Assessment of Nutritional Status - Clinical Flashcards
what are the two aspects of clinical assessment?
medical records
physical examination
What is source oriented medical records? (SOMR)
Patient ID Admission notes physicians orders lab reports medication records consents consultations operating room records progress notes
What are problem orientated medical records? (POMR)
problems identified during data collection
What information should medical history generally include?
Description of patient
Relevant environmental, social and family influences
What nutrition related information would be obtained during clinical assessment?
weight gain/loss appetite increase/suppression diarrhoea/constipation info regarding unusual food intake history of nutrient deficiency errors in metabolism use of dietary supplements
Why are details of prescription and over the counter medication useful in clinical assessment?
drugs can interact with nutrients weight metabolism digestion appetite
List the 4 nutritional screening tools
WAVE
REAP
MUST
NMA
What does WAVE stand for?
weight
activity
variety
excess
What does REAP stand for?
Rapid eating and activity assessment for patients
what does MUST stand for?
malnutrition universal screening tool
what does NMA stand for?
mini nutritional assessment
often used on the elderly
describe the difference between primary and secondary nutrient deficiency
primary - comes from inadequate dietary intake
secondary - comes from other factors such as drugs, disease and dietary components such as caffeine.
What is the difference between signs and symptoms?
signs - observations made by a qualified examiner
symptoms - manifestations reported by the patient
What is the role of physical examination in clinical assessment?
assess rate of decline
assess speed of recovery
reveal further information RE the aetiology of malnutrition
what are some limitations of physical examination?
non-specific signs
two-directional signs
examiner error
What are the two forms of protein-energy malnutrition?
Kwashiorkor
Marasmus
What is the most common sign of malnutrition in children?
growth failure
what does the term ‘wasting’ describe?
deficit in weight for height
What does the term ‘stunting’ describe?
deficit in height for age
describe the 4 classification of PEM
Normal
acute PEM - wasted but not stunted
chronic PEM - stunted and wasted
past PEM - stunted but not wasted (indicating past malnutrition)
what does kwashiorkor indicate?
protein deficiency
What does marasmus indicate?
energy deficiency
under which circumstances are kwashiorkor and marasmus seen?
- under developed countries
- disease such as AIDS and some cancers
- alcoholism
What symptoms are characteristic of anorexia nervosa?
extreme and rapid weight loss
irrational fear of weight gain
poor body image
what are some risk factors for anorexia nervosa?
- female
- western society
- low self esteem
- criticism regarding weight/appearance/eating behaviours
- perfectionism
- sexual abuse
what are the two types of anorexia nervosa?
- restricting type
- non restricting type (ppt engages in binge purge episodes)
Describe bulimia nervosa
recurrent episodes of binge eating followed by purging (e.g., self induced vomiting and laxative misuse)
What is the main difference between anorexia nervosa and bulimia nervosa?
anorexia nervosa is often associated with weight loss whilst bulimia nervosa is associated with weight maintenance
what are some characteristics of binge eating disorder?
eating when not hungry unable to stop eating eating rapidly eating in secret/alone eating until uncomfortable full
