Individuals and Groups Flashcards
Steps in the NCP
ADIME
Who says nutrition screen must be in 48hrs?
Joint Commission
What is not included in subjective global assessment?
labs, subjective so no objective data
Assessment data includes
anthropometrics labs/medical nfpe client hx food hx
diet history
patterns of eating
food record
diary, tracking of everything eaten
24-hour recall
mental recall, over- under- report is concern
food frequency
how often time is consumed. used in community setting
Formula for estimated desirable body weight
Hamwi
Amputation percentages
whole leg - 16 lower leg and foot - 6 entire arm - 5 forearm and hand - 2.3
Amputation calculation
Adjusted IBW = (100-% amputation)/100 x IBW for ht
Spinal cord injury weight adjustments
quad - reduce by 10-15% of table weight para - reduce by 5-10%
Arm muscle area AMA is useful in
measuring growing children; uses circumference and tricep skin fold
BMI categories
under 18.5 underwt 25 overweight 30 obese
Healthy BMI in elderly
24-29
Waist circumference
M 40 W 35 independent risk factor for disease central adiposity
Waist to hip ratio
risk factor for obesity diseases M 1.0 or greater is problem F 0.8
BIA requirements
evals fat-free mass well hydrated, no etoh, caff, or diuretics in 24 hr
4 parts of NFPE
inspection palpation auscultation percussion (not by RD)
If hair is thin, sparse
low vitamin c
If hair is easily pluckable
low protein
Serum albumin:
3.5-5.0
low - edema, surgery
high - dehydration
Albumin and protein status
not good indictor due to long half-life
Transferrin measures
visceral protein, but not good measure of pro status
Transferrin rises with
Iron deficiency
TTHY transthyretin and protein status
shorter half-life, measures change pro quickly limited usefulness
Creatinine normal ranges
M 0.6-1.2 mg
F 0.5-1.1 mg
What does creatinine measure?
somatic protein
creatinine to height index
estimates lean body mass creatinine excreed/24hrs compared to ht
BUN normal
10-20 mg/dl, indicator of renal disease
BUN:Creatinine ratio normal
10-15:1
TLC total lymphocyte count normal and indication
>2700 low in pro-energy malnut
CRP
indicates inflammation
Free erythrocyte protoporphyrin
lead poisoning. lead depletes iron and competes with calcium
Prothrombin time
11-12.5 seconds
megestrol acetate name and effect
Megase
appetite stimulant
Dextroamphetamine name and effect
Adderall
appetite suppressant, anorexia
Orlistat effect
reduce fat absorption by binding lipase
need v/m supplement
Marinol
appetite stimulant
Methylphenidate name and effect
ritalin
wt loss, anorexia, nausea
Statins warning
avoid grapefruit juice
Loop and thiazied diurectics
Deplete potassium, in creas potassium intake
Lithium warning
need consisten Na and caff to prevent lithium holding - toxicity
Anticoagulant name and warning
Warfarin
Keep Vitamin K steady
Propofol notice
1.1 kcal/cc because in oil
cyclosporin purpose and warning
immunosuppressant
hyper everything- glucose, tension, lipids, kalemia
Levodopa purpose and warning
Parkinson’s
protein and B6 decrease effectivness
take in morning with low pro
Tyramine
do not take with MAOI
avoid aged cheese, sauerkraut, lunch meat
Curcumin name and effect
Educational readiness assessment looks at
HRA Health Risk Appraisal
Infant mortality
PPFP
Nutrition survey
cross-sectional, id problem, prevalence of disease
Nutrition surveillance
ongoing data collection
detect changes in trends
Common surveillance measures
ht, wt, hematocrit, hemoglobin, cholesterol
NSI name and purpose
Nutrition Screening initiative
improve elderly nutrition
NSI examples
DETERMINE
LEVEL 1
LEVEL 2 (more info on nut status)
PNSS: name, agency, purpose
Pregnancy Nut Surveillance System
HHS
low income, high risk pregnant
id and reduce health risk
WWEIA: name, agency, purpose
What We Eat in America
diet part of NHANES
NHANES oversamples
over 65, African Americas, Hispanics
BRFSS: name, agency, purpose
Bhx Risk Factor Surveillance System
HHS
adulst 18+, smoke, etoh, food
YRBSS: name, agency, purpose
Youth Risk Bhx Surveillance System
HHS
grades 9-12
What do BRFSS and YRBFSS help?
monitor change in risk behaviors and target helath promotion efforts for most at risk groups
Which two programs are part of USDA Commodity Food donation/distribution programs?
