PES statements
Presentation for NUT 390i
By Chris Shelton
NUT 4700
PES = Problem, Etiology,
Signs/Symptoms
• PES statements are written by Registered
Dietitians. They are used when an RD
diagnoses a patient’s problem or needs.
• It’s a simple written statement that
identifies the Problem; states the
Etiology of the problem; and gives the
Signs or Symptoms that support the
diagnosis of a patient.
When do RDs write a PES?
Writing PES statements
• There is a standardized language for writing a
PES statement:
• It always includes: whatever the Problem is,
how it is related to the Etiology of the
problem, as evidenced by the Signs or
Symptoms that you see as an RD
• The key words in this statement are “related
to” and “as evidenced by.”
PES examples
• 70-yr old white male admitted for cardiac
bypass surgery. Doctor sees that patient is
underweight so refers patient to RD
• RD conducts an assessment and finds patient
has lost weight (15 pounds in 3 months)
without trying and has been eating poorly for
several weeks. He lives alone at home and his
wife died 3 months ago
PES examples
• A sample PES would be:
• “Involuntary weight loss related to missing
meals as evidenced by loss of 15 pounds over
3 months.”
• The Problem is the weight loss. The Etiology is
related to missing meals. The Signs or
Symptoms are the 15 pounds lost over 3
months.
More PES examples
• “Inadequate energy intake related to calorie
intake not meeting calculated needs as
evidenced by 15lb weight loss in 3 months.”
More PES examples
• Based on lab results:
• “Inadequate mineral intake (iron) related to
iron intake not meeting needs as evidenced by
low Hgb/Hct and ferritin.”
More PES examples
• Socioeconomic:
• “Limited access to food related to inability to
acquire food as evidenced by lack of income.”
Don’t forget
• PES statements are a written diagnosis of a
patient’s nutritional problem.
• A PES is a simple statement that identifies the
Problem, gives the Etiology of the diagnosis
and states the Signs/Symptoms that support
the diagnosis.
• Always use the words “related to” and “as
evidenced by.”
Thank you!
References:
• Mahan KL, Escott-Stump S. Krause’s Food and Nutrition
Therapy. 12th ed. St. Louis, MO: Saunders Elsevier; 2008.
• Lecture notes from NUT 4700 with Anne Keller, MS, RD;
Metropolitan State University of Denver; Aug. 2013.