Nutrition

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Trace DC27-6

DiraChart Clinical Reference
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1. Purpose and clinical relevance

DiraChart Clinical Reference

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4. Normal findings

The reference range below is the yardstick for “normal/at-baseline.” Normal findings are documented in Mode A with the skilled rationale that follows in Section 6 — never as “WNL” alone.

  • Intake adequate to meet estimated needs, with appetite at baseline.
  • The prescribed therapeutic diet followed and tolerated.
  • Weight stable at the patient's baseline or goal.
  • No malnutrition-risk indicators — no significant unintentional weight loss, adequate intake, and no new muscle wasting.
  • Chewing and swallowing adequate for the prescribed diet.
  • Enteral nutrition, when present, tolerated with an intact, clean site and the correct formula and rate.
  • No GI symptoms limiting intake.
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