Domain II, Topic A, Screening and Assessment Flashcards
The _________ ____ _______ (NCP) is a standardized consistent structure and framework used to provide nutrition care
Nutrition Care Process
The steps of the NCP are laid out in ADIME, _____, ________, _________, _______, and ________
Assess, Diagnose, Intervene, Monitor, Evaluate
____ reviewed during the assessment step is reviewed during all steps of the NCP
Data
Preliminary nutrition assessment techniques should be used to identify people who are ____________ or who are at risk for ____________
Malnourished, Malnutrition
All health care team members can play a __________ role in nutrition screening
supportive
______ of the _________ step should include a client’s history, lab results, weight, and physical signs
Review, screening
For _________ to be accurate it must be ________ (able to identify patients without a condition), and _________ (able to identify patient’s with a condition)
screening, specific, sensitive
The _____ __________ requires nutrition risk be identified in hospitalized patients within __ hours of admission, but does not mandate a method of screening.
Joint Commission, 24
The screening tool of _________ ______ __________ (SGA) takes history, intake, GI symptoms, functional capacity, physical appearance, edema, and weight change into account
Subjective Global Assessment
The screening tool of ____ ___________ __________ (MNA) evaluates independence, medications, number of full meals consumed each day, protein intake, fruits and vegetables, fluid, mode of feeding (65 years of age and older)
Mini Nutritional Assessment
The screening tool of the _________ _________ __________ (NSI) is used in the elderly
Nutrition Screening Initiative
The screening tool of the _________ ___________ ____ _____ (GNRI) Gereiatric Nutritional Risk Index evaluates serum albumin and weight changes
Geriatric Nutritional Risk Index
The screening tool of the ___________ _________ ____ (MST) is used in acute hospitalized adult populations and evaluates recent weight loss and recent poor dietary intake
Malnutrition Screening Tool
The screening tool of the _________ ____ _________ (NRS) is used in medically and surgically hospitalized populations, evaluates % weight loss, BMI, intake, used over 70 years
Nutrition Risk Screening
The screening tool of the ____________ _________ _________ ____ (MUST) evaluates BMI, unintentional weight loss, effect of acute disease on intake for more than 5 days
Malnutrition Universal Screening Tool
Nutrition __________ is initiated by referral or screening of individuals at nutrition risk
assessment
Nutrition __________ makes comparisons between collected data and reliable standards
assessment
Nutrition __________ is an on going, dynamic process that involves continual reassessment and analysis of patient/client/group/needs
assessment
Nutrition __________ provides the basis for the nutrition diagnosis
assessment
The components of nutrition assessment include ______, _______, and ________.
review, cluster, identify
The ______ component of nutrition assessment analyzes data for factors that affect nutritional and health status
review
The ______ component of nutrition assessment assembles data for comparison with characteristics of a suspected diagnosis: food / nutrition related history, anthropometrics, lab/medical tests, nutrition focused physical findings, client history
Cluster
The ______ component of nutrition assessment uses the findings from the first two components to produce standards and criteria for interpretation and decision making. Indicators are clearly defined markers that can be observed and measured. They are also used to monitor and evaluate progress towards nutrition outcomes. Nutrition care criteria are what indicators are compared against
identify
____________ includes date, time, pertinent data and comparison with standards, patient’s perceptions, values an motivation related to problem; changes in patient’s level of understanding, behaviors, outcomes, reason for discharge
documentation
____ _______ include present eating patterns, do not ask leading question
diet history
____ ______ includes a food diary and a record of everything eaten in a specific period of time
Food record
a __ ____ _____ is a mental record of everything eaten in the previous 24 hours
24 hour recall
____ ________ _____ are how often an item is consumed. Community setting. Quick way to determine intakes on large numbers of people
Food Frequency Lists
Pertinent _______ and ______ _______ provides insight into nutrition related problems
Pertinent Medical and Family History
Medium Frame Hamwi Equation for woman = ___ lbs for first 5’, add __ lbs for each inch over and subtract __ lbs for each inch under
100, 5, 5
Small Frame Hamwi Equation for woman = ___ lbs for first 5’, add __ lbs for each inch over and subtract __ lbs for each inch under. Subtract __%
100, 5, 5, 10
Large Frame Hamwi Equation for woman = ___ lbs for first 5’, add __ lbs for each inch over and subtract __ lbs for each inch under. Add __%
