Domain 2 Flashcards
Subjective Global Assessment (SGA)
history, intake, GI symptoms, functional capacity, physical appearance, edema, weight changes
Mini Nutritional Assessment (MNA)
evaluates independence, medications, number of meals consumed each day- for those 65 years and older.
Nutrition Screen Initiative (NSI)
designed for the elderly to discover nutrition risk
Geriatric Nutritional Risk Index (GNRI)
tests serum albumin and weight changes
Malnutrition Screening Tool (MST)
acute hospitalized adult population- weight loss, recent poor dietary intake
Nutrition Risk Screening (NRS)
medical surgical hospitalized- % weight loss, BMI, intake, >70 years
Malnutrition Universal Screening Tool (MUST)
BMI, unintentional weight loss, effect of acute disease on intake for more than 5 days
What components are typically reviewed for a nutrition screening?
food/nutrition history, anthropometrics, lab/medical tests, nutrition-focused physical findings, client history
diet history
present patterns of eating
food record
food diary, record of everything eaten in a specific amount of time
24 hour recall
mental recall of everything eaten in pervious 24 hours. Quick tool to estimate a sample daily intake in the clinical setting
food frequency lists
how often an item is consumed in the community setting. best way to understand intake from a large amount of people
What formula estimates desirable body weight?
Hamwi formula:
Men- 106 lb for the first 5 ft, 6 lb for every inch above 5’
Women- 100 lb for first 5 ft, 5 lb for every inch above 5’
Small frame: -10%, Medium frame: +10%
Amputation adjustments for entire leg, lower leg with foot, entire arm, forearm with hand
entire leg: 16%
lower leg with foot: 6%
entire arm: 5%
forearm with hand: 2.3%
Adjusted IBW: (100-% amputation)/100 X IBW for original height
Adjusted IBW weight for spinal cord injury (quadriplegic; paraplegic)
quadriplegic: reduce IBW weight by 10-15%
paraplegic: reduce IBW weight by 5-10%
% weight change
[(usual weight - actual (current) weight) / usual weight] x100
What is considered significant weight loss?
10% weight loss within 6 months
Standards for triceps skinfold thickness (male;female)
Measures body fat reserves; measures calorie reserves
Male: 12.5 mm; Female: 16.5 mm
Standards for arm muscle area (male;female)
Measures skeletal muscle mass (somatic protein)
Male: 25.3 cm; Female: 23.2 cm
*important to measure in growing children
BMI formula
kg/m^2 or (lb/in^2) x 703
at risk waist circumference for men and women
men >40 in, women >35 in
at risk waist to hip ratio for men and women
men >1.0, women >0.8
Bioelectrical Impedance Analysis
used at bedside to evaluate fat free mass and total body water
Bod Pod
measures body composition by determining body density by measuring the amount of air displace.
Considerations for thin, dry hair
vitamin c or protein deficiency
considerations for pale, dry eyes and poor vision
vitamin a, zinc or riboflavin deficiency
considerations for swollen, red, dry, cracked lips
riboflavin, pyridoxine or niacin deficiency
considerations for smooth, slick, purple, white coating tongue
iron deficiency
considerations for sore, red, swollen, bleeding gums
vitamin c deficiency
considerations for missing, loose, teeth
calcium deficiency, poor intake
considerations for pale, dry, scaly skin
iron, folic acid, zinc deficiency
considerations for brittle, thin, spoon shaped nails
iron or protein deficiency
Normal range for serum albumin
3.5-5.0 g/dl
- levels above normal range likely due to dehydration
- low levels associated with edema or surgery
normal range for serum transferrin
> /= 200 mg/dl
- increases with iron deficiency, transports iron to bone marrrow
normal range for transthyretin/prealbumin
16-40 mg/dl
normal range for retinol-binding protein
3-6 mg/dl
- binds and transports retinol
normal range for hematocrit
men- 42-52%
women- 37-47%
pregnant women- 33%
newborn- 44-64%
- volume of packed cells in whole blood
normal range for hemoglobin
men- 14-17 g/dl
women- 12-15 g/dl
pregnant women </= 11 g/dl
-iron containing pigment of red blood cells
normal range for serum ferriton
men 12-300 ng/ml
women 10-150 ng/ml
-indicates size of iron storage pool
normal range for serum creatinine
0.6-1.4 mg/dl
-related to muscle mass; measures somatic protein
normal range for creatinine height index
normal = 80%
ratio of creatinine excreted/24 hours to height
normal range for blood urea nitrogen
10-20 mg/dl
- related to protein intake
normal range for BUN:creatinine ratio
10-15:1
normal range for urinary creatine clearance
115+/- 20 ml/minute
- measures glomerular filtration, renal function
normal range for total lymphocyte count
> 2700 cells/cu mm
-measures immunocompetency
define C-reactive protein
marker of acute inflammatory stress
- when elevated CRP decreases, PAB increases
define Free erythrocyte protoporphyrin
direct measure of toxic effects of lead on heme synthesis. Increased in lead poisoning. Lead depletes iron leading to anemia
define prothrombin time
evaluates clotting adequacy; change in vitamin K intake will alter rate (11.0-12.5 seconds)
define hair analysis
useful in measuring intake of toxic metals
activity factors for sedentary, active and stressed
1.2
1.3
1.5
Mifflin St Jeor Equation
Men: (10 × weight in kg) + (6.25 × height in cm) - (5 × age in years) + 5
Women: (10 × weight in kg) + (6.25 × height in cm) - (5 × age in years) - 161
megestrol acetate
appetite stimulant
dextroamphetamine
appetite suppressant, anorexia, nausea, weight loss
orlistate
decreased fat absorption by binding lipase, vitamin/mineral supp.
marinol
appetite stimulant
mythylphenidate (Ritalin)
anorexia,, weight loss, nausea
statins
decreased LDL, TG; increase HDL
chemotherapy
malabsorption
mineral oil, cholestyramine
decrease absorption of fat, fat soluble vitamins
glucocorticoids, antibiotics
protein deficits
oral contraceptives
decrease folate, B6, C
loop diuretics
deplete thiamin, potassium, magnesium, calcium, sodium
thiazide diuretics
decrease potassium, magnesium, calcium, sodium
antibiotics
decrease vitamin k
steroids
decrease bone growth, CHO intolerance
methotrexate
decrease folate
lithium carbonate (antidepressant)
increased appetite, weight gain; must maintain sodium and caffeine levels
anticoagulant (warfarin sodium)
antagonizes vitamin K; avoid Ginkgo biloba extract, garlic, ginger, vitamin A and E
propofol
sedative; 1.1 calories/ml, check TG
phenobarbital
decreased folic acid, vitamins B12, D, K B6
cyclosporine (immunosuppresant)
hyperlipidemia, hyperglycemia, hyperkalemia, hypertension