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CDR Exam > II A: Assessment & screening > Flashcards

II A: Assessment & screening Flashcards

0
Q

steps of the NCP?***

A

assess, diagnose, intervene, monitor, evaluate (ADIME)

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1
Q

what is the nutrition care process?

A

STANDARDIZED, CONSISTENT structure and framework to provide nutrition care (solely standardized care = not individualized)

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2
Q

what is nutrition screening?**

A

use of PRELIMINARY NUTRITION ASSESSMENT TECHNIQUES to identify people who are malnourished or at risk

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3
Q

who can participate in nutrition screening? how long does it take?***

A
  • all health care team members

- brief 5-10 minutes

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4
Q

specificity vs sensitivity

A

specific - can you find the patients without a condition?

sensitive - can you ID those who have a condition?

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5
Q

if no emerging nutrition problem exists after nutrition screening, what should be done?

A

document that discharge from nutrition care is appropriate

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6
Q

the Joint Commission & screening***

A

identify risk within 24 HOURS OF ADM, but DO NOT MANDATE A METHOD of screening

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7
Q

types of screening tools***

A

SGA, MNA, NSI, GNRI

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8
Q

SGA - what is it? what does it stand for?***

A

SCREENING tool - Subjective Global Assessment

hx, intake, wt change, functional capacity, physical appearance, edema, ETC., but NO LABS!!

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9
Q

MNA - what is it? what does it stand for?***

A

SCREENING tool - Mini Nutritional Assessment

ELDERLY

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10
Q

NSI - what is it? what does it stand for?***

A

SCREENING tool - Nutrition Screening Initiative

ELDERLY

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11
Q

GNRI - what is it? what does it stand for?***

A

SCREENING tool - Geriatric Nutritional Risk Index

ELDERLY (serum albumin & weight changes)

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12
Q

_____ provides the basis for the nutrition diagnosis

A

assessment

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13
Q

assessment is initiated by?

A

referral/screening for nutritional risk factors

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14
Q

types of assessment data

A

food/nutrition related hx, anthropometrics, labs/medical tests, nutrition-focused physical findings, client hx

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15
Q

the 3 components of assessment are?

A

RCI review, cluster, identify - look at the pt data, cluster everything together (food hx, anthropometrics, labs, etc.), and then identify them against a standard

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16
Q

components of nutrition assessment**

A
  • food/nutrition-related history
  • anthropometrics
  • biomedical
  • nutrition-focused physical findings
  • client history
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17
Q

what are nutrition indicators?

A

clearly defined markers that can be observed and measured

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18
Q

ways to assess dietary intake?

A

diet hx, food record, 24 hr recall, FFQ

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19
Q

diet history

A

PRESENT pattern of eating, no leading Qs

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20
Q

food record

A

exact record of everything eaten in a specific period of time

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21
Q

24 hour recall

A

mental recall of everything eaten in past 24 hours; quick tool used in clinical setting

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22
Q

food frequency lists***

A

how often an item is consumed; large group of people (quick method)

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23
Q

FFQ can be done in what kind of setting? how?**

A

COMMUNITY- done by THEMSELVES

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24
Q

desirable body weight for women***

A

HAMWI - 100 lbs + 5 (for each inch past 5’) [subtract 5 for each inch under 5’]

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25
Q

desirable body weight for men***

A

HAMWI - 106 lbs + 6 (for each inch past 5’) [subtract 6 for each inch under 5’]

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26
Q

desirable/ideal body weight for a small frame? large frame?***

A

subtract (small) or add (large) 10%

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27
Q

amputations & desirable body weight***

A

(100- % amputation)/100 x IBW

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28
Q

amputation for entire leg***

A

16%

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29
Q

amputation for lower leg with foot (BKA)***

A

6%

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30
Q

amputation for entire arm***

A

5%

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31
Q

amputation for forearm with hand***

A

2.3%

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32
Q

% weight change formula***

A

(usual weight - actual weight) / usual weight x 100

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33
Q

what is the % weight change formula used to assess?***

A

potential NUTRITION RISK!

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34
Q

what does the triceps skinfold thickness (TSF) measure?

A

body fat and calorie reserves

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35
Q

arm muscle area (AMA) is important to measure in whom?***

A

growing children

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36
Q

arm muscle area measures what?

A

skeletal muscle mass (somatic protein)

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37
Q

how is AMA (arm muscle area) determined?

A

TSF & AC (arm circumference)

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38
Q

healthy BMI**

A

18.5-24.9 (BMI is AKA Quetlet’s index)

39
Q

when do BMI for age charts begin to be used?

A

age 2 (once you can obtain an appropriate height/stature)

40
Q

BMI equation

A

weight (kg) / height (m) SQUARED
OR
weight (lbs) / height (in) SQUARED x 703

41
Q

healthy BMI for most elderly

A

24-29

42
Q

waist circumference - risk for disease #***

A

> 40 M, >35 F

43
Q

waist-hip-ratio (WHR)- risk for disease #***

A

> 1.0 M; >0.8 W

44
Q

type of obesity that correlates with an increased risk for co-morbidities of obesity

A

android- apple shaped/men (abdominal obesity)

45
Q

if hair is thin, sparse, dull/dry/brittle, or easily pluckable, what should be considered in the nutritional focused physical exam?***

A

vitamin C or protein deficiency

46
Q

eyes: pale, dry, poor vision- what could be the cause?

