2 Nutritional assessment

Question 0

What is the most important indicator of a nutritional assessment?

Answer 0

Weight. Should be taken immediately if admitted into the hospital.

Question 1

What are the goals of nutritional assessment?

Answer 1

1) ID patients who need nutritional support

2) use as a baseline to evaluate the response of the intervention

Question 2

What four things does an initial nutrition screening consist of?

Answer 2

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)

Question 3

What method is used to assess diet inadequacy?

Answer 3

Dietary

Question 4

What method is used to assess change at tissue level?

Answer 4

Biochemical

Question 5

What method is used to assess change in body fluid levels?

Answer 5

Biochemical

Question 6

What method is used to assess change in tissue function?

Answer 6

Anthropometric and biochem

Question 7

What method is used to assess enzyme activity?

Answer 7

Biochem

Question 8

What method is used to assess functional change?

Answer 8

Behaviour and physiology

Question 9

What measurements are in the category of anthropometrics?

Answer 9

Height, weight, circumference, skinfolds, WHR, MAMC

Question 10

Where are the largest calorie reserves in the body?

Answer 10

Fat and muscle

Question 11

How much protein is in the average person?

Answer 11

13 kg

Question 12

What values should you check to see if someone has lost lean body mass?

Answer 12

Check MAMC and creatine levels (proportional to muscle mass)

Question 13

What are three ways of measuring height?

Answer 13

Standing (standiometer), arm span (not with spinal deformities, not for API/AA), knee height (wheel chair bound)

Question 14

How is frame size determined?

Answer 14

r= height/wrist circumference in cm. Medium is 9.6-10.4 male, 10.1-11 female

Question 15

How is ideal body weight calculated?

Answer 15

Hamwi method
106 lb (5ft)+6 lb/inch men
100lb(5ft)+5 lb/inch women

Question 16

How is weight change calculated?

Answer 16

(UBW - current weight) / UBW

Question 17

What are the cut-offs for weight circumference?

Answer 17

> 102 cm (men), >88 cm (women)

Question 18

What are the cut off for waist to hip ratio?

Answer 18

> 1.0 (men), >0.8 (women)

Question 19

What four sites are used for skinfold measurement?

Answer 19

Triceps, subscapular, biceps, suprailiac

Question 20

What is the half life and function of S.albumen? What would cause low/high values?

Answer 20

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.

Question 21

What is the half life and function of S.transferrin? When might it be low/high?

Answer 21

8-10 days. Iron transport. High with Fe deficiency, pregnancy, chronic loss. Low with acute illness, chronic infection, PEM, systemic disease

Question 22

What is the half life and function of TBPA? When would it be high/low?

Answer 22

2 days. Transport for T3 and T4, carrier for RBP. High with renal disease. Low with liver disease, PEM, chronic loss, malabsorption, hyperthyroidism.

Question 23

What is the half life and function of s. RBP? When would it be high/low?

Answer 23

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

Question 24

How can immune function be tested for?

Answer 24

Delayed cutaneous hypersensitivity (<5-10mm). Lymphocyte count. Can also look at protein and energy status.

Question 25

How is nitrogen balance calculated?

Answer 25

UUN=nitrogen loss
1 g nitrogen in 6.25 g of protein
N balance (g/day)= (protein intake(g)/ 6.25) - (UUN + 4)

Question 26

What does creatine excretion represent? When does it change?

Answer 26

Proportional to muscle mass. Increases with exercise, stress, animal protein, menstruation, infection, fever, trauma. Decreases with renal failure and age.