Exam 2 Flashcards
Risk factors for eating disorders include being woman, family history of ___, ___,___ and ___, ___, LGBTQ community, ___, frequency and severity of dieting, exposure to social media, and ____
Depression
Anxiety
ED
Substance abuse
High BMI during adolescence
Perfectionism
Athletes
What are the categories of anthropometrics?
Height, length, stature
Weight
Head circumference
Other body part measurements
Body fat distribution
Anthropometric measures can be sensitive indicators of health, ____, nutritional status, ____, and ___
Growth and development
Response to nutritional support
Body composition
What are common errors of anthropometrics?
Measuring technique
Consistency in technique
Units of measure
Calculations
How do you convert # to kg?
Use an example of someone who is 150#
150/2.2= 68.2 kg
How do you convert feet to centimeters?
Use an example of someone who is 5’5”
First convert feet to inches
5’5” = 65 inches
65 x 2.54cm = 165.1 cm
How do you convert centimeters to meters?
Use example of someone who is 165.1 cm
165.1cm /100= 1.65 m
What equation is used to calculate IBW? What are the equations?
Hamwi equation
100+ 5 for female
106+6 for male
How do you calculate IWR?
Hamwi method +/- 10%
If current birth weight is within the IWR what is the % IWR?
100%
ex) IWR is between 108 and 132#
CBW is 125 so it’s within the range so % IWR is 100%
If current body weight is below the IWR what is the % IWR?
If CBW low, use lower number for IWR
ex) IWR is between 108 and 132#
If CBW is 105 use 108 so
105/108= 97% IWR
If current body weight is at the upper end of IWR what is the % IWR?
If CBW high, use higher number for IWR
ex) IWR is between 108 and 132#
If CBW is 150# use 132 so
150/132= 114% IWR
How do you calculate BMI?
kg/ m2
ex) 68 kg/ 1.63^2= 25.2
T or F
Usual body weight is more relevant than IBW
True
When is the only time you should use UBW in calculations?
If there’s documentation of edema or fluid overload or fluid weight loss
When looking at IWR or BMI how much should you subtract from 100% for someone that has
Below knee amputation=
Above knee amputation=
Above elbow amputation=
Paraplegia=
Quadriplegia=
Below knee amputation= 6%
Above knee amputation= 10%
Above elbow amputation= 3%
Paraplegia= 7%
Quadriplegia= 13%
If a person with a below knee amputation has an IWR of 108 to 132#, what would their new IWR be?
BKA= -6% so 100%-6%= 94%
Multiply 108-132 x 94%= 101-124#
If someone’s CBW is 155# but a week ago they weighed 150#, how would you calculate weight change?
155-150= 5#
5/150= 3.3% x1 wk gain
When calculating weight change do you use CBW or previous weight?
Previous weight
What would be considered significant weight loss or gain?
1 week=
1 month=
3 months=
6 months=
12 months=
1 week= > 2%
1 month= > 5%
3 months= >7.5%
6 months= >10%
12 months= >20%
ex) a patient went from 150# to 130# in three months
Is their weight loss significant?
150-130= 20#
20/150 = 13.3% so yes significant weight loss
IWR classifications
Underweight=
Normal weight=
Overweight=
Obese=
IRW classifications
Underweight= <100%
Normal weight= within IWR
Overweight= >100-129%
Obese= 130% or above
BMI classifications
Underweight=
Normal weight=
Overweight=
Obese class 1=
Obese class 2=
Obese class 3=
BMI classifications
Underweight= <18.5
Normal weight= 18.5-24.9
Overweight= 25-29.9
Obese class 1= 30 to <35
Obese class 2= 35 to <40
Obese class 3= 40+
T or F
Always do measurements 3 times
False, twice
Ways you can measure height are stature which means ___, length which means ____, or estimating height using ___ or __
Standing height
Recumbent length (for 24 mos or under)
Knee height or arm span
When measuring NIH waist circumference should you measure below or above the illiac crest? What about belly button
Above iliac crest
Below belly button
When measuring WHO waist circumference where should the measuring tape be located?
Upper most point of illiac crest and lowest rib
What is desirable measurements for WC?
NIH=
WHO=
NIH
male= <40” or 102 cm
female= <35” or 88 cm
WHO
male= <37” or 94 cm
female= <31.5” or 80 cm
How do you calculate WHTR?
What about disease risk?
