&NA;Malnutrition in critically ill patients is caused by inadequate intake, absorption, and/or utilization of nutrients with a frequently compounding increased metabolic need. The nurse plays a pivotal role in the identification of patients at risk for nutritional deficits and collaborates with appropriate resources to obtain a comprehensive nutritional assessment and the required nutritional care. A five‐step approach to nutritional support is presented and applied to three clinical situations. Through the use of a systematic decision‐making process, the critical care practitioner ensures that patients receive adequate nutritional support for optimal organ function