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NUTR 482 Dietetic Practice > Lecture 1 NPG Intro and Nutritional Assessment > Flashcards

Lecture 1 NPG Intro and Nutritional Assessment Flashcards

1
Q

NCP

A

Nutrition Care Process

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2
Q

Purpose of the NCP

A

Indentify, treat and prevent malnutrition

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3
Q

Malnutrition

A

Malnutrition refers to deficiencies, excesses or imbalances in a person’s intake of energy and/or nutrients
* undernutrition
* overweight/ obesity

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4
Q

Consequences of malnutrition

A
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5
Q

Types of malnutrition

A
  • starvation related
  • chronic disease-related
  • acute disease or injury-related
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6
Q

Parts of the NCP

A
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7
Q

What is nutritional screening

A

A process to identify an individual who is:
* At risk of malnutrition (risk factors are present that impair intake and/or increase the body’s needs for nutrients and/or energy)
* Malnourished
* Likely to benefit from further nutrition assessment and treatment

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8
Q

Considerations for choosing a screening tool

A

Rapid and simple process not neccessarily conducted by a nutrition professional
* Ease of use
* Inexpensive to collect on all patients
* Front-line personnel can use
* Specific to the population of use

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9
Q

Nutritional screening versus nutritional assessment

A
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10
Q

Describe the nutritional assessment

A

Identify the nutrition problem (s) and make decisions about the underlying cause (s)
* systematic approach to collect, record, and interpret relevant data from patients, clients, family members, caregivers, and other individuals and groups.
* Ongoing, dynamic process: data collection and continual reassessment and analysis of client’s status compared to specific criteria.

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11
Q

Nutrition Assessment Data Includes:

A
  • Client’s history
  • (ABCD’s)
  • A = Anthropometric
  • B = Biochemical/ lab data
  • C = Clinical, physical examination
  • D = Diet History
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12
Q

What are the data sources for nutrition assessment data?

A
  • Heath Record System (e.g. labs, medical dx)
  • Created during assessment - to be added to health record (diet hx, current anthropometry measures, additional client hx collected during interview).
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13
Q

What is included in anthropometrics?

A
  • BMI
  • waist circumference
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14
Q

normal BMI range for older adults

A

65 years and older is 22 – 29.9 kg/m2.

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15
Q

Height conversions

A

5 feet 2 inches (5’ 2”)
* 5 feet * 12 inches per foot = 60 inches
* 60 inches + 2 inches = 62 inches
* 62 inches * 2.54 cm per inch = 157.48 cm

1 foot = 12 inches
1 inch = 2.54 cm

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16
Q

Calculation BMI for Jody’s measurements from her Doctor’s appointment
* Weight: 145 lbs
* Height: 5’1”

A
  1. 145 lbs/ 2.2 = 65.9 kg
  2. 5 feet x 12 = 60 inches + 1 inch = 61 inches x 2.54 = 154.94 cm = 1.5494 m
  3. 65.9/1.5494 cm2 = 27.45 kg/m2
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16
Q

Weight conversions

A

1 kg = 2.2 pounds

16
Q

What is included in biochemical data?

A
  • protein: plasma aa level, serum albumin, CRP
  • nutrients: retinol, iodine, calcium, vitamin D
  • lipids: cholesterol, triglycerides, lipoprotein
  • electrolytes
  • kidney and renal function
  • glucose
  • HbA1C
  • iron panel
  • micronutrient status, etc

first 3 are most common

17
Q

Laboratory Values that Identify Increased Health Risk

A
  • High blood pressure (≥ 130/85 mm Hg, or receiving meds)
  • High blood glucose levels (≥ 5.6 mmol/L, or receiving meds)
  • High triglycerides (≥ 1.7 mmol/L, or receiving meds)
  • Low HDL-Cholesterol (< 1.0 mmol/L in men or < 1.3 mmol/L in women)
  • High LDL-Cholesterol (>3.5 mmol/L, or receiving meds)
  • Large waist circumference (≥ 102 cm in men, 88 cm in women; variably by ethnicity)
18
Q

What is included in the clinical/ physical exam?