Desirable=
Disease risk=
Obese=
NOT ON TEST
Waist circumference/ height
Desirable= <.5
Disease risk= >.55
Obese= >.6
How do you calculate WHR?
What is desirable?
NOT ON TEST
Waist circumference/ hip circumference= waist to hip ratio (WHR)
Desirable
men= <0.90
women= <0.85
What body parts are used to estimate body fat?
Waist
Hip
Wrist
Forearm (biggest part)
Percent body fat ranges for males:
Essential=
Normal=
Overweight=
Obese=
Essential= 3-5%
Normal= 10-20.9%
Overweight=>21-24.9%
Obese=>25%
Percent body fat for females:
Essential=
Normal=
Overweight=
Obese=
Essential=10-12%
Normal= 15-30.9%
Overweight=>31-36.9%
Obese=> 37%
What does PEM stand for and who is affected by it?
Protein/ energy malnutrition
30% of hospitalized and 60% of elderly patients
Patients with PEM have longer hospital stays, ___, ___, pressure ulcers, ____, and deaths
More readmissions
Hospital acquired infections
Slower wound healing
You can assess the nutritional status of the hospitalized patient by doing what 2 things?
Nutritional screening (done w/in 24-48 hours)
Or
Nutritional assessment (A,B,C,D, M)
T or F
Resting energy expenditure is not measured, it’s estimated
True
What are the components of 24 hour energy expenditure?
REE
TEE
TEF
Always use CBW unless you should use UBW when what?
Unless there is documented edema, ascites, or fluid overload
When is Mifflin St. Jeor equation used?
For overweight/ obese classification
TDEE in-hosptial activity factors are:
Unresponsive=
Confined to bed=
In and out of bed for showers/ therapy=
Unresponsive= 1.0
Confined to bed= 1.1
In and out of bed for showers/ therapy= 1.2
TDEE out of hospital activity factors are:
Only activities of daily living/ no exercise=
Low active, walking 2 miles/d=
Active, walking 7.3 miles/d=
Very active, 16.7 miles/d=
Only activities of daily living/ no exercise= 1.3
Low active, walking 2 miles/d=1.4
Active, walking 7.3 miles/d=1.6
Very active, 16.7 miles/d=1.9
When talking about TDEE in relation to TED, what factors would put patients into a 1.2 category?
Significant weight loss
Major surgery
Moderate infection
Body trauma
Cancer
COPD
ventilator
Long bone fracture
Severe open wound
HIV
burns <20% of body
When talking about TDEE in relation to TED, what factors would put patients into a 1.8 category?
Multiple fractures
Burns >20% of body
Severe infection
T or F
If a patient falls into both 1.2 and 1.8 TED TDEE factors, you should always use the less severe one
False, use the more severe
What is the quick TDEE?
25-30 kcal/kg
(Use 25 for obese)
Overestimates & no activity or disease factor used
What are the protein needs of:
adults=
65+ yr olds=
Renal disease (pre-dialysis)=
Major surgery, moderate infection & trauma, open skin blisters/ burns, open wounds, dialysis=
Severe infections/ trauma, major wounds and burns=
Cancer=
Cancer cachexia=
Pregnancy
Adults= 0.8
65+ yr olds= 1.0
Renal disease (pre-dialysis)=0.8
Major surgery, moderate infection & trauma, open skin blisters/ burns, open wounds, dialysis= 1.2
Severe infections/ trauma, major wounds and burns= 1.5
Cancer=1.5
Cancer cachexia= 1.5
Pregnancy= +25 g/d
When estimating protein needs, who would fall into the 1.2 category?
Major surgery
Moderate infection and trauma
Small open skin blisters/burns
Open wounds
Dialysis
When estimating protein needs, who would fall into the 1.5 category?
Severe infections/trauma
Major wounds/burns
Cancer
Cancer cachexia
What number do you use to estimate normal hydration?
30 ml/kg
When should you use 35 ml/d when estimating hydration needs?
Dehydration
Diarrhea
Draining wounds
Fever
Ostomy
Burns
You can assess if nutritional needs are being met protein wise by looking at ___ and ___. Calorie needs by ____. And Signs and symptoms of over hydration or under hydration
Skin integrity and healing
Weight maintenance
Weight loss can result from serious disease, ____, ____, or ____.
Energy deficit
Increased excretion of excess water
Dehydration
Weight gain can indicate depletion of lean and fat tissues, development of ____, abnormal accumulation of body fluids such as ___,___, or ____.
Adipose tissue
Edema
Ascites
Renal/heart failure
