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"+i.toUpperCase(),l.appendChild(u),s.length>1){const p=document.createElement("img");p.src=Z,p.width=12,p.height=12,l.appendChild(p);const f=document.createElement("div");f.className="preview-variant-menu";for(const v of t.variants.filter(w=>w.id!==t.currentVariant)){const w=document.createElement("div");w.className="preview-variant-menu--item";const T=document.createElement("div");T.className="menu-variant-label",T.style.backgroundColor=this.getVariantColor(v.label).bg,T.style.color=this.getVariantColor(v.label).text,T.style.flexShrink="0",T.innerText=v.label.toUpperCase(),w.appendChild(T);const U=document.createElement("span");U.innerText=v.title?v.title:"Untitled variant "+v.label.toUpperCase(),w.appendChild(U),w.addEventListener("click",()=>{this.pickVariant(v.id)}),f.appendChild(w)}c.appendChild(f),l.addEventListener("click",()=>{f.className!=="preview-variant-menu preview-variant-menu__visible"?f.classList.add("preview-variant-menu__visible"):f.classList.remove("preview-variant-menu__visible")}),document.addEventListener("click",v=>{v.target instanceof Element&&!l.contains(v.target)&&f.className==="preview-variant-menu preview-variant-menu__visible"&&f.classList.remove("preview-variant-menu__visible")})}else l.style.pointerEvents="none",h.style.margin="0";c.appendChild(l),r.appendChild(c);const g=document.createElement("div"),m=document.createElement("button");m.id="shoplift-exit-preview-button",m.innerText="Exit",g.appendChild(m),m.addEventListener("click",()=>{this.exitPreview()}),r.appendChild(g),document.body.appendChild(r),requestAnimationFrame(()=>{r.classList.add("visible")})})}pickVariant(t){var e,i,s,r;if(this.state.temporary.previewConfig){const n=this.state.temporary.previewConfig,o=new URL(window.location.toString());if(n.testTypeCategory===y.UrlRedirect){const c=(e=n.variants.find(l=>l.id===n.currentVariant))==null?void 0:e.redirectUrl;if(o.pathname===c){const l=(i=n.variants.find(h=>h.id===t))==null?void 0:i.redirectUrl;l&&(o.pathname=l)}}if(n.testTypeCategory===y.Template){const c=(s=n.variants.find(l=>l.id===n.currentVariant))==null?void 0:s.pathName;if(c&&o.pathname===c){const l=(r=n.variants.find(h=>h.id===t))==null?void 0:r.pathName;l&&l!==c&&(o.pathname=l)}}n.currentVariant=t,this.persistTemporaryState(),this.queueRedirect(o)}}exitPreview(){var e,i,s,r;const t=new URL(window.location.toString());if(((e=this.state.temporary.previewConfig)==null?void 0:e.testTypeCategory)===y.Template&&t.searchParams.delete("view"),((i=this.state.temporary.previewConfig)==null?void 0:i.testTypeCategory)===y.Script&&t.searchParams.delete("slVariant"),((s=this.state.temporary.previewConfig)==null?void 0:s.testTypeCategory)===y.UrlRedirect){const o=this.state.temporary.previewConfig.variants.filter(l=>l.label!=="a"&&l.redirectUrl!==null).map(l=>l.redirectUrl),c=(r=this.state.temporary.previewConfig.variants.find(l=>l.label==="a"))==null?void 0:r.redirectUrl;o.includes(t.pathname)&&c&&(t.pathname=c)}this.state.temporary.previewConfig=void 0,this.persistTemporaryState(),this.hidePage(),this.queueRedirect(t)}handleTemplatePreview(t){const e=t.currentVariant,i=t.variants.find(n=>n.id===e);if(!i)return!1;this.log("Setting up template preview for type",i.type);const s=new URL(window.location.toString()),r=s.searchParams.get("view");return this.typeFromTemplate()==i.type&&r!==i.affix&&i.affix&&(this.log("Template type matches current variant, redirecting"),s.searchParams.delete("view"),this.log("Setting the new viewParam"),this.hidePage(),s.searchParams.set("view",i.affix),this.queueRedirect(s)),r!==null&&r!==i.affix&&(s.searchParams.delete("view"),this.hidePage(),this.queueRedirect(s)),!0}handleUrlPreview(t){var n;const e=t.currentVariant,i=t.variants.find(o=>o.id===e),s=(n=t.variants.find(o=>o.isControl))==null?void 0:n.redirectUrl;if(!i)return!1;this.log("Setting up URL redirect preview");const r=new URL(window.location.toString());return r.pathname===s&&!i.isControl&&i.redirectUrl!==null&&(this.log("Url matches control, redirecting"),this.hidePage(),r.pathname=i.redirectUrl,this.queueRedirect(r)),!0}handleScriptPreview(t){const e=t.currentVariant,i=t.variants.find(n=>n.id===e);if(!i)return!1;this.log("Setting up script preview");const s=new URL(window.location.toString());return s.searchParams.get("slVariant")!==i.id&&(this.log("current id doesn't match the variant, redirecting"),s.searchParams.delete("slVariant"),this.log("Setting the new slVariantParam"),this.hidePage(),s.searchParams.set("slVariant",i.id),this.queueRedirect(s)),!0}async handlePricePreview(t){const e=t.currentVariant,i=t.variants.find(s=>s.id===e);return i?(this.log("Setting up price preview"),i.domSelectors&&i.domSelectors.length>0&&(E(document,{testId:t.testId,hypothesisId:i.id,selectors:i.domSelectors}),await this.ensureCartAttributesForExistingPriceTests(!0)),!0):!1}async finalize(){const t=await this.getCartState();t!==null&&this.queueCartUpdate(t),this.pruneStateAndSave(),await this.syncAllEvents()}setShoplift(){this.log("Setting up public API");const e=this.urlParams.get("slVariant")==="true",i=e?null:this.urlParams.get("slVariant");window.shoplift={isHypothesisActive:async s=>{if(this.log("Script checking variant for hypothesis '%s'",s),e)return this.log("Forcing variant for hypothesis '%s'",s),!0;if(i!==null)return this.log("Forcing hypothesis '%s'",i),s===i;const r=this.testConfigs.find(o=>o.hypotheses.some(c=>c.id===s));if(!r)return this.log("No test found for hypothesis '%s'",s),!1;const n=this.state.essential.visitorTests.find(o=>o.testId===r.id);return n?(this.log("Active visitor test found",s),n.hypothesisId===s):(await this.manuallySplitVisitor(r),this.testConfigs.some(o=>o.hypotheses.some(c=>c.id===s&&this.state.essential.visitorTests.some(l=>l.hypothesisId===c.id))))},setAnalyticsConsent:async s=>{await this.onConsentChange(s,!0)},getVisitorData:()=>({visitor:this.state.analytics.visitor,visitorTests:this.state.essential.visitorTests.filter(s=>!s.isInvalid).map(s=>{const{shouldSendToGa:r,...n}=s;return n})})}}setShopliftStub(){this.log("Setting up stubbed public API");const e=this.urlParams.get("slVariant")==="true",i=e?null:this.urlParams.get("slVariant");window.shoplift={isHypothesisActive:s=>Promise.resolve(e||s===i),setAnalyticsConsent:()=>Promise.resolve(),getVisitorData:()=>({visitor:null,visitorTests:[]})}}async manuallySplitVisitor(t){this.log("Starting manual split for test '%s'",t.id),await this.handleVisitorTest([t]),this.saveState(),this.syncAllEvents()}async handleVisitorTest(t){await this.filterTestsByAudience(this.testConfigs,this.state.analytics.visitor??this.buildBaseVisitor(),this.state.essential.visitorTests);let e=t?t.filter(i=>this.testsFilteredByAudience.some(s=>s.id===i.id)):[...this.testsForUrl(this.testsFilteredByAudience),...this.domTestsForUrl(this.testsFilteredByAudience)];try{if(e.length===0)return this.log("No tests found"),!1;this.log("Checking for existing visitor test on page");const i=this.getCurrentVisitorHypothesis(e);if(i){this.log("Found current visitor test");const o=this.considerRedirect(i);return o&&(this.log("Redirecting for current visitor test"),this.redirect(i)),o}this.log("No active test relation for test page");const s=this.testsForUrl(this.inactiveTestConfigs.filter(o=>this.testIsPaused(o)&&o.hypotheses.some(c=>this.state.essential.visitorTests.some(l=>l.hypothesisId===c.id)))).map(o=>o.id);if(s.length>0)return this.log("Visitor has paused tests for test page, skipping test assignment: %o",s),!1;if(this.hasThemeAndOtherTestTypes(this.testsFilteredByAudience)){this.log("Store has both theme and non-theme tests");const o=this.visitorActiveTestType();this.log("Current visitor test type is '%s'",o);let c;switch(o){case"templateOrUrlRedirect":this.log("Filtering to non-theme tests"),c=h=>h!