Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Nutrition and Drug Monitoring > Introduction to Nutritional Assessment > Flashcards

Introduction to Nutritional Assessment Flashcards

1
Q

What is effection fo Malnutrition and their complications?

A
  • Impaired immune response: Infection
  • Impaired wound healing: Prolonged recovery
  • Muscle wasting: Inactivity, Falls
  • Decreased respiratory and cardiac muscle contraction: Pneumonia, Heart failure
  • Inactivity: Thromboembolism, Pressure sores
  • Impaired thermoregulation: Hypothermia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the Nutritional status?

A

‘Condition of body resulting from intake, absorption and utilisation of food, taking into account factors of pathological significance’

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What does a nutriotional assement involve?

A

Involves

  • Screening Tools
  • Dietary Assessment
  • Clinical Assessment
  • Biochemical Assessment
  • Calorimetry,
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Wh does we perform a nutrtional assessment?

A
  • Determine whether nutritional needs being met
  • Identify patients at higher risk of morbidity/mortality without nutrition support
  • Chart patients progress with time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are some screening Tools?

A

Subjective Global Assessment (SGA)

  • Symptoms
  • History
  • Examination findings

Likelihood of Malnutrition Index (LMI)

  • Biochemistry
  • Haematology
  • Examination findings

Malnutrition Universal Screening Tool (MUST)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is a dietary assement used for?

A

Identify:

  • Loss of appetite
  • Difficulty buying / preparing food
  • Difficulty eating food
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the methods for a dietary assessment?

A
  • Quantitative food diary
  • Food frequency questionnaires
  • Photographs
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

How is a clinical assessment of nutrition undertaken?

A

Clinical History

  • Increased nutritional requirements
  • Increased nutrient losses
  • Decreased nutrient absorption

Clinical Examination

  • Generalised signs of malnutrition
  • Signs / Symptoms of specific nutritional disorders Waist circumference

Anthropometric Measurements

  • Height / Weight / BMI
  • BMI = Weight (Kg) / Height2 (m
  • Skinfold thickness
  • Mid-arm circumference
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

How is nutrition biochemically assessed?

A

Measure

  • Albumin
  • Pre-albumin
  • IGF-1
  • Transferrin
  • Retinol binding protein
  • Fibronectin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What can Biochemcial Assessment of Nutrition be affected by?

A
  • Acute phase response
  • Concurrent liver and renal disease
  • Hydration status
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How can Calorimetry be conducted?

A
  • Can be directly calculated by measuring the heat expended by an individual exercising in an enclosed chamber
  • Can be indirectly calculating by measuring the oxygen consumed and the amount of carbon dioxide expended
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How can X-Ray be used for assessment of nutrition?

A

Can be used through X-ray and DEXA scan to look at the body composition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What are sources of Energy in the UK Adult diet?

A
  • Carbohydrates = 45.7%
  • Protein = 15.6%
  • Fat = 33.3%
  • Alcohol = 5.2%
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the energy requirements within the body?

A

Basal metabolism:

  • Biosynthesis of tissues during continuous turnover = 40%
  • Maintenance of ionic gradients across membranes, especially electrical activity of nerve cells = 40%
  • Involuntary muscle contraction of breathing, peristalsis, heart = 20%

Additional needs:

  • Biosynthesis of new tissue during energy storage, growth, replacement of any losses
  • Voluntary muscle contraction
  • Thermoregulation
  • Thermogenesis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

How is the Total Energy Expenditure calculated?

A
  • Alteration in BMR due to disease process +
  • Physical Activity +
  • Metabolic response to food (dietary induced thermogenesis; DIT)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How is the an individuals enery requirements estimated in clinical practice?

A
  • Estimating the BMR
  • Adding appropriate stress factor (disease process)
  • Adding a combined factor for activity and DIT
17
Q

How is the BMR estimated?

A

BMR = ‘the energy expenditure (eg. kcal/day) of the body at rest, at thermoneutrality, and in the postabsorptive state’. BMR is 45-70% of TEE

BMR is principally determined by body mass and therefore, varies with:

  • Body weight
  • Body composition
  • Age
  • Gender
18
Q

How is BMR estimated?

