Exam 1 Flashcards
1
Q
What does ADIME stand for
A
Assesment, Diagnosis, Ingtervention, Monitoring/Evaluation
2
Q
SOP
A
Standards of Practice
3
Q
SOPP
A
Standards of Professional Performance
4
Q
6 Standards of SOPP
A
1-Quality in Practice
2-Competence and accountability
3-Provisions of Service
4-Application of Research
5-Communication and Application of Knowledge
6-Utilization and Management of Resources
5
Q
Who gets a nutrtion screening and who does it?
A
Everyone; any member of the healthcare team
6
Q
Who gets a nutrition assesment and who does it?
A
Only those at risk; RD
7
Q
What is a sign?
A
Biochemical value taken from the medical chart
8
Q
What is a symptom?
A
In the physical/clinical exam; mostly complaints
9
Q
When do you rescreen or reasses?
A
7 days depending on the level of nutritional risk
10
Q
Health belief model
A
Persons belief about health may influence food choices and likelihood for change
11
Q
Primary Nutrition Problem
A
Based on dietary intake
12
Q
Secondary nutrition problem
A
Pathological condition that causes inadequacies (surgery, medications etc.)
13
Q
BMI Interpretation values
A
<18.5-Underweight
18.5-24.9-Normal Weight
25-29.9-Overweight
>30-Obese
14
Q
BMI interpretation in Children
A
<5th Percentile-Underweight
5-85th-Normal
>85th-Overweight
>95th-Obese
15
Q
WHO Growth Charts are for who?
A
Children 0-2 y/o
16
Q
CDC Growth charts are for who?
A
Children 2-20 y/o
17
Q
IBW Interpretation Values
A
<90%-Underweight
90-110%-Normal
>110%-Overweight
>130%-Obese
18
Q
%Wt change calculation
A
=(CBW-UBW)/UBW*100
19
Q
%Wt Change Interpretations-Significant
A
1 Week-1-2%
1 Mo-5%
3 Mo-7.5%
6 Mo-10%
20
Q
%Wt Change Interpretations-Severe
A
1 Week->2%
1 Mo->5%
3 Mo->7.5%
6 Mo->10%
21
Q
Waist Circumference for at Risk
A
Men>40im Women >35in
Asians- Men>35.5in Women>31.5in
22
Q
Which calculation is most accurate for all populations?
A
Mifflin-St. Jeor
23
Q
Do you multiply by an activity factor and stress factor?
A
No
24
Q
Adjusted Body weight for Obese Calculation
A
(ABW-IBW)*.25+IBW
25
Protein for healthy Adult
0.8-1.0g/kg
26
Protein for Underweight/Loosing Weight
0.9-1.2g/kg
27
Protein for protein depleated
1.25-2g/kg
28
Protein for Fracture, infection trauma, fever
1.5-2g/kg
29
Protein for extensive burns
1.5-3.0g/kg
30
Fluid rule of thumb
1mL/kcal
31
Significant Digits for Height
cm-tenths
| m-hundreths
32
Significant digits for protein
Tenths
33
Significant digits for mg/dL
Whole
34
Significant digits for mmol/L
Tenths
35
Key Calculations for Every Patient
Enery, Fluid, Protein
36
Lab Values indicating protein-energy status
Albumin and pre-albumin
37
Lab Values indicating Hydration
Lab values falsely elevated
38
Lab Values indicating renal disease
BUN, Cr, K, PO4
39
Lab Values indicating metabolic issues
Glc, insulin, T4, K
40
Lab Values indicating anemia
Fe, B6, B12
41
Precision
Ability to reproduce a value multiple times
42
Accuracy
Closeness of the reported value to the actual value
43
Plasma
WBC and RBC Removed; clotting factors present but bound to anti-coagulant
44
Serum
RBC, WBC, and clotting factors removed
45
Creatinine Height Index Indication Values
60-80%-mild skeltal depletion
40-59%-moderate
<40%-severe
46
CHI calculation
24 hr urine collection/expected 24 hr urine*100
47
Nitrogen Balance equation
(Protein intake/6.25)-Urine N+2
48
Nitrogen Balance Indication Values
+/-2-balance
| >+2-Positive
49
Negative Acute Phase Proteins
Albumin, Pre-albumin, Transferrin, Transthyretin, RBP
50
Positive Acute Phase Proteins
CRP, Fibrinogen
51
Albumin changes reflect what?