=="theme";break;case"theme":this.log("Filtering to theme tests"),c=h=>h==="theme";break;case null:c=Math.random()>.5?(this.log("Filtering to theme tests"),h=>h==="theme"):(this.log("Filtering to non-theme tests"),h=>h!=="theme");break}const l=e.filter(h=>h.hypotheses.every(u=>!u.isControl||!c(u.type)));this.log(`Blocking visitor from being assigned to filtered test IDs: ["${l.map(h=>h.id).join('", "')}"]`),this.state.essential.visitorTests.push(...l.map(h=>({createdAt:new Date,testId:h.id,hypothesisId:null,isThemeTest:h.hypotheses.some(u=>u.type==="theme"),shouldSendToGa:!1,isSaved:!0,isInvalid:!0,themeId:void 0}))),e=e.filter(h=>h.hypotheses.some(u=>u.isControl&&c(u.type)))}if(e.length===0)return this.log("No tests found"),!1;const r=e[Math.floor(Math.random()*e.length)],n=this.pickHypothesis(r);if(n){this.log("Adding local visitor to test '%s', hypothesis '%s'",r.id,n.id),this.queueAddVisitorToTest(r.id,n);const o=this.considerRedirect(n);return o&&(this.log("Redirecting for new test"),this.redirect(n)),o}return this.log("No hypothesis found"),!1}finally{this.includeInDomTests(),this.saveState()}}includeInDomTests(){const t=this.getDomTestsForCurrentUrl(),e=this.getVisitorDomHypothesis(t);for(const i of t){this.log("Evaluating dom test '%s'",i.id);const r=e.find(n=>i.hypotheses.some(o=>n.id===o.id))??this.pickHypothesis(i);if(!r){this.log("Failed to pick hypothesis for test");continue}if(r.isControl){this.log("Control hypothesis - applying DOM selectors and watching for variant selectors");const n=i.hypotheses.filter(o=>o.id!==r.id).flatMap(o=>{var c;return((c=o.domSelectors)==null?void 0:c.map(l=>({...l,testId:i.id})))??[]});n.length>0&&F(document,{testId:i.id,hypothesisId:r.id,selectors:n},o=>{this.queueAddVisitorToTest(o,r),this.syncAllEvents()})}if(!r.domSelectors||r.domSelectors.length===0){this.log("No selectors found, skipping hypothesis");continue}this.log("Watching for selectors"),E(document,{testId:i.id,hypothesisId:r.id,selectors:r.domSelectors},n=>{this.queueAddVisitorToTest(n,r),this.syncAllEvents()})}}considerRedirect(t){if(this.log("Considering redirect for hypothesis '%s'",t.id),t.isControl)return this.log("Skipping redirect for control"),!1;if(t.type==="basicScript"||t.type==="manualScript")return this.log("Skipping redirect for script test"),!1;const e=this.state.essential.visitorTests.find(n=>n.hypothesisId===t.id),i=new URL(window.location.toString()),r=new URLSearchParams(window.location.search).get("view");if(t.type==="theme"){if(!(t.themeId===themeId)){if(this.log("Theme id '%s' is not hypothesis theme ID '%s'",t.themeId,themeId),e&&e.themeId!==t.themeId&&(e.themeId===themeId||!this.isThemePreview()))this.log("On old theme, redirecting and updating local visitor"),e.themeId=t.themeId;else if(this.isThemePreview())return this.log("On non-test theme, skipping redirect"),!1;return this.log("Hiding page to redirect for theme test"),this.hidePage(),!0}return!1}else if(t.type!=="dom"&&t.type!=="price"&&t.affix!==template.suffix&&t.affix!==r||t.redirectPath&&!i.pathname.endsWith(t.redirectPath))return this.log("Hiding page to redirect for template test"),this.hidePage(),!0;return this.log("Not redirecting"),!1}redirect(t){if(this.log("Redirecting to hypothesis '%s'",t.id),t.isControl)return;const e=new URL(window.location.toString());if(e.searchParams.delete("view"),t.redirectPath){const i=RegExp("^(/w{2}-w{2})/").exec(e.pathname);if(i&&i.length>1){const s=i[1];e.pathname=`${s}${t.redirectPath}`}else e.pathname=t.redirectPath}else t.type==="theme"?(e.searchParams.set("_ab","0"),e.searchParams.set("_fd","0"),e.searchParams.set("_sc","1"),e.searchParams.set("preview_theme_id",t.themeId.toString())):t.type!=="urlRedirect"&&e.searchParams.set("view",t.affix);this.queueRedirect(e)}async refreshVisitor(t){if(t===null||!this.state.essential.isFirstLoad||!this.testConfigs.some(i=>i.visitorOption!=="all"))return;this.log("Refreshing visitor"),this.hidePage();const e=await this.getVisitor(t);e&&e.id&&this.updateLocalVisitor(e)}buildBaseVisitor(){return{shopifyAnalyticsId:this.shopifyAnalyticsId,device:this.device,country:null,...this.state.essential.initialState}}getInitialState(){const t=this.getUTMValue("utm_source")??"",e=this.getUTMValue("utm_medium")??"",i=this.getUTMValue("utm_campaign")??"",s=this.getUTMValue("utm_content")??"",r=window.document.referrer,n=this.device;return{createdAt:new Date,utmSource:t,utmMedium:e,utmCampaign:i,utmContent:s,referrer:r,device:n}}checkForThemePreview(){var t,e;return this.log("Checking for theme preview"),window.location.hostname.endsWith(".shopifypreview.com")?(this.log("on shopify preview domain"),this.clearThemeBar(!0,!1,this.state),(t=document.querySelector("#sl-preview-bar-hide"))==null||t.remove(),!1):this.isThemePreview()?this.state.essential.visitorTests.some(i=>i.isThemeTest&&i.hypothesisId!=null&&this.getHypothesis(i.hypothesisId)&&i.themeId===themeId)?(this.log("On active theme test, removing theme bar"),this.clearThemeBar(!1,!0,this.state),!1):this.state.essential.visitorTests.some(i=>i.isThemeTest&&i.hypothesisId!=null&&!this.getHypothesis(i.hypothesisId)&&i.themeId===themeId)?(this.log("Visitor is on an inactive theme test, redirecting to main theme"),this.redirectToMainTheme(),!0):this.state.essential.isFirstLoad?(this.log("No visitor found on theme preview, redirecting to main theme"),this.redirectToMainTheme(),!0):this.inactiveTestConfigs.some(i=>i.hypotheses.some(s=>s.themeId===themeId))?(this.log("Current theme is an inactive theme test, redirecting to main theme"),this.redirectToMainTheme(),!0):this.testConfigs.some(i=>i.hypotheses.some(s=>s.themeId===themeId))?(this.log("Falling back to clearing theme bar"),this.clearThemeBar(!1,!0,this.state),!1):(this.log("No tests on current theme, skipping script"),this.clearThemeBar(!0,!1,this.state),(e=document.querySelector("#sl-preview-bar-hide"))==null||e.remove(),!0):(this.log("Not on theme preview"),this.clearThemeBar(!0,!1,this.state),!1)}redirectToMainTheme(){this.hidePage();const t=new URL(window.location.toString());t.searchParams.set("preview_theme_id",""),this.queueRedirect(t)}testsForUrl(t){const e=new URL(window.location.href),i=this.typeFromTemplate();return t.filter(s=>s.hypotheses.some(r=>r.type!=="dom"&&r.type!=="price"&&(r.isControl&&r.type===i&&r.affix===template.suffix||r.type==="theme"||r.isControl&&r.type==="urlRedirect"&&r.redirectPath&&e.pathname.endsWith(r.redirectPath)||r.type==="basicScript"))&&(s.ignoreTestViewParameterEnforcement||!e.searchParams.has("view")||s.hypotheses.map(r=>r.affix).includes(e.searchParams.get("view")??"")))