A

vitamin A, zinc, or riboflavin deficiencies

47
Q

lips: swollen, red, dry, cracked- what could be the cause?

A

riboflavin, pyridoxine, niacin deficiencies

48
Q

tongue: smooth, slick, purple, white coating- what could be the cause?

A

vitamin or iron deficiencies

49
Q

gums: sore, red, swollen, bleeding- what could be the cause?

A

vitamin C deficiency

50
Q

teeth: missing, loose, loss of enamel- what could be the cause?

A

calcium deficiency, poor intake

51
Q

skin: pale, dry, scaly- what could be the cause?

A

iron, folic acid, zinc deficiency

52
Q

nails: brittle, thin, spoon-shaped- what could be the cause?

A

iron or protein deficiency

53
Q

serum albumin- appropriate lab value?***

A

3.5-5.0 g/dL

54
Q

what is serum albumin?***

A

VISCERAL protein - blood and organs

55
Q

hypoalbuminemia is associated with?***

A

edema or surgery

56
Q

hyperalbuminemia is associated with?***

A

dehydration

57
Q

half life of serum albumin?** what does this indicate?**

A

long half life…does NOT reflect current protein intake

58
Q

what is transferrin?

A

protein that transports iron in the blood stream; serum level controlled by iron storage pool

59
Q

what happens to the lab value tranferrin with iron deficiency?

A

RISES

60
Q

transferrin can be determined from what lab value?

A

TIBC- total iron binding capacity, or the amount of iron capable of being bound to serum proteins

61
Q

prealbumin is AKA**

A

transthyretin (TTHY)

62
Q

half life of PAB? what does this indicate?***

A

SHORT- picks up changes in PRO status quickly

63
Q

what is retinol-binding protein?

A
  • shortest half-life, circulates with PAB

- binds & transports retinol

64
Q

appropriate levels of Hct (hematocrit) for men and women***

A

M 42-52%

W 35-47%

65
Q

Hct level for pregnant women***

A

33%

66
Q

what is Hct? what is Hgb?***

A
  • Hct= volume of packed cells in the blood

- Hgb= iron-containing pigment of RBCs

67
Q

where are RBCs produced?

A

bone marrow

68
Q

Hgb levels for men and women***

A

M 14-17 g/dL; W 12-15 g/dL

69
Q

Hgb level for pregnant women***

A

<= 11

70
Q

what is ferritin?

A

storage form of iron

71
Q

appropriate level of serum creatinine?***

A

0.6-1.4 mg/dL

72
Q

what is serum CRT related to?** what may it indicate?**

A

r/t MUSCLE MASS

73
Q

what does serum CRT measure?***

A

SOMATIC PROTEIN

74
Q

what may abnormal serum creatinine indicate?**

A

may indicate RENAL DISEASE or muscle wastage

75
Q

what is the creatinine height index?***

A

ratio of creatinine excreted / 24 hours ro height

76
Q

what does the creatinine height index (CHI) estimate?***

A

SOMATIC protein

77
Q

appropriate BUN levels?***

A

10-20 mg/dL

78
Q

appropriate BUN:creatinine ratio***

A

10-15:1

79
Q

BUN is related to what nutrient’s intake?

A

protein

80
Q

BUN is an indicator of what disease?

A

renal

81
Q

what does urinary creatinine clearance measure?

A

GFR- glomerular filtration & renal function

82
Q

what is TLC? what does it measure?

A

total lymphocyte count: measures immunocompetency (immune system)

83
Q

normal levels of TLC***

A

(total lymphocyte count) = >2700 cells/cu mm

84
Q

how is lab value of TLC affected with protein-energy malnutrition?

A

DECREASES

85
Q

what is CRP?***

A

C-reactive protein = MARKER OF INFLAMMATORY STRESS (NOT nutritional status)

86
Q

relationship between CRP and PAB

A

inverse: when elevated CRP decreases (aka progressing towards a less inflamed state), PAB increased

87
Q

what is FEP?

A

free erythrocyte protoporphyrin

88
Q

what does FEP measure?***

A

toxic effects of lead on heme synthesis; INCREASED IN LEAD POISONING

89
Q

relationship between lead and iron

A

lead depletes iron –> anemia

90
Q

normal lab value for prothrombin time***

A

11.0-12.5 seconds

91
Q

what can prolong prothrombin time?

A

anticoagulants

92
Q

what is prothrombin time?

A

evaluates clotting adequacy

93
Q

changes in ____ intake will alter rate of prothrombin time

A

vitamin K

94
Q

hair analysis is useful for?

A

measuring intake of toxic metals (NOT for nutritional assessment)

95
Q

activity factors

A

BEE x AF

1.2 = sedentary, 1.3 = active, 1.5 = stressed

96
Q

what is PAL?

A

physical activity levels

CDR Exam (34 decks)

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