CSFP, TEFAP
CSFP: name, agency, purpose
Commodity Supplemental Food Program
USDA
monthly commodity canned/packaged
low income, 60+
TEFAP: name, agency, purpose
The Emergency Food Assistance PRogram
USDA
commondity, short term hunger relief for low income
NSLP: name, agency, purpose
National School Lunch Program
USDA, entitlement
children, low income, uses surplus foods
What nutrient requirements for NSLP at lunch?
1/3 avg of weekly requirement for pro, A, C, iron, Ca
SMP: name, agency, purpose
Special Milk Program
USDA
children in schools who do not participate in other federal meal programs
SFSP: name, agency, purpose
Summer Food SErvice Program
USDA, entitlement
food in summers for low income, <18
CACFP: name, agency, purpose
Child and Adult Care Food Program
USDA
public and nonprofit
commodity foods, education
FFVP: name, agency, purpose
Fresh Fruit and Vegatble Program
USDA
intro produce to kids to prevent chronic disease and obesity
WIC: name, agency, purpose
Women, INfant Children
USDA, not entitlement
low income, nut risk
WIC priorities
priority: pregnant, breastfeeding, babies under 1
EFNEP: name, agency, purpose
Expanded Food and Nutrition Edu Prgram
USDA
grants to univesities, edu to low income homemakers
no food!
NSIP: name, agency, purpose
Older Americans Nutrition Act Nutrition
NSIP provides what types of meals?
Nutrition services incentives program
60+, regardless of income
congregate: ambulatory elderly
Meals on Wheels: homebound elderly
SNAP: name, agency, purpose
Supplmental Nutrition Assistance Program
USDA, entitlement
low income, nut risk not considered
IBT: name, agency, purpose
Intensive Behavioral therapy
Medicare B
physician required, continuation based on wt at month 7
Medicaid: agency, purpose
HHS
all ages, blind, disabled, dependent children
Medicare requirements
65+, any age with ESRD
Headstart: agency, purpose
HHS
child participation in food edu
low income, ages 3-5
NETP: name, agency, purpose
Nutrition Edu and Training Program
USDA
edu to teachers and foodservice staff
SFMNP: name, agency, purpose
Seniors Farmer’s Market Nutrition Program
USDA
grants to state for low income 60+
coupons, edu
Nutrition diagnosis
nutrition problem Rd is responsible for treating independently
Medical diagnosis
disease that does not change as long as condition lasts
Diagnosis domains (3)
Clinical, Intake, Bhx/Environmental
PES
problem related to etiology as evidenced by s/s
Altered GI Funtion NC-1.4
problem inside GI tract
digestion, absorption, elimination
Impaired Nutrient Utilization NC-2.1
metabolism problem after nutrient in circulatory system
Choosing intervention priorities
Resolve etiology
Or reduce s/s
If no nutrition problem now that needs intervention
“No nutrition diagnosis at this time”
Primary Prevention
health promotion
reduce exposure to disease promotor
Secondary prevention
risk reduction
program for those with elevated risk factors
FTC: name and purpose
federal trade commission
truth in advertising
no bogus weight claims
tv, radio, internet
Tertiary prevention
rehabilitation efforst
reduce severity of symptons, manage complications
When diet orders are incorrect?
Contact who wrote the order
Largest domestic hunger-relief org
Feeding America
Who cannot participate in CSFP?
Those in WIC at same time