A

Schofield Equation

19
Q

What affects the BMR estimate calculation?

A
  • Nutritional status
  • Hormonal effects
  • Pharmacological
  • Pregnancy and lactation
  • Disease
  • Trauma
  • Ambient temp etc
20
Q

What are the stress factors in Clinical estimate of TEE?

A
  • Severe sepsis = 10-30%
  • Extensive surgery = 10-30%
  • Fractures/trauma = 10-30%
  • Burns/wounds = 50-150%
  • RDS = 20%
21
Q

What examples of Physical Activity and DIT?

A

1. Activity = energy expended during active movement of skeletal muscle

Hospital:

  • Bedbound immobile = +20%
  • Bedbound mobile/ sitting = +30%
  • Mobile on ward = +40%

Community – multiply the BMR by Physical Actively Level (PAL):

  • Sedentary or Light = 1.40 – 1.89
  • Moderately Active = 1.70 – 1.69
  • Vigorous = 2.00 – 2.40

2. Add 10% for specific dynamic action of food

22
Q

What are the sources of Proteins?

A
  • Grains
  • Cereals
  • Fish
  • Meat
  • Nuts
  • Dairy
23
Q

What are requirements for Protein?

A
  • Adults 1.0 g/Kg/day (0.16 g Nitrogen/Kg/day)
  • Children 1.5 g/Kg/day (0.24 g Nitrogen/Kg/day)
  • Neonates 2.5 g/Kg/day (0.4 g Nitrogen/Kg/day)
24
Q

What are the constant obligatory lossess of Proteins?

A
  • Urine - urea (also ammonia, urate, creatinine and some free amino acids)
  • Faeces
  • Desquamated skin
25
Q

What are the states of Proteins?

A

Anabolic state

  • Intake/Synthesis of protein/amino acid sources greater than rate of utilisation and/or excretion

Catabolic state

  • Utilisation and/or excretion of protein/amino stores greater than intake/synthesis
26
Q

How do we calculate Protein Loss?

A

Nitrogen excretion (g/24hr) = (Urine urea (mmol/24hr) x 28)/1000

+20% to account for non-urea urinary nitrogen losses

+2 g to account for non-urinary nitrogen losses

  • Nitrogen excretion < Nitrogen intake = Anabolic
  • Nitrogen excretion > Nitrogen intake = Catabolic
27
Q

How can Protein Depletion occur?

A
  • Failure to meet energy requirements, resulting in use of tissue protein as an energy source
  • Failure to absorb or utilise dietary protein as a result of GI disorders or liver disease
  • Catabolic response to trauma, sepsis, surgery, with net negative nitrogen balance
  • Excessive protein loss from body due to eg burns, nephrotic syndrome, exudative losses
28
Q

What doe Long term depletion of protein result in?

A
  • Stunted growth
  • Poor wound healing
  • Increased susceptibility to infection
  • Anaemia
29
Q

What are sources of Carbohydrate Metabolism?

A
  • Grains
  • Pulses
  • Fruit
  • Rice
  • Maize
  • Refined sugars

Typically, 4-5 g/Kg/day

30
Q

How are Carbohydrates stored in the body?

A
  • Liver and muscle major store of body CHO in form of glycogen
  • Hepatic glycogen depleted within 24 hrs if no CHO ingestion, after this blood glucose concentrations maintained by gluconeogenesis from amino acids, lactate and glycerol
  • No specific syndromes associated with Carbohydrate deficiency alone
31
Q

What are sources of Fat?

A
  • Meat
  • Dairy
  • Nuts/Seeds/Fish/Olives/Avocado etc
32
Q

What are fat requirements from the body?

A
  • Fat intake no more than 35% total energy requirements
  • No more than 1/3 of this supplied as saturated fat
  • Adults ~1-1.5 g/Kg/day
33
Q

What are the sign/sumtptoms associated with Fat deficiency?

A
  • Dermatitis
  • Night blindness
  • Rickets / Osteomalacia
  • Fragile red blood cells
  • Poor clotting function
  • Neuropathy

Nutrition and Drug Monitoring (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions