Nurse: “Before we begin treatment today, I’d like to check in on how eating and drinking have been going since your first cycle. Can you tell me what a typical day of food and fluids has looked like for you?"
Patient: “I haven’t been eating much. Nothing sounds good, and I get full quickly.”
Nurse: “Tell me more about the times of day when eating feels easiest—and when it feels most difficult.”
Patient: “Breakfast is usually okay, but by afternoon I feel nauseated and don’t want much.”
Nurse: “What have you been able to tolerate when nausea shows up?”
Patient: “Toast, soup, and sometimes a smoothie. Meat has been hard.”
Nurse: “How has your appetite changed compared with before treatment?”Patient: “I’m definitely eating less. My daughter keeps reminding me to eat.”
Nurse: “What have you noticed about your weight, energy, strength, or ability to do your usual activities?”
Patient: “I think I’ve lost a few pounds. I’m tired and have not been walking like I usually do.”
Nurse: “What symptoms have made it harder to eat or drink—such as nausea, changes in taste, mouth soreness, constipation, diarrhea, pain, or feeling full quickly?”
Patient: “The nausea and metallic taste are the biggest problems. I’m also not drinking as much because everything tastes strange.”
Nurse: “What concerns you most about eating and drinking between now and your next treatment?”
Patient: “I’m worried I’ll keep losing weight and won’t be strong enough for chemo.”
Nurse: “That makes sense. What kind of support would feel most helpful—ideas for foods and fluids that may be easier to manage, help with the nausea, or a conversation with our oncology dietitian?”
Patient: “I’d like to talk with the dietitian. I need more ideas.”
• Reduced oral intake and decreased appetite since the first cycle.
• Possible unintentional weight loss.• Nausea, early satiety, altered taste, and reduced fluid intake—symptoms that can significantly affect nutrition and hydration.
• Declining energy and function, shown by decreased walking and activity.
• The patient’s priority: maintaining enough strength to continue treatment.
• A clear next step: complete the organization’s validated nutrition-risk screen, assess weight trends and relevant symptoms, address nausea according to the care plan, and refer to oncology nutrition services as indicated
The nurse does not begin with, “Are you eating okay?” That question can easily produce a short answer such as “fine” or “not really.”
Instead, questions such as “Can you tell me what a typical day of food and fluids has looked like?” and “What symptoms have made it harder to eat or drink?” help the nurse understand:
• Intake: What the patient is actually able to eat and drink.
• Barriers: Which symptoms, practical challenges, or emotional concerns are interfering.
• Impact: Changes in weight, strength, energy, and daily function.
• Priorities: What the patient is most worried about and what support they want.
*A conversation is not a replacement for a validated nutrition screening or comprehensive dietitian assessment. It is the bridge that helps clinicians recognize risk early, individualize support, and make timely referrals.
