recommendation = ) 2. Monitor individuals for signs and symptoms of dehydration including change in weight, skin turgor, urine output, elevated serum sodium, and/or calculated serum osmolality. (Strength of Evidence = C; Strength of Recommenda- tion = ) 3. Provide additional fluid for individuals with dehydration, elevated temperature, vomiting, profuse sweating, diar- rhea, or heavily exuding wounds. (Strength of Evidence = C; Strength of Recommendation = ) Fluid serves as the solvent for vitamins, minerals, glucose and other nutrients and transports nutrients and waste products though the body. Health professionals should monitor individuals’ hydration status, checking for signs and symptoms of dehydration such as: changes in weight, skin turgor, urine output, elevated serum sodium, or calculated serum osmolality.7

Vitamins and Minerals

1. Provide/encourage individuals assessed to be at risk of pressure ulcers to consume a balanced diet that includes good sources of vitamins and minerals. (Strength of Evidence = C; Strength of Recommendation = ) 2. Provide/encourage an individual assessed to be at risk of a pressure ulcer to take vitamin and mineral supplements when dietary intake is poor or deficiencies are confirmed or suspected. (Strength of Evidence = C; Strength of Rec- ommendation = ) 3. Provide/encourage an individual with a pressure ulcer to consume a balanced diet that includes good sources of vitamins and minerals. (Strength of Evidence = B; Strength of Recommendation = ) 4. Provide/encourage an individual with a pressure ulcer to take vitamin and mineral supplements when dietary in- take is poor or deficiencies are confirmed or suspected. (Strength of Evidence = B; Strength of Recommendation =

)

Sources: Reprinted with permission from National Pressure Ulcer Advisory Panel, European Pressure Ulcer Advisory Panel, Pan Pacific Pres- sure Injury Alliance. Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline. Washington, DC: National Pressure Ulcer Advisory Panel; 2014.