}domTestsForUrl(t){const e=new URL(window.location.href);return t.filter(i=>i.hypotheses.some(s=>(s.type==="dom"||s.type==="price")&&s.domSelectors&&s.domSelectors.some(r=>new RegExp(M(r)).test(e.toString()))))}async filterTestsByAudience(t,e,i){const s=[];let r=e.country;!r&&t.some(n=>n.requiresCountry&&!i.some(o=>o.testId===n.id))&&(this.log("Hiding page to check geoip"),this.hidePage(),r=await this.makeJsonRequest({method:"get",url:`${this.eventHost}/api/v0/visitors/get-country`,signal:AbortSignal.timeout(this.getCountryTimeout)}).catch(n=>(this.log("Error getting country",n),null)));for(const n of t){if(this.log("Checking audience for test '%s'",n.id),this.state.essential.visitorTests.some(l=>l.testId===n.id&&l.hypothesisId==null)){console.log(`Skipping blocked test '${n.id}'`);continue}const o=this.visitorCreatedDuringTestActive(n.statusHistory);(i.some(l=>l.testId===n.id&&(n.device==="all"||n.device===e.device&&n.device===this.device))||this.isTargetAudience(n,e,o,r))&&(this.log("Visitor is in audience for test '%s'",n.id),s.push(n))}this.testsFilteredByAudience=s}isTargetAudience(t,e,i,s){const r=this.getChannel(e);return(t.device==="all"||t.device===e.device&&t.device===this.device)&&(t.visitorOption==="all"||t.visitorOption==="new"&&i||t.visitorOption==="returning"&&!i)&&(t.targetAudiences.length===0||t.targetAudiences.reduce((n,o)=>n||o.reduce((c,l)=>c&&l(e,i,r,s),!0),!1))}visitorCreatedDuringTestActive(t){let e="";for(const i of t){if(this.state.analytics.visitor!==null&&this.state.analytics.visitor.createdAt<i.createdAt||this.state.essential.initialState.createdAt<i.createdAt)break;e=i.status}return e==="active"}getDomTestsForCurrentUrl(){return this.domTestsForUrl(this.testsFilteredByAudience)}getCurrentVisitorHypothesis(t){return t.flatMap(e=>e.hypotheses).find(e=>e.type!=="dom"&&e.type!=="price"&&this.state.essential.visitorTests.some(i=>i.hypothesisId===e.id))}getVisitorDomHypothesis(t){return t.flatMap(e=>e.hypotheses).filter(e=>(e.type==="dom"||e.type==="price")&&this.state.essential.visitorTests.some(i=>i.hypothesisId===e.id))}getHypothesis(t){return this.testConfigs.filter(e=>e.hypotheses.some(i=>i.id===t)).map(e=>e.hypotheses.find(i=>i.id===t))[0]}hasThemeTest(t){return t.some(e=>e.hypotheses.some(i=>i.type==="theme"))}hasTestThatIsNotThemeTest(t){return t.some(e=>e.hypotheses.some(i=>i.type!=="theme"&&i.type!=="dom"&&i.type!=="price"))}hasThemeAndOtherTestTypes(t){return this.hasThemeTest(t)&&this.hasTestThatIsNotThemeTest(t)}testIsPaused(t){return t.status==="paused"||t.status==="incompatible"||t.status==="suspended"}visitorActiveTestType(){const t=this.state.essential.visitorTests.filter(e=>this.testConfigs.some(i=>i.hypotheses.some(s=>s.id==e.hypothesisId)));return t.length===0?null:t.some(e=>e.isThemeTest)?"theme":"templateOrUrlRedirect"}pickHypothesis(t){let e=Math.random();const i=t.hypotheses.reduce((r,n)=>r+n.visitorCount,0);return t.hypotheses.sort((r,n)=>r.isControl?n.isControl?0:-1:n.isControl?1:0).reduce((r,n)=>{if(r!==null)return r;const c=t.hypotheses.reduce((l,h)=>l&&h.visitorCount>20,!0)?n.visitorCount/i-n.trafficPercentage:0;return e<=n.trafficPercentage-c?n:(e-=n.trafficPercentage,null)},null)}typeFromTemplate(){switch(template.type){case"collection-list":return"collectionList";case"page":return"landing";case"article":case"blog":case"cart":case"collection":case"index":case"product":case"search":return template.type;default:return null}}queueRedirect(t){this.saveState(),this.disableReferrerOverride||(this.log(`Saving temporary referrer override '${document.referrer}'`),this.state.temporary.originalReferrer=document.referrer,this.persistTemporaryState()),window.setTimeout(()=>window.location.assign(t),0),window.setTimeout(()=>void this.syncAllEvents(),2e3)}async syncAllEvents(){const t=async()=>{if(this.isSyncing){window.setTimeout(()=>void(async()=>await t())(),500);return}try{this.isSyncing=!0,await this.syncEvents(),this.syncGAEvents()}finally{this.isSyncing=!1}};await t()}async syncEvents(){var i,s;if(!this.state.essential.consentApproved||!this.shopifyAnalyticsId||this.state.analytics.queue.length===0)return;const t=this.state.analytics.queue.length,e=this.state.analytics.queue.splice(0,t);this.log("Syncing %s events",t);try{const r={shop:this.shop,visitorDetails:{shopifyAnalyticsId:this.shopifyAnalyticsId,device:((i=this.state.analytics.visitor)==null?void 0:i.device)??this.device,country:((s=this.state.analytics.visitor)==null?void 0:s.country)??null,...this.state.essential.initialState},events:this.state.essential.visitorTests.filter(o=>!o.isInvalid&&!o.isSaved&&o.hypothesisId!=null).map(o=>new $(o.testId,o.hypothesisId,o.createdAt)).concat(e)};await this.sendEvents(r);const n=await this.getVisitor(this.shopifyAnalyticsId);n!==null&&this.updateLocalVisitor(n);for(const o of this.state.essential.visitorTests.filter(c=>!c.isInvalid&&!c.isSaved))o.isSaved=!0}catch{this.state.analytics.queue.splice(0,0,...e)}finally{this.saveState()}}syncGAEvents(){if(!this.gaConfig.sendEvents){if(R)return;R=!0,this.log("UseGtag is false — skipping GA Events");return}if(!this.state.essential.consentApproved){this.log("Consent not approved — skipping GA Events");return}if(this.isSyncingGA){this.log("Already syncing GA - skipping GA events");return}const t=this.state.essential.visitorTests.filter(e=>e.shouldSendToGa);if(t.length===0){this.log("No GA Events to sync");return}this.isSyncingGA=!0,this.log("Syncing %s GA Events",t.length),Promise.allSettled(t.map(e=>this.sendGAEvent(e))).then(()=>this.log("All gtag events sent")).finally(()=>this.isSyncingGA=!1)}sendGAEvent(t){return new Promise(e=>{this.log("Sending GA Event for test %s, hypothesis %s",t.testId,t.hypothesisId);const i=()=>{this.log("GA acknowledged event for hypothesis %s",t.hypothesisId),t.shouldSendToGa=!1,this.persistEssentialState(),e()},s={exp_variant_string:`SL-${t.testId}-${t.hypothesisId}`};this.shopliftDebug&&Object.assign(s,{debug_mode:!0});function r(n,o,c){window.dataLayer=window.dataLayer||[],window.dataLayer.push(arguments)}this.gaConfig.mode==="gtag"?r("event","experience_impression",{...s,event_callback:i}):(window.dataLayer=window.dataLayer||[],window.dataLayer.push({event:"experience_impression",...s,eventCallback:i}))})}updateLocalVisitor(t){let e;({visitorTests:e,...this.state.analytics.visitor}=t);for(const i of this.state.essential.visitorTests.filter(s=>!e.some(r=>r.testId===s.testId)))i.isSaved=!0,i.isInvalid=!0;for(const i of e){const s=this.state.essential.visitorTests.findIndex(n=>n.testId===i.testId);s!==-1?(i.isInvalid=!1,this.state.essential.visitorTests.splice(s,1,i)):this.state.essential.visitorTests.push(i)}this.state.analytics.visitor.storedAt=new Date}async getVisitor(t){try{return await this.makeJsonRequest({method:"get",url:`${this.eventHost}/api/v0/visitors/by-key/${this.shop}/${t}`})}catch{return null}}async sendEvents(t){await this.makeRequest({method:"post",url:`${this.eventHost}/api/v0/events`,data:JSON.stringify(t)})}getUTMValue(t){const i=decodeURIComponent(window.location.search.substring(1)).split("&");for(let s=0;s<i.length;s++){const r=i[s].split("=");if(r[0]===t)return r[1]||null}return null}hidePage(t){this.log("Hiding page"),this.cssHideClass&&!window.document.documentElement.classList.contains(this.cssHideClass)&&(window.document.documentElement.classList.add(this.cssHideClass),t||setTimeout(this.removeAsyncHide(this.cssHideClass),2e3))}showPage(){this.cssHideClass&&this.removeAsyncHide(this.cssHideClass)()}getDeviceType(){function t(){let i=!1;return function(s){(/(android|bb\d+|meego).+mobile|avantgo|bada\/|blackberry|blazer|compal|elaine|fennec|hiptop|iemobile|ip(hone|od)|iris|kindle|lge |maemo|midp|mmp|mobile.+firefox|netfront|opera m(ob|in)i|palm( os)?|phone|p(ixi|re)\/|plucker|pocket|psp|series(4|6)0|symbian|treo|up\.(browser|link)|vodafone|wap|windows ce|xda|xiino/i.test(s)||/1207|6310|6590|3gso|4thp|50[1-6]i|770s|802s|a wa|abac|ac(er|oo|s\-)|ai(ko|rn)|al(av|ca|co)|amoi|an(ex|ny|yw)|aptu|ar(ch|go)|as(te|us)|attw|au(di|\-m|r |s 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wa|abac|ac(er|oo|s\-)|ai(ko|rn)|al(av|ca|co)|amoi|an(ex|ny|yw)|aptu|ar(ch|go)|as(te|us)|attw|au(di|\-m|r |s )|avan|be(ck|ll|nq)|bi(lb|rd)|bl(ac|az)|br(e|v)w|bumb|bw\-(n|u)|c55\/|capi|ccwa|cdm\-|cell|chtm|cldc|cmd\-|co(mp|nd)|craw|da(it|ll|ng)|dbte|dc\-s|devi|dica|dmob|do(c|p)o|ds(12|\-d)|el(49|ai)|em(l2|ul)|er(ic|k0)|esl8|ez([4-7]0|os|wa|ze)|fetc|fly(\-|_)|g1 u|g560|gene|gf\-5|g\-mo|go(\.w|od)|gr(ad|un)|haie|hcit|hd\-(m|p|t)|hei\-|hi(pt|ta)|hp( i|ip)|hs\-c|ht(c(\-| |_|a|g|p|s|t)|tp)|hu(aw|tc)|i\-(20|go|ma)|i230|iac( |\-|\/)|ibro|idea|ig01|ikom|im1k|inno|ipaq|iris|ja(t|v)a|jbro|jemu|jigs|kddi|keji|kgt( |\/)|klon|kpt |kwc\-|kyo(c|k)|le(no|xi)|lg( g|\/(k|l|u)|50|54|\-[a-w])|libw|lynx|m1\-w|m3ga|m50\/|ma(te|ui|xo)|mc(01|21|ca)|m\-cr|me(rc|ri)|mi(o8|oa|ts)|mmef|mo(01|02|bi|de|do|t(\-| |o|v)|zz)|mt(50|p1|v 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this.makeJsonRequest({method:"get",url:`${window.location.origin}/cart.js`});return t===null||(t.note===null&&(t=await this.makeJsonRequest({method:"post",url:`${window.location.origin}/cart/update.js`,data:JSON.stringify({note:""})})),t==null)?null:{token:t.token,total_price:t.total_price,total_discount:t.total_discount,currency:t.currency,items_subtotal_price:t.items_subtotal_price,items:t.items.map(e=>({quantity:e.quantity,variant_id:e.variant_id,key:e.key,price:e.price,final_line_price:e.final_line_price,sku:e.sku,product_id:e.product_id}))}}catch(t){return this.log("Error sending cart info",t),null}}async ensureCartAttributesForExistingPriceTests(t){var e;try{if(this.log("Checking visitor assignments for active price tests"),t&&this.state.temporary.previewConfig){const i=this.state.temporary.previewConfig;this.log("Using preview config for merchant:",i.testId);let s="variant";if(i.variants&&i.variants.length>0){const r=i.variants.find(n=>n.id===i.currentVariant);r&&r.isControl&&(s="control")}this.log("Merchant preview - updating hidden inputs:",i.testId,s),this.updatePriceTestHiddenInputs(i.testId,s,!0);return}for(const i of this.state.essential.visitorTests){const s=this.testConfigs.find(n=>n.id===i.testId);if(!s){this.log("Test config not found:",i.testId);continue}const r=s.hypotheses.find(n=>n.id===i.hypothesisId);if(!r||r.type!=="price"){this.log("Skipping non-price hypothesis:",i.hypothesisId);continue}this.log("Found potential price test, validating with server:",i.testId);try{const n=await this.makeJsonRequest({method:"get",url:`${this.eventHost}/api/v0/visitors/price-test/${i.testId}/${(e=this.state.analytics.visitor)==null?void 0:e.id}`});if(!n){this.log("Failed to validate price test with server:",i.testId);continue}if(!n.isActive||!n.isPriceTest||!n.visitorAssigned){this.log("Price test validation failed - Active:",n.isActive,"PriceTest:",n.isPriceTest,"Assigned:",n.visitorAssigned);continue}this.log("Price test validated successfully, updating hidden inputs:",i.testId,n.assignment),this.updatePriceTestHiddenInputs(i.testId,n.assignment,t)}catch(n){this.log("Error validating price test with server:",i.testId,n);const o=r.isControl?"control":"variant";this.updatePriceTestHiddenInputs(i.testId,o,t)}}}catch(i){this.log("Error ensuring cart attributes for existing price tests:",i)}}updatePriceTestHiddenInputs(t,e,i){try{this.log("Updating hidden inputs with price test data:",t,e);const s=`${t}:${e}:${i?"t":"f"}`,r=l=>{const h=l.getAttribute("data-sl-pid");if(this.log(`shouldUpdateInput called with productId: "${h}", isMerchant: ${i}`),!h)return this.log("No product ID on input, returning true"),!0;if(i&&this.state.temporary.previewConfig){const g=this.state.temporary.previewConfig;this.log("Using preview config for merchant");const m=e==="control"?"a":"b",p=g.variants.find(f=>f.label===m);if(!p)return this.log("Target variant not found in preview config for label:",m),!1;this.log(`Checking product ID ${h} against domSelectors for variant ${m}:`,p.domSelectors);for(const f of p.domSelectors||[]){const v=f.cssSelector.match(/data-sl-attribute-(?:p|cap)="(\d+)"/);if(v){const w=v[1];if(this.log(`Extracted ID from selector: ${w}, comparing to: ${h}`),w===h)return this.log("Product ID match found in preview config:",h,"variant:",p.label),!0}else this.log(`Could not extract ID from selector: ${f.cssSelector}`)}return this.log("No product ID match in preview config for:",h,"variant:",m),!1}const u=this.testConfigs.find(g=>g.id===t);if(!u)return this.log("Test config not found for testId:",t),!1;for(const g of u.hypotheses||[])for(const m of g.domSelectors||[]){const p=m.cssSelector.match(/data-sl-attribute-(?:p|cap)="(\d+)"/);if(p&&p[1]===h)return this.log("Product ID match found:",h,"for test:",t),!0}return this.log("No product ID match for:",h,"in test:",t),!1},n=new MutationObserver(l=>{l.forEach(h=>{h.addedNodes.forEach(u=>{if(u.nodeType===Node.ELEMENT_NODE){const g=u,m=g.matches('input[name="properties[_slpt]"]')?[g]:g.querySelectorAll('input[name="properties[_slpt]"]');m.length>0&&this.log(`MutationObserver found ${m.length} new hidden input(s)`),m.forEach(p=>{const f=p.getAttribute("data-sl-pid");this.log(`MutationObserver checking new input with data-sl-pid="${f}"`),r(p)?p.value!==s&&(p.value=s,this.log("Updated newly added hidden input:",s)):(p.remove(),this.log("Removed newly added non-matching hidden input for product ID:",p.getAttribute("data-sl-pid")))})}})})}),o=()=>{const l=document.querySelectorAll('input[name="properties[_slpt]"]');this.log(`Found ${l.length} existing hidden inputs to check`),l.forEach(h=>{const u=h.getAttribute("data-sl-pid");this.log(`Checking existing input with data-sl-pid="${u}"`),r(h)?(h.value=s,this.log("Updated existing hidden input:",s)):(h.remove(),this.log("Removed non-matching hidden input for product ID:",h.getAttribute("data-sl-pid")))})},c=()=>{document.body?(n.observe(document.body,{childList:!0,subtree:!0}),this.log("Started MutationObserver on document.body"),o()):document.readyState==="loading"?document.addEventListener("DOMContentLoaded",()=>{document.body&&(n.observe(document.body,{childList:!0,subtree:!0}),this.log("Started MutationObserver after DOMContentLoaded"),o())}):setTimeout(c,10)};c(),window.__shopliftPriceTestObserver=n,window.