Lecture 7: Nutritional Assessment

Question 1

How do you calculate caloric need (kcal/kg) to maintain wait in sedentary hospitalized pt vs. acute or severely ill pts (trauma, burn, etc.)?

Answer 1

• Sedentary = 30-35 kcal/kg of BW
• Acute/Severely ill = 35-40 kcal/kg of BW

Question 2

Obesity can be defined as a BMI of?

Answer 2

≥30

Question 3

Obesity can be defined as a waist circumference of what in both men and women; how is this measured?

Answer 3

• Men = >40’‘
• Women = >35’’
• Circumference measured at the uppermost lateral border of the iliac crest during normal (minimal) respiration

Question 4

Tetracyclines affect which 4 nutrients?

Answer 4

Calcium, magnesium, iron, and Vit B12

Question 5

The Abx Neomycin and Kanamycin affect which 2 nutrients?

Answer 5

Fat-soluble vitamins and B12

Question 6

The Abx Sulfasalazine affects which nutrient?

Answer 6

Folate

Question 7

The anticonvulsants, Phenobarbital and Phenytoin, affect which 4 nutrients?

Answer 7

Calcium, Vit D, Folate, and Niacin

Question 8

The cytotoxic agent, Methotrexate affects which nutrient?

Answer 8

Folate

Question 9

Mineral oil used as a laxative affects which nutrients?

Answer 9

Water, electrolytes, fat and fat-soluble vitamins

Question 10

The anti-tuberculosis drug, Isoniazid, affects which nutrients?

Answer 10

Pyridoxine (B6) and Niacin (B3)

Question 11

The Thiazide diuretic, Furosemide, affects the status of which 4 nutrients?

Answer 11

K+, Mg²⁺, Ca²⁺, and zinc

Question 12

The medications, lithium and amiodarone affect the status of which nutrient?

Answer 12

Iodine

Question 13

Unintentional weight loss of how much (%) over 6 months and 1-year is considered significant?

Answer 13

• 5% over 6 months

or

• 10% over 1-year

Question 14

How to calculate % weight change?

Answer 14

%weight change = [(usual wt. - current wt.)/(usual wt.)] x 100

Question 15

The thickness of which area of the body can be used to assess subcutaneous fat?

Answer 15

Tricep skinfold thickness: ~50% of body fat is subcutaneous

Question 16

Rapid weight gain is more likely related to; while weight loss is related to?

Answer 16

• Weight gain = fluid retention
• Weight loss = tissue loss

Question 17

Dry and scaly skin w/ a cellophane appearance is related to a deficiency of which nutrient?

Answer 17

Protein

Question 18

Flaking dermatitis is related to which nutrient deficiency?

Answer 18

Zinc

Question 19

Follicular hyperkeratosis is related to which nutrient deficiency?

Answer 19

Vitamin A

Question 20

Pigmentation changes of skin, especially in sun exposed areas is related to which nutrient deficiency?

Answer 20

Niacin

Question 21

Petechiae of the skin is related to which nutrient deficiency?

Answer 21

Vitamin C

Question 22

Purpura of the skin is related to which nutrient deficiencies?

Answer 22

Vitamin C and Vitamin K

Question 23

Glossitis of the tongue is related to which nutrient deficiencies?

Answer 23

Riboflavin + Niacin + B vitamins + Folate and iron

Question 24

Angular stomatitis and cheilosis (dry, cracking, ulcerating lips) is related to which nutrient deficiencies?

Answer 24

Riboflavin, pyridoxine (B6), and Niacin

Question 25

Bleeding gums may be a sign of which 2 nutritional deficiencies?

Answer 25

**Vit C** and **riboflavin**

Question 26

Interosseous muscle atrophy, squaring off of shoulders, poor hand grip and leg strength (temporal, supraspinatus) may be associated with deficiencies of which nutrients?

Answer 26

**Protein** + **calories** + **Vit D**

Question 27

Tetany is associated with which 2 nutritional deficiencies?

Answer 27

**Calcium** and **Mg²⁺**

Question 28

Spooning of the nail beds is associated with which nutritional deficiency?

Answer 28

Iron

Question 29

Parotid enlargement is associated with which nutritional deficiency?

Answer 29

Protein

Question 30

Corkscrew hairs is associated with which nutritional deficiency?

Answer 30

Vitamin C

Question 31

Which lab value associated with inflammation may be helpful in identifying nurtritional deficiencies?

Answer 31

- **Albumin \<3.5 g/dL** is considered indicative of **mild** systemic inflammatory response - **\<2.4 g/dL** represents **severe** systemic inflammatory response that produces **anorexia** (limiting food intake) and **↑ protein catabolism**

Question 32

Which labs may be helpful in identifying iron, B12, and folate deficiencies?

Answer 32

**CBC**

Question 33

What does it mean when packaging says light in sodium/lightly salted or reduced fat/less fat?

Answer 33

Means there is at least **50% less** than the **regular product**

Question 34

What does it mean when packaging says reduced sodium or reduced fat?

Answer 34

There is at least **25% less** than the **original product**

Question 35

When a food label says trans fat free, what does this mean?

Answer 35

The food has **\<0.5 g trans fat** per serving; doesn't mean it's not there

Question 36

Glossitis, stomatitis, vertigo and **burning** paresthesia's are common with what nutritional deficiency?

Answer 36

Niacin