2 Nutritional assessment Flashcards
What is the most important indicator of a nutritional assessment?
Weight. Should be taken immediately if admitted into the hospital.
What are the goals of nutritional assessment?
1) ID patients who need nutritional support
2) use as a baseline to evaluate the response of the intervention
What four things does an initial nutrition screening consist of?
1) pre-existing conditions that affect nutrition status (usually pathology)
2) conditions that increase nutrition requirements.
3) dietary intake (appetite, intolerance, restriction)
4) assessment (anthropometric, biochemical, clinical, dietary)
What method is used to assess diet inadequacy?
Dietary
What method is used to assess change at tissue level?
Biochemical
What method is used to assess change in body fluid levels?
Biochemical
What method is used to assess change in tissue function?
Anthropometric and biochem
What method is used to assess enzyme activity?
Biochem
What method is used to assess functional change?
Behaviour and physiology
What measurements are in the category of anthropometrics?
Height, weight, circumference, skinfolds, WHR, MAMC
Where are the largest calorie reserves in the body?
Fat and muscle
How much protein is in the average person?
13 kg
What values should you check to see if someone has lost lean body mass?
Check MAMC and creatine levels (proportional to muscle mass)
What are three ways of measuring height?
Standing (standiometer), arm span (not with spinal deformities, not for API/AA), knee height (wheel chair bound)
How is frame size determined?
r= height/wrist circumference in cm. Medium is 9.6-10.4 male, 10.1-11 female
How is ideal body weight calculated?
Hamwi method
106 lb (5ft)+6 lb/inch men
100lb(5ft)+5 lb/inch women
How is weight change calculated?
(UBW - current weight) / UBW
What are the cut-offs for weight circumference?
> 102 cm (men), >88 cm (women)
What are the cut off for waist to hip ratio?
> 1.0 (men), >0.8 (women)
What four sites are used for skinfold measurement?
Triceps, subscapular, biceps, suprailiac
What is the half life and function of S.albumen? What would cause low/high values?
14-21 days. Maintains osmotic pressure, transport large insoluble molecules/drugs/Ca/Zn. High if dehydrated, Low if malabsorption, poor synthesis, over hydration, edema, acute illness, and aging.
What is the half life and function of S.transferrin? When might it be low/high?
8-10 days. Iron transport. High with Fe deficiency, pregnancy, chronic loss. Low with acute illness, chronic infection, PEM, systemic disease
What is the half life and function of TBPA? When would it be high/low?
2 days. Transport for T3 and T4, carrier for RBP. High with renal disease. Low with liver disease, PEM, chronic loss, malabsorption, hyperthyroidism.
What is the half life and function of s. RBP? When would it be high/low?
10-12 hrs. Retinol transport from liver to periphery, circulates with TBPA. High during renal disease. Low during vit A def, zinc def, metabolic stress, hyperthyroidism, liver disease
How can immune function be tested for?
Delayed cutaneous hypersensitivity (<5-10mm). Lymphocyte count. Can also look at protein and energy status.
How is nitrogen balance calculated?
UUN=nitrogen loss 1 g nitrogen in 6.25 g of protein N balance (g/day)= (protein intake(g)/ 6.25) - (UUN + 4)
What does creatine excretion represent? When does it change?
Proportional to muscle mass. Increases with exercise, stress, animal protein, menstruation, infection, fever, trauma. Decreases with renal failure and age.
