Help with an Outcome (goal) for a care plan on a homeless man with impaired nutrition

[randg111]

I am having a difficult time coming up with an Outcome for my care plan.

I have a homeless man with a nursing diagnosis of Impaired Nutrition: less than body requirements r/t homelessness and lack of resources.

The homeless man is not in the hospital setting. We are doing this based on his everyday living environment. So, I'm not sure what kind of outcome would be reasonable. I also need to come up with an intervention.

I was thinking along the lines of...outcome: he will eat at least one complete meal a day.

For intervention: I could provide information to him of the location of all the local food pantries and mission shelters that serve meals.

I don't know....it just doesn't seem like that is enough, or even appropriate.

Anyone have any suggestions? Thanks in advance.

[Daytonite, BSN, RN]

i'm afraid to ask. . .was this the nursing diagnosis you were given? because the etiology (cause) of the impaired nutrition: less than body requirements has to be why the patient has an insufficient intake. this is a physiological diagnosis and homelessness and lack of resources are really psychosocial problems. the baseline reason he has insufficient intake is that he isn't getting enough food to eat. if he is not able to find where to get meals then that should be diagnosed as ineffective coping (poor problem solving skills) or ineffective health maintenance (insufficient resources, i.e. money, shelter). the diagnostic statement needs to be corrected to state something more appropriate such as impaired nutrition: less than body requirements r/t inadequate intake aeb [supporting data, i.e. weight and height]. an outcome will be your predicted results (how you can make his intake adequate) through your independent nursing actions. your nursing intervention targets the supporting data and needs to lead toward achieving the outcome. another suggestion would be to use ineffective health maintenance r/t insufficient financial resources aeb unable to buy food necessary to meet daily rda requirements. outcome: patient will be supplied the locations of places where he can obtain free balanced meals several times a day. make sure you make some calls to find out what resources actually are available in your area for the homeless. you may be surprised at what is (or isn't) available and what kind of hoops the clients have to jump through to get these services.

[randg111]

Thank you for your suggestions. I am nearing the end of my first semester (thank goodness!!) and the complete care plans are still pretty new.

The diagnosis I included in my original post was obtained in a collaborated effort, and approved. So, I was trying to work from it.

Your suggestions make sense. I really appreciate the rationalizations as well! It really helps.

Geesh, I feel like I'm never going to make it through these next 3 semesters!! Glad I found this site! It seems to be very helpful, with lots of insite. Awesome!

[Daytonite, BSN, RN]

You'll make it. You learned to tie your shoelaces and drive a care, didn't you? Care planning and diagnosing take time and experience to learn. Care planning is determining the patient's nursing problems. Using the nursing process is the best way to do that. The nursing process is a problem solving method. It takes some time to get used to it, but its sequence of steps is pretty rational. There are also nursing diagnosis references to help in the choice of diagnoses. By looking through these diagnoses (there are 188 of them) periodically and looking at their definitions, related factors and defining characteristics you have an idea of what diagnoses are actually available. That's how I knew there was something else to use beside the nutrition diagnosis for this patient. A lot rests with the way you view the problem. When I saw "homeless" and "lack of resources" I started seeing more than just a nutrition problem.

[randg111]

Thanks for the encouragement.

For that scenario, we had to use the priority diagnosis. Which is why nutrition was suggested because without that, the body can deteriorate. That was our rationalization anyway. :uhoh21:

Your suggestions make more sense though. I have to look in my NANDA book again and see what I can pull from there that is similar, or comparable. We have to reference our book and it just doesn't seem like there are enough choices in that thing!