A
  • general appearance
  • skin
  • nails
  • hair
  • spooring of nails
  • gums
  • eyes
  • BP
19
Q

What is included in a diet history?

A
  • Intake vs. Requirements for Macronutrients and Micronutrients
  • Assess the quality of the diet: balance of nutrients vs. type of food eaten
  • Meal timing/patterning
  • Food skills and knowledge (shopping, cooking, label eating)
  • Meal locations (frequency of eating out)
  • Dietary restrictions
  • Food allergies
  • Ethnical, cultural, social patterns
20
Q

Factors to consider in diet history

A
  • setting
  • population characteristics
  • disease state and severity
21
Q

references or comparative standards for assessing diet

A
  • national guidelines: CFG & DRIs
  • clinical guidelines: ASPEN, ESPEN, foundations
22
Q

Describe the CFG plate

A

Eating a variety of healthy foods each day
* 1/2 plate: Have plenty of vegetables and fruits
* 1/4 plate: eat protein foods
* 1/4 plate: choose whole grain foods
* Make water your drink of choice

23
What habits are encouraged through the CFG?
* Be mindful of your eating habits * Cook more often * Eat meals with others * Enjoy your food * Other: use food labels, limit foods high in sodium, sugars and saturated fats, be aware of food marketing
24
Acceptable Macronutrient Distribution Ranges (AMDRs)
* CHO: 45-65% * PRO: 10-35% * FAT: 20-35%
25
26
Recommended Dietary Allowance for Protein for adults
Adults age 19- 69y: 0.80 g/kg/day
27
CHO minimum
130 g/d * brain activity
28
Fibre reccomendations
14 g/1000 kcal/d or ~ 25 to 38 g/d * Females 18-50 yrs: 25 g/day (AI) * Females 51+ yrs: 21 g/day (AI) * Males 18-50 yrs: 38 g/day (AI) * Males 51+ yrs: 30 g/day (AI)
29
free/ added sugar reccomendations
< 25% total energy/day
30
Estimating TEE
1. BMR via MSJ 2. TEE = BMR x AF
31
What body weight to use when estimating energy needs
* normal BMI = actual body weight * not normal BMI = ideal body weight
32
How is energy needs best estimated in older adults?
Energy (kcal) per weight (kg) ranges for older adults to estimate energy needs * Women (healthy): 25-35 kcal/kg/day * Men (healthy): 30-40 kcal/kg/day * Underweight (W/M): 25-30 kcal/kg/day and more for weight gain * BMI ≥ 30 kg/m2 refer to NPGs
33
Weight adjusted recommendations
* Adults: 25 – 30 kcal/kg/day * 500 – 750 calorie reduction from current daily intake for weight loss * 500 – 750 calorie addition to current daily intake if underweight/ unintended weight loss * Obesity (BMI ≥ 30 kg/m2) = 21 kcal/kg/day * Obesity (BMI ≥ 40 30 kg/m2) = 11 – 14 kcal/kg/day
34
Weight loss recommendations
5-10% (current weight) * Calorie intakes < 1200 kcal/day DO NOT meet nutritional adequacy requirements * Very low calorie diets (< 800 kcal/day) MUST be physician supervised
35
protein recommendations
* Adults 18-65 yoa: range of 0.8-1.2 g/kg * Older adults 65+ years: 1.0-1.2 g/kg IBW
36
IBW range for adults < 65 years of age
Acceptable BMI range 18.5-24.9
37
Recommended sodium requirements
* 1500 mg for <50y = 0.75 tsps or 3.75 g salt/day (1 tsp = 2300 mg sodium) * 1300 mg for 51-70y * 1200 mg > 71y
38
Vit D recommendations
* 600 IU for 1-70y * 800 IU for >70y
39
Calcium recommendations
* 1000 mg for men 19-70y and 1200 mg for >70y * 1200 mg for women 19-50y and 1200 mg for >51y
40
Fluid recommendations
* Females: 2.7 L * Males: 3.0 L

NUTR 482 Dietetic Practice (5 decks)

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