100, 5, 5, 10
Medium Frame Hamwi Equation for men = ___ lbs for first 5’, add __ lbs for each inch over and subtract __ lbs for each inch under
106, 6, 6
Small Frame Hamwi Equation for men = ___ lbs for first 5’, add __ lbs for each inch over and subtract __ lbs for each inch under. Subtract __%
106, 6, 6, 10
Large Frame Hamwi Equation for men = ___ lbs for first 5’, add __ lbs for each inch over and subtract __ lbs for each inch under. Add __%
106, 6, 6, 10
Amputation adjustments to Hamwi: Entire Leg __%, Lower leg with foot __%, entire Arm __%, forearm with hand __%,
16, 6, 5, 2.3
Adjusted IBW = (100 - % amputation) / 100 x ___ for ________ ______
IBW for original height
Spinal Cord Injury adjustments to Hamwi: Quadraplegic reduced by __ - __ % of table weight; paraplegic reduced by _ - __% of table weight
10 - 15, 5 - 10
% weight change formula: ((___ - ABW) / ___) x 100
UBW, UBW
Significant weight loss is __% in last 6 months
10
_______ ________ _________ (TSF) measures body fat reserves; measures calorie reserves; standard male has _____ mm, standard female has ____ mm
Tricep Skinfold Thickness, 12.5, 16.5
___ ______ ____ (AMA) measures skeletal muscle mass (somatic protein; is determined using TSF and arm circumference; standard male = ____ cm, standard female = ____ cm; important to measure growth in children
Arm Muscle Area, 25.3, 23.2
Metric formula for BMI: (kg/______^2)
height in meters
English formula for BMI: (lbs/ (__ x ___))
in., 703
Healthy adult BMI: ____ - ____
18.5 - 24.9
Overweight BMI: __ - __
25 - 29
Obese BMI: __ and above
30
Waist Citcumference > __M and >__F is independent risk factor for disease when out of proportion to total body fat
40, 35
_____ _____________ is the best unit of measure for disease risk. _____ _____________ predicts central adiposity
waist circumference
_____ / ___ _____ (WHR) differentiates between android and gynoid obesity, WHR of 1 or greater in men or 0.8 in women is indicative of android obesity and and increased risk for obesity related diseases (diabetes, hypertension
Waist / hip ratio
_____________ _________ ________ (BIA) is used at bedside to evaluate fat free mass and total body water; must be well hydrated, no caffeine, alcohol or diuretics in the past 4 hours, no exercise int eh past 4 - 6 hours; fever, electrolyte imbalance and extreme obesity may affect reliability
Bioelectrical Impedance Analysis
___ ___ measures body composition by determining body density by measuring the amount of air displaced (as accurate as underwater weighing)
Bod Pod
_________ _________ ________ ____ (NFPE) assesses physical signs of nutritional deficiencies
Nutrition Focused Physical Exam
Hair that is thin, sparse, dull, dry, brittle, or pluckable is a sign of a vitamin _ or _______ deficiency
C, protein
Eyes that are pale, dry, poor vision are signs of a vitamin _, ____, __________ deficiency
A, inc, riboflavin
Lips that are swollen red, dry, or cracked are signs of a __________, __________, or ______ deficiency
riboflavin, pyridoxine, niacin
Tongue that is smooth, slick, purple, or has a white coating is a sign of various _______ or ____ deficiencies
vitamin, iron
Gums that are sore, red, swollen, or bleeding are signs of a vitamin _ deficiency
C
Teeth that are missing, loose, or losing enamel are signs of a _______ deficiency or ____ oral intake
calcium, poor
Skin that is pale, dry, or scaly is a sign of ____, _____ acid, or ____ deficiencies
Iron, folic, zinc
Nails that are brittle, thin, or spoon shaped are signs of ____ or _______ deficiencies
Iron, protein
Normal serum albumin is ___ - ___ g/dL. Albumin maintains collodial osmotic pressure; hypoalbuminemia associated with edema and surgery; levels above normal range likely due to dehydration; long half life; does not reflect current protein intake
3.5 - 5
Normal serum transferrin > ___ mg/dL. Visceral protein controlled by iron storage pool; rises with deficiency; can be determined from Total Iron Binding Capacity (TIBC); not useful as a measure of protein status
200
_____________ (TTHY) is also known as __________ (PAB)
Transthyretin, prealbumin
Noraml prealbumin __ - __ mg/dL; short half life; picks up changes in protein status quickly; during inflammation; liver synthesizes CRP at expense of PAB; limited usefulness in screening or assessment
16 - 40
Normal _______ - _______ _______ (RBP); circulates with prealbumin; shortest half life (__ hours); binds and transports retinol
Retinol binding protein, 12
__________ (Hct) is volume of packed cells in whole blood.
Hematocrit
Normal male hematocrit __ - __%
42 - 52
Normal female hematocrit __ - __%
37 - 47
Normal pregnant hematocrit __ - __
44 - 64
__________ (Hgb) is iron containin pigment of red blood cells; eryhrocytes are produced in bone marrow
Hemoglobin
Normal male hemoglobin __ - __ gm / dL
14 - 17
Normal female hemoglobin __ - __ gm / dL
12 - 15
Normal pregnanat hemoglobin greater than or equal to __ gm/dL
11
Serum _______ indicates size of iron storage pool
ferritin
Normal female serum ferritin __ - ___ ng/mL
10 - 150