exam 1 nutritional assessment Flashcards
undernutrition
results from insufficient intake or low body stores
poor wound healing, loss of muscle mass, functional decline, altered immune status, growth faltering
overnutrition
results from intake or stores of nutrients in excess
obesity, hypercholesterolemia, and toxic levels of stored vitamins
Negative health consequences
Not mutually exclusive
malnutrition
Includes excess, deficient, or an imbalance of nutrients that lead to disease states.
Associated with negative health outcomes, increased length of stay, increased infection rates.
Continuing research documents hospitals are doing a poor job of nutritional assessment
Only 50% hospitalized malnourished clients had documentation of nutritional assessment
screening and assessment
Foundation for nutritional intervention goals
Registered dietitian’s responsibility in most cases
Nurses plan early nutritional interventions.
what is screening
Less comprehensive Identify presence of risk factors Serve as initial step Cost-effective Brief and noninvasive Required within 24 hours of admission Nurse's responsibility
patients often underreport
alcohol use
obese clients
low socioeconomic or educational level clients
clients on restricted diets
patients often overreport
intake of fruits and vegetables
Use of several sample days
Miss significant alterations
use of screening or assessment tools
Streamline identification of at-risk individuals
Screening tools suggest need for further assessment.
Assessment tools determine nutritional status.
Many tools exist; many new tools in development
findings that impact nutritional status or indicate altered nutritional health
Poor dental health, swallowing difficulties, gastrointestinal complaints, limited strength, and alterations in cognition or vision
Medical conditions and treatments
Document findings
physical changes
May indicate an issue that has been present for weeks, months, or longer
Medical conditions or environmental effects
Combine physical assessment with other parameters.
older adults
Disproportionate risk Nutrition Screening Initiative: DETERMINE checklist completed by older adults or those who interact with older adults not for use in in-patient setting
food intolerance
food sensitivity
symptoms may include gas or diarrhea
no immune response
not life-threatening
food allergy
food hypersensitivity
symptoms may include hives or anaphylaxis
triggers immune response
can be life-threatening
common allergens include nuts, wheat, and eggs
the food safety safety chains include those who
grow food
ship food
process food
store and supply food
harmful substances that can make food unsafe include
foodborne contaminants
environmental contaminants
naturally occurring toxins
pesticides
FDA (Food and Drug Administration)
establishes federal standards
regulates most foods, drugs, and cosmetics
USDA (Department of Agriculture)
monitors safety of meat, poultry, and eggs
educates the public
CDC (Centers for Disease Control)
promotes general health
offers resources for consumers
EPA (Environmental Protection Agency)
regulates pesticide use
ensures water safety
deals with environmental disasters and cleanup efforts
contaminants in the food chain
don't break down Examples: methylmercury pesticides contaminated water naturally occurring contaminants such as poisonous mushrooms
two types of food borne illness
foodborne infection (pathogen-caused) foodborne intoxication (toxin-cause)
most at risk for food borne illness
the immunosuppressed
the very old and very young
pregnant women
those with poor nutritional status
potential sources for food borne illness
raw animal products
raw fruits and vegetables
staphylococcus aureus
common symptoms of food borne illness include
nausea vomiting abdominal cramps diarrhea fever
limiting exposure
Sustainable agriculture limits the use of pesticides.
Consumers can reduce exposure by taking steps such as:
washing produce
discarding the outer layer of fruits and vegetables
eating a variety of foods