__shopliftPriceTestValue=s,this.log("Set up DOM observer for price test hidden inputs")}catch(s){this.log("Error updating price test hidden inputs:",s)}}async makeJsonRequest(t){const e=await this.makeRequest(t);return e===null?null:JSON.parse(await e.text(),k)}async makeRequest(t){const{url:e,method:i,headers:s,data:r,signal:n}=t,o=new Headers;if(s)for(const l in s)o.append(l,s[l]);(!s||!s.Accept)&&o.append("Accept","application/json"),(!s||!s["Content-Type"])&&o.append("Content-Type","application/json"),(this.eventHost.includes("ngrok.io")||this.eventHost.includes("ngrok-free.app"))&&o.append("ngrok-skip-browser-warning","1234");const c=await this.fetch(e,{method:i,headers:o,body:r,signal:n});if(!c.ok){if(c.status===204)return null;if(c.status===422){const l=await c.json();if(typeof l<"u"&&l.isBot)throw new P}throw new Error(`Error sending shoplift request ${c.status}`)}return c}queueAddVisitorToTest(t,e){if(!this.state.essential.visitorTests.some(i=>i.testId===t)&&(this.state.essential.visitorTests.push({createdAt:new Date,testId:t,hypothesisId:e.id,isThemeTest:e.type==="theme",themeId:e.themeId,isSaved:!1,isInvalid:!1,shouldSendToGa:!0}),e.type==="price")){const i=e.isControl?"control":"variant";this.log("Price test assignment detected, updating cart attributes:",t,i),this.updatePriceTestHiddenInputs(t,i,!1)}}queueCartUpdate(t){this.queueEvent(new O(t))}queuePageView(t){this.queueEvent(new D(t))}queueEvent(t){!this.state.essential.consentApproved&&this.state.essential.hasConsentInteraction||this.state.analytics.queue.length>10||this.state.analytics.queue.push(t)}legacyGetLocalStorageVisitor(){const t=this.localStorageGet(this.legacySessionKey);if(t)try{return JSON.parse(t,k)}catch{}return null}pruneStateAndSave(){this.state.essential.visitorTests=this.state.essential.visitorTests.filter(t=>this.testConfigs.some(e=>e.id==t.testId)||this.inactiveTestConfigs.filter(e=>this.testIsPaused(e)).some(e=>e.id===t.testId)),this.saveState()}saveState(){this.persistEssentialState(),this.persistAnalyticsState()}loadState(){const t=this.loadAnalyticsState(),e={analytics:t,essential:this.loadEssentialState(t),temporary:this.loadTemporaryState()},i=this.legacyGetLocalStorageVisitor(),s=this.legacyGetCookieVisitor(),r=[i,s].filter(n=>n!==null).sort((n,o)=>+o.storedAt-+n.storedAt)[0];return e.analytics.visitor===null&&r&&({visitorTests:e.essential.visitorTests,...e.analytics.visitor}=r,e.essential.isFirstLoad=!1,e.essential.initialState={createdAt:r.createdAt,referrer:r.referrer,utmCampaign:r.utmCampaign,utmContent:r.utmContent,utmMedium:r.utmMedium,utmSource:r.utmSource,device:r.device},this.deleteCookie("SHOPLIFT"),this.deleteLocalStorage(this.legacySessionKey)),!e.essential.consentApproved&&e.essential.hasConsentInteraction&&this.deleteLocalStorage(this.analyticsSessionKey),e}loadEssentialState(t){var o;const e=this.loadLocalStorage(this.essentialSessionKey),i=this.loadCookie(this.essentialSessionKey),s=this.getInitialState();(o=t.visitor)!=null&&o.device&&(s.device=t.visitor.device);const r={timestamp:new Date,consentApproved:!1,hasConsentInteraction:!1,debugMode:!1,initialState:s,visitorTests:[],isFirstLoad:!0},n=[e,i].filter(c=>c!==null).sort((c,l)=>+l.timestamp-+c.timestamp)[0]??r;return n.initialState||(t.visitor!==null?n.initialState=t.visitor:(n.initialState=s,n.initialState.createdAt=n.timestamp)),n}loadAnalyticsState(){const t=this.loadLocalStorage(this.analyticsSessionKey),e=this.loadCookie(this.analyticsSessionKey),i={timestamp:new Date,visitor:null,queue:[]},s=[t,e].filter(r=>r!==null).sort((r,n)=>+n.timestamp-+r.timestamp)[0]??i;return s.queue.length===0&&t&&t.queue.length>1&&(s.queue=t.queue),s}loadTemporaryState(){const t=this.sessionStorageGet(this.temporarySessionKey),e=t?JSON.parse(t,k):null,i=this.loadCookie(this.temporarySessionKey);return e??i??{isMerchant:!1,timestamp:new Date}}persistEssentialState(){this.log("Persisting essential state"),this.state.essential.isFirstLoad=!1,this.state.essential.timestamp=new Date,this.persistLocalStorageState(this.essentialSessionKey,this.state.essential),this.persistCookieState(this.essentialSessionKey,this.state.essential)}persistAnalyticsState(){this.log("Persisting analytics state"),this.state.essential.consentApproved&&(this.state.analytics.timestamp=new Date,this.persistLocalStorageState(this.analyticsSessionKey,this.state.analytics),this.persistCookieState(this.analyticsSessionKey,{...this.state.analytics,queue:[]}))}persistTemporaryState(){this.log("Setting temporary session state"),this.state.temporary.timestamp=new Date,this.sessionStorageSet(this.temporarySessionKey,JSON.stringify(this.state.temporary)),this.persistCookieState(this.temporarySessionKey,this.state.temporary,!0)}loadLocalStorage(t){const e=this.localStorageGet(t);if(e===null)return null;try{return JSON.parse(e,k)}catch{return null}}loadCookie(t){const e=this.getCookie(t);if(e===null)return null;try{return JSON.parse(e,k)}catch{return null}}persistLocalStorageState(t,e){this.localStorageSet(t,JSON.stringify(e))}persistCookieState(t,e,i=!1){const s=JSON.stringify(e),r=i?"":`expires=${new Date(new Date().getTime()+864e5*365).toUTCString()};`;document.cookie=`${t}=${s};domain=.${window.location.hostname};path=/;SameSite=Strict;${r}`}deleteCookie(t){const e=new Date(0).toUTCString();document.cookie=`${t}=;domain=.${window.location.hostname};path=/;expires=${e};`}deleteLocalStorage(t){window.localStorage.removeItem(t)}getChannel(t){var i;return((i=[{"name":"cross-network","test":(v) => new RegExp(".*cross-network.*", "i").test(v.utmCampaign)},{"name":"direct","test":(v) => v.utmSource === "" && v.utmMedium === ""},{"name":"paid-shopping","test":(v) => (new RegExp("^(?:Google|IGShopping|aax-us-east\.amazon-adsystem\.com|aax\.amazon-adsystem\.com|alibaba|alibaba\.com|amazon|amazon\.co\.uk|amazon\.com|apps\.shopify\.com|checkout\.shopify\.com|checkout\.stripe\.com|cr\.shopping\.naver\.com|cr2\.shopping\.naver\.com|ebay|ebay\.co\.uk|ebay\.com|ebay\.com\.au|ebay\.de|etsy|etsy\.com|m\.alibaba\.com|m\.shopping\.naver\.com|mercadolibre|mercadolibre\.com|mercadolibre\.com\.ar|mercadolibre\.com\.mx|message\.alibaba\.com|msearch\.shopping\.naver\.com|nl\.shopping\.net|no\.shopping\.net|offer\.alibaba\.com|one\.walmart\.com|order\.shopping\.yahoo\.co\.jp|partners\.shopify\.com|s3\.amazonaws\.com|se\.shopping\.net|shop\.app|shopify|shopify\.com|shopping\.naver\.com|shopping\.yahoo\.co\.jp|shopping\.yahoo\.com|shopzilla|shopzilla\.com|simplycodes\.com|store\.shopping\.yahoo\.co\.jp|stripe|stripe\.com|uk\.shopping\.net|walmart|walmart\.com)$", "i").test(v.utmSource) || new RegExp("^(.*(([^a-df-z]|^)shop|shopping).*)$", "i").test(v.utmCampaign)) && new RegExp("^(.*cp.*|ppc|retargeting|paid.*)$", "i").test(v.utmMedium)},{"name":"paid-search","test":(v) => new 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Imbalanced Nutrition Nursing Diagnosis & Care Plan (Assessment & Interventions) – devshopsimplenursing
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Imbalanced Nutrition Nursing Diagnosis & Care Plan
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Nutrition plays a significant role in how the body heals, fights infection, and maintains strength.
So, when a patient’s intake doesn’t match their body’s needs, nurses turn to the imbalanced nutrition nursing diagnosis to guide care. Whether it’s too few calories, too many, or nutrients gone missing, having a plan is key to preventing complications and supporting recovery. Because when nutrition is off, just about everything else can be too.
What is Imbalanced Nutrition?
Understanding imbalanced nutrition is the first step in recognizing its impact on patient care.
With the right assessment and interventions , nurses play a vital role in helping patients regain nutrition balance.
Definition and Overview
Imbalanced nutrition is when nutrient intake doesn’t align with the body’s energy needs. It can impact physical and cognitive functioning, immune response, and overall quality of life.
