Adult And Peds Nutrition Flashcards
What are the different licenses for a registered dietitian?
RD
RDN (registered dietitian/nutritionist)
LD (licensed dietitician)
CD (certified dietician)
What are the different setting that a RD can work in?
Hospital Outpatient clinic Food service School systems Community (WIC) Business and industry Private practice Eating disorders Public health Authors Culinary nutrition
What is nutrition?
The study of nutrients in food, how the body uses them, and the relationship between diet, health, and disease
The chemical and functional components of food
The physiological effects of food components
How human behavior affects food choices
The impact of the surrounding environment on food choices
Biochemistry
What is medical nutrition therapy?
Nutritional diagnostic, therapy, and counseling services for the purpose of disease management which is facilitated by a registered dietician – used in A LOT of diseases
What is the purpose of nutrition assessment?
To accurately determine nutritional status
To identify current and potential nutritional and medical problems
To monitor changes in nutritional status during national policy changes, fortification programs, nutrition intervention or the course of a chronic or acute illness
What are the main nutritional disorders in the US?
Acute or chronic protein-energy malnutrition (PEM)
Linear growth failure
Combination of PEM and linear growth failure
What is part of the nutrition assessment?
Dietary, medical, and medication history (24-hour recall, food diary, food frequency questionnaire)
Physical exam
Growth, anthropometric, and body composition measurements
Lab data and tests
Intervention and monitoring
What is the general physical exam for nutrition?
Anthropometrics, size for age, fat stores, muscle wasting, activity level
What is in the skin physical exam for nutrition?
Pallor, dryness, petechiae, ecchymosis, wounds, rash, hair thinning/dislocation/loss, nail changes, edema
What is in the eyes PE for nutrition?
Discoloration, lesions, clouding, unusual movements
What is part of the mouth PE for nutrition?
Stomatitis, glossitis, gum bleeding/swelling, dentition
What is part of the CV PE for nutrition?
Heart rate, loud S2, S3, S4, new murmur, edema, delayed cap refill
What is part of the GI PE for nutrition?
Hepatomegaly, abdominal dissension, feeding tube site appearance
What is part of the skeletal PE for nutrition?
Refusal to walk, joint swelling genu varum/valgum, subcutaneous fat and muscle wasting
What is part of the neuro PE for nutrition?
Developmental milestone status, deep tendon reflexes, sensory loss, ataxia
What is the Z score on growth charts?
Number of standard deviations from the mean height and weight values for age
What entities have growth charts for peds?
WHO, CDC
What anthropometrics are used to evaluate growth in children?
Weight
Length (under 2 years)
Height (over 2 years)
Occipital frontal circumference (under 2 years)
Weight for length (under 2 years)
Body mass index (BMI) (over 2 years) - weight kg/height meters or weight pounds x 703/ height in inches
What is the average rate of weight gain in grams per day for a newborn?
30 grams per day
What is the average rate of weight gain in grams per day for a 6 month old?
15 grams per day
What is the average rate of weight gain in grams per day for a 12 month old?
10 grams per day
What is the average rate of weight gain in grams per day for a 1-3 year old?
6 grams per day
Most babies lose about ___% of birth weight and regain it by ____ weeks of age
10%, regain by 2-3 weeks
Most healthy infants double birth weight by ___ months of age, and triple by ___ months of age
6, 12
After three months of age, the rate of weight gain in breastfed infants may be ___ than that of a formula-fed infant
Lower
Not true for length or head circumference
What laboratory data might be used in a nutrition assessment?
Visceral protein, albumin, prealbumin, ferritin
What anthropometrics are used to evaluate adults?
BMI
Waist circumference
Why might waist circumference be a better tool for assessing body fat than BMI?
Fat located in the abdominal region may be associated with greater health risks than fat below or above the waist
What does BMI take into account?
Height and weight
What does BMI not take into account?
Not adjusted for muscle mass, age, sex, fitness
What should BMI not be a proxy for?
Body composition Health behaviors Fitness Dietary quality Intervention adherence
What is weight stigma?
Negative social impact of weight bias and discrimination
What is weight bias?
Beliefs and preferences for or against a particular body shape or size
The inclination to form unreasonable judgements based on a bias
What is allostatic load?
Cumulative effect of chronic stressors on cardiovascular, nervous, and metabolic syndromes
Higher levels of weight stigma are associated with more than ___ x the risk of allostatic load
2X
Allostatic load is postulated to have these effects…
Metabolic and lipid dysregulation
Impaired glucose metabolism
Increased inflammation- increased risk for Type II DM, HTN, CVD
Who is at risk for acute malnutrition?
Protein-energy malnutrition (PEM) most likely in hospitalized patients
Who is at risk for chronic malnutrition?
Patients with GI, renal, or cardiac diseases
What hypermetabolic states are at risk for malnutrition?
Burns, fever, traumatic injury, malignancy
