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High Risk Nutrition Care Plan Guidelines 10

• Provide anthropometric monitoring to address weight concerns, delayed growth, and nutritional inadequacies. Including referrals to the HCP for growth and development concerns as well as possible need for a nutritional supplement. • Provide information on how to improve the intake of dairy products, green leafy vegetables, nuts, eggs, and fish, when appropriate. • Provide suggestions for addressing age-appropriate feeding skills and behavioral and developmental issues associated with feeding, including referrals when appropriate. • For adults with FASD (Nutritional Risk 902 may also be appropriate) staff may provide individualized nutrition education that is appropriate for the learning level of the participant/caregiver. • Adults with FASD may need individualized food packages to meet their needs. For example, A ready to use infant formula may be appropriate if the parent is unable to prepare powder or concentrated infant formula correctly.

All Other Nutritional Risks Considered High Risk at CPA Discretion

See Risk Criteria/Definition for other risks that may be considered High Risk by the CPA.

Assessment, counseling, and referral guidelines: • Complete nutritional assessment according to WIC protocol. • Counsel and provide nutrition education according to assessment findings. • Make referrals, if appropriate, according to Section 3.5 of the WIC Procedure Manual.

Documentation: • Check “High Risk Education” on the Nutrition Education screen under Nutrition Education topics and enter the appropriate risk/diagnosis under Topic Status. • Document the specific details regarding the nutritional assessment and nutrition care plan in the Nutrition Assessment field on the Care Plan Summary screen in Crossroads.

High Risk Care Plan Follow Up For clinics served by Nutrition Associate or Registered Nurse (RN): • The Nutrition Associate or RN may determine High Risk (HR) status and provide counseling/Nutrition Education according to assessment, counseling, and referral guidelines specified for each Nutritional Risk, consulting with a Registered Dietitian (RD) if necessary. • Document according to guidelines specified for each Nutritional Risk. • The Registered Dietitian (RD) must review charts of all participants on the AL High-Risk Participants Report in Crossroads to ensure High Risk guidelines are being followed and evaluate the nutrition care plan. If more counseling/education is indicated based on documentation, the RD will contact the participant to complete high risk follow-up counseling. The RD will document High Risk follow up in the Nutrition Assessment field