Types of nutritional imbalances
1. Less than body requirements – This occurs when nutrient intake is insufficient to meet the body’s metabolic demands, leading to malnutrition, muscle wasting, and compromised immunity.
2. More than body requirements – This involves excessive intake of nutrients, leading to obesity , metabolic syndrome, and increased risk of chronic diseases.
Causes of Imbalanced Nutrition (Related To)
Knowing the underlying causes helps in creating effective care plans.
Inadequate Food Intake
Poor appetite because of illness or medication side effects
Socioeconomic constraints limiting access to nutritious food
Difficulty in chewing or swallowing
Metabolic Disorders
Malabsorption syndromes (e.g., Crohn’s disease , Celiac disease) impair nutrient absorption.
Diabetes affects glucose metabolism, leading to imbalanced energy intake.
Thyroid disorders (hypothyroidism or hyperthyroidism) influence metabolic rate.
Psychological Factors
Eating disorders like anorexia nervosa or bulimia impact food intake.
Depression and anxiety can reduce appetite or cause emotional overeating.
Chronic Illnesses Affecting Digestion and Absorption
Gastrointestinal diseases, e.g., irritable bowel syndrome (IBS), and pancreatitis, impair nutrient digestion.
Chronic infections or cancer increase metabolic demands and reduce intake.
Signs and Symptoms (As Evidenced By)
Recognizing symptoms early is key to effective intervention.
Weight Loss or Gain
Unintentional weight changes over a short period
Body mass index (BMI) outside the normal range for age and sex
Muscle Wasting or Excess Adiposity
Decreased muscle mass and strength in undernutrition
Increased fat accumulation in overnutrition
Fatigue, Weakness, Poor Wound Healing
Generalized weakness and decreased energy levels
Delayed healing and increased susceptibility to infections
Lab Value Abnormalities
Albumin: Low levels indicate protein malnutrition.
Glucose: High or low levels indicate poor glycemic control.
Hemoglobin: Low levels may indicate anemia due to nutrient deficiencies (iron, B12, folate).
Risk Factors for Imbalanced Nutrition
Identifying risk factors can aid in early intervention and prevention.
Age-related Considerations
Pediatric patients: Higher nutritional demands for growth and development
Geriatric patients: Decreased appetite, altered taste, and digestive issues
Socioeconomic Factors Affecting Diet
Limited access to nutritious food because of financial constraints
Lack of knowledge about healthy eating patterns
Medical Conditions Influencing Appetite and Digestion
Chronic illnesses (e.g., cancer, renal disease ) affecting appetite and digestion
Post-surgical conditions requiring special dietary adjustments
Nursing Assessment for Imbalanced Nutrition
A comprehensive assessment is essential to achieving an accurate diagnosis.
Subjective vs. Objective Data Collection
Subjective: Appetite changes, dietary history, and gastrointestinal symptoms
Objective: Weight, BMI, muscle mass, lab values , and physical examination
Nutritional Screening Tools
BMI: Assesses weight status relative to height
Dietary history: Analyzes food intake patterns and nutrient adequacy
Lab values: Measures albumin, glucose , hemoglobin, and electrolytes for metabolic evaluation
Nursing Diagnosis for Imbalanced Nutrition
Formulating accurate nursing diagnoses guides effective care planning .
Common nursing diagnoses for nutrition imbalance
Imbalanced nutrition: Less than body requirements
Imbalanced nutrition: More than body requirements
Risk for deficient fluid volume related to malnutrition
Examples of imbalanced nutrition nursing diagnoses
Coming up with the right nursing diagnosis for nutrition imbalanced means connecting the dots between what’s causing the issue and how it’s showing up in the patient.
Here are two go-to examples — one for undernutrition (malnutrition) and one for overnutrition.
For malnutrition
Imbalanced nutrition: Less than body requirements related to inadequate food intake as evidenced by significant weight loss and muscle wasting
For overnutrition
Imbalanced nutrition: More than body requirements related to excessive caloric intake as evidenced by increased BMI and adiposity
Expected Outcomes & Nursing Goals
Clear goals help in evaluating the effectiveness of interventions.
Achieve and maintain adequate nutritional status within [specific time frame].
Stabilize weight and prevent complications associated with malnutrition or obesity.
Improve lab values (e.g., albumin, glucose) and alleviate physical symptoms.
Nursing Interventions for Imbalanced Nutrition
Targeted interventions support nutritional balance and recovery.
Nutritional Monitoring & Assessment
Regular weight checks and BMI assessments
Calorie counts and dietary intake monitoring
Lab monitoring (albumin, glucose, electrolytes)
Dietary Modifications
For undernutrition: High-calorie, nutrient-dense foods, and supplements
For overnutrition: Caloric restriction with balanced macronutrients
Type
Undernutrition
Overnutrition
What it means
Not getting enough nutrients
Getting too many nutrients (esp. calories/fat)
Common causes
Poor intake, illness, malabsorption, poverty
Overeating, sedentary lifestyle, high-calorie diet
At-risk patients
Older adult, cancer, post-op, eating disorder patients
Patients with obesity, diabetes, hypertension (high blood pressure)
Signs and symptoms to watch for
Weight loss, fatigue, brittle hair/nails, poor wound healing
Weight gain, high blood pressure, high cholesterol, edema
Nursing focus
Encourage intake, supplements, monitor labs
Nutrition education, portion control, monitoring labs
Education & Counseling
Educate patients on proper nutrition and healthy eating habits.
Counsel patients on portion control, meal planning, and reading food labels.
Imbalanced Nutrition Nursing Care Plan Examples
Once a nurse identifies an imbalanced nutrition nursing diagnosis, the next step is to select the right nursing interventions and rationales for imbalanced nutrition.
These care plan examples illustrate how targeted interventions can support recovery and restore nutritional balance in various patient populations.
Care Plan #1: Malnutrition in Elderly Patients
Nursing Diagnosis
Imbalanced Nutrition: Less Than Body Requirements
Related To:
Decreased appetite due to age-related physiological changes, medications, or chronic illness
Difficulty swallowing (dysphagia) associated with neurological conditions (e.g., stroke , Parkinson’s disease ) or weakened oral muscles
Sensory changes affecting taste and smell, leading to reduced food intake
Social factors such as isolation, depression, or financial constraints impacting food access
As Evidenced By:
Unintentional weight loss (>5% of body weight in one month or >10% over six months)
Reduced muscle mass and strength (sarcopenia)
Low BMI for age and height
Poor oral intake documented through dietary assessments
Lab findings indicating nutritional deficiencies (e.g., low albumin, prealbumin, hemoglobin)
Expected Outcomes
Achieve and maintain a healthy weight.
Short-term Goals:
Increase caloric and nutrient intake within one to two weeks.
Maintain or achieve a weight gain of at least 0.5-1 kilograms (kg) per week.
Improve dietary variety and ensure adequate protein, vitamin, and mineral intake.
Enhance appetite and eating experience.
Long-term Goals:
Stabilize weight within a healthy range for age and height within one to three months.
Prevent further weight loss, muscle wasting, and complications related to malnutrition.
Improve overall energy levels, physical functioning, and quality of life.
Maintain adequate hydration status and prevent dehydration.
Assessment
Subjective Data Collection
Dietary History:
Assess usual food intake patterns, meal frequency, and portion sizes.
Identify food preferences, dislikes, and cultural or religious dietary restrictions.
Document appetite changes, food aversions, or early satiety.
Evaluate fluid intake and potential signs of dehydration (e.g., dry mouth, low urine output).
Psychosocial Assessment:
Identify psychosocial factors affecting nutrition, such as loneliness, depression, or financial constraints.
Assess the ability to purchase and prepare meals independently.
Objective Data Collection
Anthropometric Measurements:
Weight and height: Record baseline weight and height to calculate BMI.
BMI: Monitor trends in BMI (<18.5 indicates undernutrition).
Mid-upper arm circumference and calf circumference: Assess muscle mass and sarcopenia.
Laboratory Tests:
Serum albumin and prealbumin: Indicate protein status and malnutrition.
Complete blood count (CBC): Check for anemia or other nutritional deficiencies.
Electrolytes and renal function tests: Assess hydration and kidney status.
Vitamin and mineral levels: Check for deficiencies (e.g., vitamin D, vitamin B12, iron).
Swallowing and Oral Assessment:
Swallowing evaluation: Identify dysphagia risk and the need for modified diets.
Oral health examination: Check for dental issues, ill-fitting dentures, or oral lesions affecting intake.
