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Good nutrition, the supply of optimal nutrients and fluid to meet requirements, is an essential component of health, with poor nutrition contributing to ill health and prolonged recovery from illness or disease. It is therefore crucial that the nutritional status of all patients is assessed and considered during the whole of the patient's care. This chapter addresses how fluid and nutrition can influence body composition, how to identify patients who are dehydrated and/or malnourished or at risk of malnutrition and, most importantly, how the patient's nutritional needs can be met.
The provision of food and fluids to patients is an integral part of basic care. In normal circumstances, adequate nutritional intake enables the body to maintain homeostasis of body composition and function but in disease states this balance can be altered. The majority of patients will achieve adequate nutrition through the oral route of diet and fluids; however, for some, additional artificial nutritional support will be required to maintain optimal body composition and function. This chapter describes how the patient's needs can be assessed and met through oral, enteral and parenteral routes of fluid and nutrition.