Illness not nutrtion
52
Lab Value for Albumin
3.5-5 g/dL
53
Lab Value for Pre-Albumin
16-45 mg/dL
54
Lab value for C-reactive protein
<1 mg/dL
55
Lab value for CRP during chronic inflammation
1-3 mg/dL
56
Lab Value for transferrin
W-215-380 mg/dL
| M-215-365 mg/dL
57
Lab value for RBP
2.1-6.4 mg/dL
58
Half life for albumin
17-21 days
59
Half life for Transferrin
8-10 days
60
Half life for Pre-albumin
2-3 days
61
Half life for RBP
10-12 hours
62
Glucose normal value
<100 mg/dL
63
Stage one of iron deficiency
Increased iron abs
| Decreased serum ferritin
64
Stage two iron deficiency
Decreased transferrin saturation
| Increased Protoporphyrin
65
Third stage iron deficiency
Decreased hemoglobin and mean corpuscular volume
66
Lab value for hemoglobin
W-12-16 g/dL
| M-14-18 g/dL
67
Macrocytic anemia
Increased MCV
| Folate and b12 deficiency
68
Microcytic anemia
Decreased MCV
| Iron deficiency
69
Electroylte conversion
(mg/AW)*valence
70
Elements with 1 valence
Chlorine, Potassium, Sodium
71
Elements with 2 valence
Calcium, Magnesium, Phosphorous
72
Medical Diagnosis
Will not change as long as the condition exists
73
Nutrition Diagnosis
may change as long as the patients status changes
74
Who is covered under employee sponsored health insurance?
Buisnesses >50 people and empoyees workin 30+ hours a week
75
What RDN services are covered under employee sponsored and individual health plans?
Varies but usually very little
76
Who is covered under individual health plans?
Self-employeed, <50 workers in company, or <30 hrs per week
77
Who is covered under Medicare?
65+, disabled, end stage renal disease
78
Medicare Part A is what?
Hospital stays covered after $1,340 deductable; paid for my todays employees
79
Medicare Part B is what?
Physician visits after $183 deducable; $164 per month; paid by social security
80
Medicare Part C is what?
Part A and B deductables and coinsurance; paid by enrolee
81
Medicare Part D is what?
Medications; paid for by enrolee and is required
82
What RDN is covered under part B?
Diabetes, Kidney disease, Obesity, ENPN
83
Who is covered under medicaid?
Low income, pregnant, disabled
84
What RDN is covered under medicaid?
Preventative wellness, Maternity, WIC, LTC, home health
85
ICD-10 Code-First three numbers
Category
86
ICD-10 Code-Next 3 numbers
Etiology/anatomic site
87
ICD-10 Code-Last number
Extention
88
Pharmaceutical phase
Physical and chemical Properties of a drug
89
Pharmaceutical phase influenced by:
Dosage, Food presence, pH, Form
90
Pharmacodynamic Phase
Drug action at the target tissue (desired theraputic response)
91
Pharmacokinetic phase
Time course of drug in the body
92
Pharmacokinetic phase-Absorption
Movement from site of administration to blood stream
93
Pharmacokinetic phase-Distribution
Leaving circulation and traveling to organs
94
Pharmacokinetic phase-Metabolism
biotramsformation for elimination-usually by urin (cytochrome p450)
95
Pharmacokinetic phase-Elimination
Fecal/urine elimination of drug remnants
96
Adrenergic drugs-
Decrease appetite
Increase satiety
Weight loss
97
Serotonergic drugs
```
Inhibit seritonin uptake
Increase satiety and decrease intake
Weight loss (Fen fen)
```
98
Weight gain drugs
Block seritonin receptor
| valproic acid and corticosteriods
99
Propofuol
Weight gain due to calories from oil
100
Magace
Wasting syndrome med
| Weight gain
101
INH for TB binds what nutrient
B6
102
What drugs are Monoamine oxidase inhibitors
Anti-depressants, microbials and neoplastics
103
MAOI inhibitors should avoid what nutrient?