Nutritional Screening Tools:
Mini nutritional assessment (MNA): Specifically designed for older adult patients
Malnutrition screening tool (MST): Identifies those at risk of malnutrition
Subjective global assessment: Comprehensive assessment of nutritional status
Interventions
Nutrient-dense, Easy-to-swallow Foods:
Offer high-calorie, high-protein foods (e.g., scrambled eggs, yogurt, cheese, and peanut butter).
Include nutrient-dense snacks (e.g., nuts, dried fruits, protein bars).
Fortify foods with protein powder, powdered milk, or liquid supplements.
Offer easily chewable or pureed foods for patients with swallowing difficulties.
Small, Frequent Meals:
Provide five to six small meals or snacks throughout the day to enhance intake without overwhelming the patient.
Schedule meals at regular intervals to establish routine eating habits.
Meal Modifications for Dysphagia:
Collaborate with a speech-language pathologist to assess swallowing ability.
Implement a dysphagia diet.
Level 1 (pureed): Smooth, pudding-like foods without lumps
Level 2 (mechanical soft): Moist, soft-textured foods easy to chew
Level 3 (advanced soft): Soft, bite-sized foods requiring minimal chewing
Use thickened liquids (nectar, honey, or pudding consistency) as recommended.
Care Plan #2: Imbalanced Nutrition Related to Eating Disorders
Nursing Diagnosis
Imbalanced Nutrition: Less Than Body Requirements Related to Psychological Factors Affecting Food Intake
Related To:
Psychological factors affecting food intake, such as distorted body image, anxiety, and fear of gaining weight
Sociocultural influences, including societal pressure for thinness or perfectionism
Comorbid psychiatric conditions such as anxiety disorders, depression , or obsessive-compulsive disorder
As Evidenced By:
Significant weight loss (>15% below ideal body weight)
Refusal to maintain a healthy weight for age and height
Loss of libido (in males) or amenorrhea (in females)
Preoccupation with food, weight, and body shape
Physical symptoms: Bradycardia, hypotension , fatigue, hair loss, dry skin, and electrolyte imbalances
Lab findings: Hypokalemia, hypomagnesemia, anemia, and abnormal liver function tests
Expected Outcomes
Achieve and maintain a healthy weight.
Short-term Goals:
Achieve weight stabilization or gradual weight gain of 0.5-1 kg per week.
Restore normal vital signs (heart rate, blood pressure) and electrolyte balance.
Improve nutritional intake to meet at least 75% of daily caloric requirements.
Establish a trusting therapeutic relationship to support recovery.
Long-term Goals:
Achieve and maintain a healthy weight within 85% to 95% of ideal body weight.
Normalize eating patterns and develop a positive relationship with food.
Correct nutritional deficiencies and promote physical health.
Enhance self-esteem and body image perception.
Prevent relapse and promote long-term recovery through continued psychological support.
Assessment
Monitor weight, vital signs, and mental health status.
Subjective Data Collection
Psychological Assessment:
Assess cognitive distortions related to body image, weight, and food.
Evaluate feelings of guilt, shame, or anxiety related to eating.
Identify emotional triggers for disordered eating behaviors.
Assess motivation for recovery and willingness to participate in treatment.
Behavioral Assessment:
Document restrictive eating patterns, binge eating episodes, or purging behaviors (e.g., vomiting, laxative use).
Evaluate exercise habits, especially excessive or compulsive exercise.
Assess social withdrawal or isolation due to body image concerns.
Objective Data Collection
Weight and Height: Daily or Weekly Weight Checks Under Standardized Conditions
BMI: Monitor trends to assess weight restoration.
Body composition: Monitor muscle mass and fat stores to assess nutritional status.
Vital Signs and Physical Examination:
Vital signs: Monitor heart rate (bradycardia), blood pressure (hypotension), and temperature (hypothermia).
Physical signs of malnutrition: Check for hair thinning, dry skin, lanugo, edema, or dental erosion (from purging).
Laboratory Tests:
Electrolytes: Check for hypokalemia, hypomagnesemia, and metabolic alkalosis or acidosis.
CBC: Identify anemia or leukopenia.
Liver function tests: Assess hepatic stress from malnutrition or purging.
Thyroid function tests: Rule out underlying thyroid abnormalities.
Nutritional Assessment:
Dietary history:
Assess daily caloric intake, food restrictions, and meal patterns.
Identify food avoidance or rituals associated with eating.
Interventions
Collaborate with a multidisciplinary team, which includes mental health professionals.
Mental health professionals: Psychiatrists, psychologists, and counselors for psychiatric management
Registered dietitian: To create individualized meal plans and monitor nutritional rehabilitation
Primary care provider: For medical evaluation, monitoring, and overall coordination of care
Nutritional Counseling and Education
Educate about balanced nutrition, portion sizes, and the importance of all food groups.
Gradually reintroduce feared foods under controlled, supportive conditions.
Caloric Restoration and Meal Planning
Start with a structured meal plan providing 1200-1500 kilocalories (kcal) per day and gradually increase to meet daily requirements.
Small, frequent meals: Consume five to six small meals to prevent gastrointestinal discomfort and promote gradual weight gain.
Nutrient-dense foods: Consume high-protein, high-calorie foods for effective weight restoration.
Care Plan #3: Overnutrition & Obesity in Patients with Diabetes
Nursing Diagnosis
Imbalanced Nutrition: More Than Body Requirements Related to Excessive Caloric Intake and
Sedentary Lifestyle
Related To:
Excessive caloric intake and consumption of high-carbohydrate or high-fat foods
Sedentary lifestyle with minimal physical activity
Emotional eating related to stress, anxiety, or depression
Lack of knowledge about healthy dietary choices and portion control
Insulin resistance associated with obesity, contributing to hyperglycemia
As Evidenced By:
BMI ≥ 30 (obesity) or ≥ 25 (overweight)
Increased waist circumference (>40 inches in men, >35 inches in women)
Elevated fasting blood glucose levels and HbA1c > 6.5%
Hyperlipidemia (elevated cholesterol and triglycerides)
Poor glycemic control with frequent hyperglycemic episodes
History of weight gain or difficulty losing weight
Expected Outcomes
Weight reduction and improved glucose control.
Short-term Goals
Achieve a weight reduction of 0.5-1 kg (one to two pounds) per week.
Improve glycemic control with fasting blood glucose levels between 80 to 130 milligrams per deciliter (mg/dL).
Increase physical activity to at least 150 minutes of moderate-intensity exercise per week.
Demonstrate knowledge of healthy food choices and portion control.
Long-term Goals
Achieve and maintain a weight loss of 5% to 10% of baseline body weight within six to 12 months.
Reduce hemoglobin A1c ( HbA1c) to < 7% and maintain within the target range.
Improve lipid profile — low-density lipoprotein (LDL) < 100 mg/dL, high-density lipoprotein (HDL) > 40 mg/dL in men and > 50 mg/dL in women.
Establish sustainable lifestyle changes to maintain weight loss and glycemic control.
Prevent or minimize complications related to diabetes and obesity (e.g., cardiovascular disease, neuropathy).
Assessment
Monitor BMI, glucose levels, and dietary patterns.
Subjective Data Collection
Dietary History
Assess daily caloric intake, meal patterns, and portion sizes.
Identify high-calorie, high-carbohydrate, and high-fat food choices.
Evaluate eating habits, including emotional eating triggers and snacking behaviors.
Document fluid intake, including sugar-sweetened beverages.
Psychosocial Assessment
Assess emotional and psychological factors contributing to overeating, including stress, anxiety, and depression.
Evaluate motivation to lose weight and readiness for lifestyle changes.
Assess for social support systems, including family involvement in dietary habits.
Identify barriers to weight loss, including financial constraints, cultural preferences, and time limitations.
Exercise and Activity Level:
Assess current level of physical activity and exercise habits.
Identify barriers to physical activity, such as lack of time, physical limitations, or lack of motivation.
Objective Data Collection
Anthropometric Measurements
Body weight and height: Measure to calculate BMI.
BMI: Monitor trends to assess weight loss progress.
Waist circumference: To assess central adiposity and cardiovascular risk.
Vital Signs and Physical Examination
Blood pressure: Monitor for hypertension related to obesity.
Heart rate and respiratory rate: Assess cardiovascular and respiratory status.
Physical signs of obesity-related complications: Look for acanthosis nigricans (insulin resistance marker), joint pain (osteoarthritis), and skin fold irritation.
Laboratory Tests
Fasting blood glucose and HbA1c: To assess glycemic control
Lipid profile: LDL, HDL, triglycerides, and total cholesterol
Liver function tests: To check for non-alcoholic fatty liver disease
Electrolytes and renal function tests: To assess overall metabolic health
Nutritional Assessment
Nutritional screening tools:
24-hour dietary recall: To assess dietary intake and eating patterns
Food frequency questionnaire: To evaluate habitual dietary intake
Calorie count and macronutrient analysis: To monitor caloric intake and macronutrient distribution
Behavioral Assessment
Identify patterns of emotional eating or binge eating.
