Chapter 3: Nutrition Risk Screening and Assessment of the Oncology Patient Flashcards
The benefits of good nutrition during cancer treatment include…
fewer complications,
better quality of life,
the ability to tolerate full treatment as prescribed
What is the purpose of nutrition screening and assessment?
To identify patients who are at risk for malnutrition.
What percent of people experience anorexia and weight loss prior to diagnosis?
40%
What percent of people experience malnutrition at some point during their treatment?
40-80%
A weight loss as little as ___ predicts a reduced response to oncology treatment, reduced survival, and reduced quality of life.
6%
What percentage of upper GI cancer patients experience weight loss?
80%
Which 2 cancers are at the highest risk of weight loss and malnutrition?
gastrointestinal and head and neck
What are the recommendations for weight loss for overweight/obese cancer survivors undergoing treatment.
There appears to be no contraindication to modest weight loss (max of 2 lbs per week) during treatment as long as the treating oncologists approve and weight loss is closely monitored and it does not interfere with treatment. However, weight loss of 6% can interfere with treatment, so that may disqualify many.
T/F: The later oncology nutrition care is implemented, the more difficult it is to modify a patient’s nutritional status.
True
T/F: Patients only need to be nutritionally screened once during cancer treatment.
False. Due to the length of treatment and the cumulative effect of treatment, nutrition screenings should be done several times throughout treatment.
How frequently should nutrition screening tools be administered?
Prior to physician visit. Weekly during radiation therapy, and every 2-3 weeks during chemotherapy and at each follow-up visit.
Name 4 Nutrition screening tools. Which 2 are best for outpatient setting?
PG-SGA (Patient-Generated- Subjective Global Assessment)
MST (Malnutrition Screening Tool)
MSTC (Malnutrition Screening tool for Cancer patients)
MUST (Malnutrition Universal Screening Tool)
** PG-SGA and MST better for out-pt setting**
Diet History Covers…
Food allergies, food logs/portion sizes, patterns of meals and snacks, use of functional foods (Ensure), alcohol, food aversions, foods tolerated.
Medication History Covers…
Amount and frequency of medications, OTC, stool softeners, laxatives, enzymes, vitamins, herbal supplements, probiotics, fiber medical marijuana or appetite stimulants.
Patient Efforts Covers…
Assessment of current strategies used by the patient to overcome difficulty with nourishment; “what is working” and willingness to modify behaviors.
Anthropometric Measurements Covers…
Measures, categorize and assess: height, current weight, usual weight, weight changes over time, BMI, adjusted if overwt, grip strength, triceps skin fold mid-upper arm circumference.
Biochemical Data Covers…
Blood work, hydration status, bioimpedence, GI function tests, etc.
A C-reactive protein (CRP) value of ____ can be used to indicate if inflammation is present.
> /= 10
Examples of nutrition focused physical findings.
NIS, vital signs, O2 levels, pulse, BP, temp, grip strength (changes in grip strength over time), stomatitis, glossitis, anemia, appearance of nails, general appearance, abdomen, dermatologic, head/neck, intra-oral cavity, assessment of taste.
What is NIS and give some examples?
Nutrition Impact Symptoms: Issues that impede intake, digestion and absorption or utilization. Anorexia, cachexia, muscle wasting, dysphagia, xerostomia, changes to taste and smell, mucositis and stomatitis, N/V, D/C, SOB, dehydration, espohagitis.
What is stomatitis?
Inflammation or soreness of the mouth.
What is glossitis?
Inflammation of the tongue.
What is mucositis?
Inflammation and ulceration of mucus membranes lining the digestive tract.
What is xerostomia?
Dry mouth.
