Medical Nutrition Therapy

Question 1

Identify three characteristics of nutrition screening in the acute care setting

Answer 1

(1) basic, (2) easy to administer, & (3) measurable

Question 2

Serum albumin is an indicator of which nutritional indice?

Answer 2

Visceral protein status

Question 3

An elevated albumin may indicate what condition

Answer 3

Dehydration

Question 4

A decreased albumin may indicate what condition?

Answer 4

Malnutrition

Question 5

A patient presents with a depleted serum albumin and protein malnutrition; identify one lab parameter that could be measured to evaluate the patient.

Answer 5

Creatine height index

Question 6

When reviewing the serum calcium level, what other lab value must be evaluated in light of a deplete serum calcium?

Answer 6

Albumin.

Serum calcium is protein-bound. Therefore, when reviewing a serum calcium level, serum albumin must also be reviewed.

Question 7

What is the formula for adjusting serum calcium when serum albumin is decreased?

Answer 7

(4- serum albumin) * (0.8 + total calcium)

Question 8

Identify the more accurate calcium lab to monitor serum calcium status in patients with hypoalbuminemia.

Answer 8

Ionized calcium

Question 9

Which hematological indices can be used to evaluate iron and protein deficiencies?

Answer 9

Hemoglobin

Question 10

Name the iron transport protein

Answer 10

Transferrrin

Question 11

What is the half-life of transferrin?

Answer 11

8-10.5 days

Question 12

A patient with heart failure presents with: serum albumin of 2.5, serum calcium of 11.5, and a weight change of 50.5 to 53.5 kg in three days. What could be the cause of this present condition?

Answer 12

Fluid retention

Question 13

A patient is admitted with a serum albumin of 3.7; following surgery, his albumin drops to 3.1. What could be the cause?

Answer 13

The albumin is a negative acute phase respondent. The drop in albumin is related to the stress of the surgery.

Question 14

The labs triiodothyronine (T3) and thyroxine (T4) are used to measure the function of which endocrine gland?

Answer 14

Thyroid gland

Question 15

A patient presents with an elevated ALT and elevated AST, what do these labs indicate?

Answer 15

liver damage or hepatocellular disease.

Question 16

What is the best test for determining iron status?

Answer 16

Ferritin

Question 17

A patient has anemia, low RBC count, and kidney disease; what hormone is involved in this disease condition?

Answer 17

Erythropoietin

Question 18

A patient has a rare urea disease, what will the labs show?

Answer 18

An elevated ammonia level

Question 19

Urea excretion is related to the intake of which macronutrient?

Answer 19

Protein

Question 20

Creatinine excretion is an indicator of what aspect of a patient’s nutritional status?

Answer 20

Muscle mass/somatic protein status

Question 21

A patient’s hematological lab values indicate low hemoglobin and low MCV; identify the nutritional deficiency.

Answer 21

Iron deficiency anemia

Question 22

Glycosolated hemoglobin (HgB A1C) reflects the serum glucose level for what time span?

Answer 22

90-120 days
8-12 weeks
3-4 months

Question 23

A glycosylated hemoglobin (HgB A1C) of 15% indicates what level of diabetes control?

Answer 23

The normal range is 4-6%, levels at 15% indicate poor control

Question 24

Identify two physical and/or biochemical manifestations of Kwashiorkor.

Answer 24

Edema
Fatty liver
Third spacing
Severely depleted serum protein & albumin

Question 25

Identify two physical and/or biochemical manifestations of marasmus.

Answer 25

Muscle wasting
Fat wasting
Wizened skin
Stunted growth
A triceps skinfold less than 10%