Assess eating triggers, including stress, boredom, or social situations.
Interventions
Develop a calorie-controlled meal plan and encourage physical activity.
Nutritional Interventions
Calorie-controlled Meal Plan
Design a hypocaloric meal plan with a deficit of 500-750 kcal per day to achieve a weight loss of 0.5-1 kg per week.
Caloric intake recommendations:
Women: 1200-1500 kcal/day
Men: 1500-1800 kcal/day
Macronutrient distribution:
Carbohydrates: 45-55% of total calories (preferably complex carbs)
Protein: 15-20% of total calories
Fat: 20-35% of total calories (preferably unsaturated fats)
Carbohydrate Counting
Educate on carbohydrate counting to maintain glycemic control.
Limit carbohydrate intake to 45 to 60 grams (g) per meal for optimal glucose control.
Encourage low-glycemic index (low-GI) foods to reduce postprandial glucose spikes.
Meal Planning and Portion Control
Teach portion control using visual aids (e.g., plate method).
Implement regular meal patterns with three balanced meals and one to two healthy snacks daily.
Promote mindful eating and awareness of hunger and satiety cues.
Dietary Modifications
Increase fiber intake (25 to 30 g per day) to promote satiety and glycemic control.
Limit saturated fat (<7% of total calories) and trans fat intake.
Reduce sodium intake (<2300 mg per day) to control blood pressure.
Behavioral and Psychological Support
Conduct motivational interviewing to enhance readiness for lifestyle change.
Implement stress management techniques (e.g., mindfulness, deep breathing exercises).
Physical Activity and Exercise
Physical activity recommendations:
Aerobic exercise: Recommend at least 75 minutes of vigorous-intensity or 150 minutes of moderate-intensity exercise per week (e.g., walking, cycling).
Strength training: Recommend at least twice per week to build muscle and improve insulin sensitivity
Lifestyle activity modifications: Encourage daily activities like walking, gardening, and household chores.
Exercise support and education:
Provide education on the benefits of physical activity for weight management and glycemic control.
Collaborate with a physical therapist for safe exercise routines in patients with mobility issues.
Encourage activity tracking using wearable devices or mobile apps.
Medical Management
Antidiabetic medications:
Adjust insulin therapy or oral hypoglycemic agents to achieve glycemic control.
Consider Glucagon-like peptide-1 (GLP-1) receptor agonists or sodium-glucose cotransporter 2 (SGLT2) inhibitors for weight loss and glucose regulation.
Pharmacologic weight loss interventions (if indicated):
Orlistat: Reduces fat absorption.
GLP-1 receptor agonists (e.g., Semaglutide): Promotes satiety and weight loss.
Multidisciplinary Collaboration
Dietitian consultation: For personalized meal planning and nutritional education
Endocrinologist: For optimal diabetes management and medication adjustments
Behavioral therapist: For emotional eating and behavioral modification strategies
Prevention of Nutrition Imbalances & Complications
With early screening, targeted education, and smart interventions, nurses can help stop nutrition issues before they start.
Early screening and intervention strategies
Nutritional Risk Screening
Screening tools:
MNA: Specifically designed for older adults.
MST: Assesses risk of undernutrition.
Nutritional risk screening 2002 (NRS-2002): For hospitalized patients, considering disease severity.
BMI: Evaluates weight status relative to height
Waist-to-hip ratio: Assesses abdominal fat distribution as a cardiovascular risk factor
Laboratory tests:
Serum albumin and prealbumin: To indicate protein status
CBC: To identify anemia or other nutritional deficiencies
Vitamin and mineral levels: To check for deficiencies (e.g., vitamin D, vitamin B12, iron)
At-Risk Populations
Infants and children: At risk for growth and developmental delays due to poor nutrition
Pregnant women: Increased nutritional demands affecting maternal and fetal health
Older adults: Risk of malnutrition due to decreased appetite, medication interactions, and altered nutrient absorption
Individuals with chronic illnesses: Including cancer, diabetes, gastrointestinal disorders, and renal disease
Socioeconomically disadvantaged populations: Limited access to nutritious foods
Early Intervention Strategies
Nutritional counseling: Provided by dietitians or nutritionists to offer personalized meal plans
Nutritional supplements: Tailored supplementation to meet individual needs (e.g., protein shakes, vitamin D, and iron supplements)
Close monitoring: Regular follow-up assessments for high-risk patients
Education programs: Patient education on portion control, balanced diet, and reading nutrition labels
Managing Nutrition in Chronic Conditions
Carbohydrate counting: To maintain glycemic control
GI education: Choosing low-GI foods to prevent spikes in blood glucose
Regular monitoring: Blood glucose levels and HbA1c testing
Dietary modifications: High-fiber foods, controlled carbohydrate intake, and reduced saturated fat
Gastrointestinal Disorders
Celiac disease: Gluten-free diet to prevent malabsorption and nutrient deficiencies
IBS: Low-FODMAP (fermentable oligosaccharides, disaccharides, monosaccharides, and polyols) diet to reduce bloating and discomfort
Inflammatory bowel disease: Anti-inflammatory foods and avoidance of trigger foods
Cardiovascular Disease
Dietary approaches to stop hypertension (DASH) diet: Low sodium, high potassium, and rich in fruits, vegetables, and whole grains
Cholesterol management: Omega-3 fatty acids, reduced trans fats, and high-fiber foods
Renal Disease
Protein intake regulation: Managing protein to reduce uremic symptoms
Electrolyte management: Potassium, phosphorus, and sodium restrictions depending on lab values
Fluid management: Monitoring intake to prevent fluid overload or dehydration
Cancer and Immunocompromised Patients
High-protein , high-calorie diets: To counteract cachexia and weight loss
Immunonutrition: Supplements with arginine, omega-3, and antioxidants to support immune function
Neutropenic diet: For immunocompromised patients to minimize infection risk
Patient Education & Discharge Planning
Discharge isn’t the finish line. It’s the handoff.
Patient education is key to keeping nutrition on track after leaving the hospital. From meal planning to spotting signs of malnutrition or overnutrition, teaching these basics helps patients stay healthy and out of the hospital.
Teaching Healthy Meal Planning
Balanced nutrition education
Educate patients on balanced diets with adequate macronutrients (carbohydrates, protein, fats) and micronutrients (vitamins and minerals).
Meal Planning Techniques:
Teach portion control and the balanced plate method (½ vegetables, ¼ protein, ¼ whole grains).
Encourage the use of meal prep to save time and reduce reliance on fast foods.
Introduce healthy cooking methods such as grilling, steaming, and baking.
Reading Nutrition Labels
Educate patients on understanding food labels for better food choices.
Shopping Tips
Guide patients on grocery shopping, focusing on fresh produce, lean proteins, and whole grains.
Recognizing Symptoms of Malnutrition or Overnutrition
Signs of Malnutrition
Unintentional weight loss, muscle wasting, fatigue, and weakened immunity
Hair thinning, brittle nails, dry skin, and poor wound healing
Signs of Overnutrition:
Weight gain, obesity, hypertension , hyperlipidemia, and Type 2 diabetes symptoms
Difficulty breathing, joint pain, and reduced mobility
When to Seek Medical Help:
Educate patients on when to seek medical attention for complications related to nutritional imbalances.
Recommended Resources for Imbalanced Nutrition
When in doubt, don’t wing it. Lean on trusted resources.
These go-to organizations offer solid, evidence-based tools and tips to support patients with nutrition imbalances, whether managing chronic conditions or building healthier habits from the ground up.
Nursing Care Plan Resources
Simplifying Nursing Care for Imbalanced Nutrition
Imbalanced nutrition doesn’t just affect the number on the scale. It impacts healing, energy, and overall patient outcomes.
As a nurse, knowing what to look for and how to respond with a well-developed nursing care plan for balanced nutrition makes all the difference. Monitor the signs, trust the lab values, and think about restoring balance to provide the best care.
References & Sources
Academy of Nutrition and Dietetics – Evidence-based guidelines and nutritional recommendations
World Health Organization – Nutritional guidelines and global health recommendations
American Diabetes Association – Guidelines for diabetes management and prevention
National Institute of Diabetes and Digestive and Kidney Diseases – Research and educational resources
National Institutes of Health – Nutritional research and health updates
Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2022). Nursing care plans: Guidelines for individualizing patient care (11th ed.). F.A. Davis.
Ignatavicius, D. D., Workman, M. L., & Rebar, C. R. (2020). Medical-surgical nursing: Concepts for interprofessional collaborative care (9th ed.). Elsevier.