Course: NURS 2750 Nutrition and the Role of the Professional Nurse

Title of Assignment: Nutritional Screening Instructions and Criteria

Course Outcomes/Upon completion of this assignment, the student will:

· CO #1: Apply theories and concepts from the arts and sciences to provide prevention-based nutritional care of clients.
· CO #5: Assess protective and predictive factors, including genetics, which influence the nutritional health of individuals, families and communities.
· CO #7: Identify integrative modalities and their role in nutritional health.

You will perform a mini nutritional assessment on the elder you have chosen for the “Health History/Wellness” assignment in NURS 2700.

1. Before completing the nutritional assessment on the elderly person:
A. Go to the following website:

View the 30-minute video titled Assessing Nutrition in Older Adults

B. There is an instructional guide you should review and may even want to take with you for reference during your interview with the elderly person. This is a step-by-step guide that makes completing this assessment very easy. Advance preparation is necessary, so you are prepared for the assessment process. You can access the guide at the following website:

Assignment Criteria:

1. Complete nutritional screening of the older adult. Ask questions regarding family history of nutrition related diseases (Type II Diabetes Mellitus, cardiovascular disease, hypertension, obesity, overweight, malnourishment, osteoporosis, certain cancers etc.) to evaluate and provide information in your plan that relates to this topic.

2. Include a typewritten reflection/evaluation of the completed assessment including the following information (2 pages maximum):

a. Summarize your findings from the screening tool; include relationship of genetics and nutritional screening findings and relate findings based on readings/assigned resources. Be specific to nutritional status only. Cite sources appropriately.

b. Develop a plan that will assist the elderly person to maintain or improve their nutritional status to promote wellness; including at least 2 individualized strategies to assist the elderly person to attain these goals. At least one of these strategies must be considered an “integrative (complementary or alternative; not directly related to nutrition) modality.” Provide rationale for how these strategies will promote nutritional health. Cite sources appropriately.

Example: Individualized strategies may include incorporating foods enjoyed in easy-to-prepare methods, involving family in the food preparation process, or encouraging a favorite activity to promote physical activity. Be creative here and specific to the individual needs of the client.

3. Follow APA format; including cover page and separate page of reference. Be sure all of your i

Complete the screen by filling in the boxes with the appropriate numbers. Total the numbers for the final screening score.


Ref. Vellas B, Villars H, Abellan G, et al. Overview of the MNA® – Its History and Challenges. J Nutr Health Aging 2006;10:456-465.
Rubenstein LZ, Harker JO, Salva A, Guigoz Y, Vellas B. Screening for Undernutrition in Geriatric Practice: Developing the Short-Form Mini
Nutritional Assessment (MNA-SF). J. Geront 2001;56A: M366-377.
Guigoz Y. The Mini-Nutritional Assessment (MNA®) Review of the Literature – What does it tell us? J Nutr Health Aging 2006; 10:466-487.
Kaiser MJ, Bauer JM, Ramsch C, et al. Validation of the Mini Nutritional Assessment Short-Form (MNA®-SF): A practical tool for identification
of nutritional status. J Nutr Health Aging 2009; 13:782-788.
® Société des Produits Nestlé SA, Trademark Owners.

© Société des Produits Nestlé SA 1994, Revision 2009.

For more information:

F2 Calf circumference (CC) in cm
0 = CC less than 31
3 = CC 31 or greater

Screening score
(max. 14 points)

12-14 points: Normal nutritional status
8-11 points: At risk of malnutrition
0-7 points: Malnourished

Last name: First name:

Sex: Age: Weight, kg: Height, cm: Date:


A Has food intake declined over the past 3 months due to loss of appetite, digestive problems, chewing or
swallowing difficulties?
0 = severe decrease in food intake
1 = moderate decrease in food intake
2 = no decrease in food intake

B Weight loss during the last 3 months
0 = weight loss greater than 3 kg (6.6 lbs)
1 = does not know
2 = weight loss between 1 and 3 kg (2.2 and 6.6 lbs)
3 = no weight loss

C Mobility
0 = bed or chair bound
1 = able to get out of bed / chair but does not go out
2 = goes out

D Has suffered psychological stress or acute disease in the past 3 months?
0 = yes 2 = no

E Neuropsychological problems
0 = severe dementia or depression
1 = mild dementia
2 = no psychological problems

F1 Body Mass Index (BMI) (weight in kg) / (height in m) 2
0 = BMI less than 19
1 = BMI 19 to less than 21
2 = BMI 21 to less than 23
3 = BMI 23 or greater

Mini Nutritional Assessment

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