318 the value of using the BMJ in nutritional assessment. It was also a chance to review· the Nutritional Guidelines for Filipinos 2000 and the Filipino Pyramid Food Guide for Today"s Lifestyle. In this case, it was clear that the guidelines provided a mechanism for ensuring th;it the nurse deliver will deliver care that is evidence-based. In general, the nursing practice guidelines included basic compon ents like: a What data is essential to assess the client's condition? How should the assessment be done o What are the intervention options: independent, dependent and collaborative interventi ons? a What are the signs and i"ndicators that the client needs refcrrnl to a doctor/ other health profcssiona Js? a What are the signs lliat the client is/not making a progress? There was a need to determine the nature of assessment data in the consultation. It was a question of doing a comprehensive physical assessment and rmrsing history or making a focused assessment. TI1e two approaches have their own merits.. This was a dilemma that we opted to solve on fill experientia l basis. Taking a comprehensive assessment has ils merits. However, it lengthened the consultation time considerably. Some clients, too, did not want to discuss matters that are perceived as unrelated to the cause for visit. lil the end, the amount of data in assessment was based on the client's condition and the judgment of the nurse handling the consultat ion. The key was to be balanced in assessme nt, being focused on the client's concern and at the same time looking at the holistic aspect of health. COMMONLY USED NURSING DIAGNOSES In the course of practice, certain nursing diagnoses emerged as the more frequently encountered ones in the clinic: NU ~COMMON LY U9ED IN ~Ol'ION NURSING CLINIC Impaired health maintenance F. a. ch client is unique and all encounters provide exciting challenges for the nurse in determining assessment parameters and what to do in the domain of independent nursing practire. There were challenging situations like the one narrated below: The clients were three middle-aged women whose cause for consultation was the feeling of imbalance. " They shared the following information: -