Tyramine
104
Grapefruit contains
Furacoumarins
105
Furacoumarins cause what
Inhibit entercytes and hepatocytes-drug toxicity
106
Natual Licorice counteracts what
Diuretics (can also be a laxative)
107
Alcohol drinkers should avoid
NSAIDS, CNS depressants, Hepatotoxic meds
108
Antabuse causes what
Buildup of Acetaldehyde
109
Phenytoin nutrient interactions
Gut pH, decreased folate, vit D, and biotin abs
110
Oral Contraceptives nutrient interactions
Increase folate excretion
| Increase circulating Vit. A
111
How does Edema affect drug
Need to increase dosage
112
D5W Nutrition
Carbohydrates in water
113
Obesity effects what in drugs
Need to calculate dosage based on Adj. BW
114
Age effects what in drugs
Children and ederly metabolize more slowly
115
Prilosec generic name
Omeprazole
116
Prilosec drug class
proton pump inhibitor
117
Prilosec Purpose
Decrease GI secretion
118
Prilosec Patient
GI-Ulcers, GERD, heartburn
119
Prilosec Mechanism
Inhibits cells that produce gastric acid
120
Prilosec Nutrition
Decrease vitamin B12 abs
121
Coumadin generic name
Warfarin
122
Coumadin drug class
anti-coagulant
123
Coumadin Purpose
blood thinner
124
Coumadin patient
Cardiac
125
Coumadin Mechanism
Inhibit vitamin K dependent synthesis of clotting factors
126
Coumadin Nutrition
Anti-vitamin K
127
Zocor generic name
Simvastatin
128
Zocor Drug class
HMG-Coa reductase inhibitor
129
Zocor Purpose
Decrease cholesterol, LDL and Cholesterol
130
Zocor patient
Cardiac, high cholesterol
131
Zocor Mechanism
Inhibit HMG-Coa reductase a rate limiting step in cholesterol biosynthesis
132
Zocor Nutrients
Grapefruit effect
133
Prednisone drug class
corticosteriod
134
Prednisone purpose
anti-inflammatory
135
Prednisone Patient
Lupus, asthma, arthritis
136
Prednisone mechanism
inhibit DNA synthesis
137
Prednisone Nutrition
Decrease Ca abs, Increase Ca excretion
Increase protein loss and water retention
Increase Blood glucose and body weight
138
Lasix Generic name
Furosemide
139
Lasix drug class
diuretic, anti-hypertensive
140
Lasix Purpose
Decrease BP
141
Lasix patient
hypertensio
142
Lasix Mechanism
Inhibit abs of Na, Cl, H20 by loop in kidney
143
Lasix Nutritional
Increased K excretion
144
Aldactone Generic name
Spironolactone
145
Aldactone drug class
diuretic, anti-hypertensive
146
Aldactone purpose
decrease BP
147
Aldactone patient
Cardiac, cirrohsis
148
Aldactone mechanis
binding receptors of aldosterone dependent Na/K pumps
149
Aldactone Nutrition
Increase K abs
150
Fluid Needs-Weight
1500 for first 20 kg
| 20 ml/kg for the rest
151
Fluid Needs-Age and Weight
16-30 (active)-40
25-55-35
55-75-30
75+=25
152
What are the 4 components of a nutritional assesment?
Anthropometrics
Biochemical
Clinical/physical exam
History/Diet
