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Nutrition Assessment > Midterm > Flashcards

Midterm Flashcards

1
Q

What is the process of becoming an RD?

A
  • complete approved Academy + Dietetics (AND) Didactic 4 year program
  • complete a postgraduate AND-approved Dietetic internship
  • pass a national registration exam
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2
Q

What are the steps involved in the Scientific Method?

A
  1. Ask a question
  2. Background research
  3. Hypothesis
  4. Test
  5. Analyze/ Conclude
  6. Communicate results
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3
Q

What are factors to consider when researching?

A
  • single or multi center
  • retrospective or prospective
  • causation or association
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4
Q

Lab/ Animal Studies

A
  • controlled conditions

- before human research is allowed

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5
Q

Case Series/ Reports

A
  • not controlled
  • early research
  • taking patient’s chart notes and applying them to a journal article
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6
Q

Case Control Studies (retrospective)

A

-comparing a non-patient group with a patient group’s history and drawing conclusions

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7
Q

Cohort Studies (prospective)

A
  • large group that is recruited for future years

- comparing the results of the patient and non-patient groups

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8
Q

Systematic Review

A

-includes analyzing published and unpublished studies

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9
Q

Meta-Analysis Review

A

-includes pooling published studies into a new data set

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10
Q

Nutrition Care Process

A

ADIME: Assessment … Diagnosis (PES statement) … Intervention … Monitoring + Evaluation

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11
Q

PES Statement

A

P: problem … as related to
E: etiology … as evidenced by
S: signs + symptoms

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12
Q

Adult AMDRs

A

Carbohydrates: 45-65%
Proteins: 10-35%
Fats: 20-35%

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13
Q

ChooseMyPlate grain portions

A

1 oz is equal to 1 slice bread, 1 cup cereal, 0.5 cup cooked rice + cereal

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14
Q

ChooseMyPlate vegetable portions

A

1 cup of raw/ cooked/ juice

2 cups of raw lead greens

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15
Q

ChooseMyPlate fruit portions

A

1 cup fruit/ juice

0.5 cup fried fruit

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16
Q

ChooseMyPlate dairy portions

A

1 cup milk/ yogurt
1.5 oz natural cheese
2 oz processed cheese

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17
Q

ChooseMyPlate protein portions

A 
1 oz meat, fish, poultry
0.5 cup cooked dry beans
1 egg
1 T peanutbutter
0.5 oz nuts or seeds
1 t oil
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18
Q 
DRI
AI
EAR
RDA
UL
A 
DRI= Dietary Reference Intakes 
AI= Adequate Intake (used when there is not enough scientific evidence)
EAR= Estimated Average Requirement (covers 1/2 the population)
RDA= Recommended Dietary Allowance (covers 97-98% of the population)
UL= tolerable upper limit (toxicity)
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19
Q 
Phytochemical 
HEI
DGA
DV
DRV
RDI
A 
phytochemical: components of plants that have disease preventing property
HEI: healthy eating index
DGA: Dietary Guidelines for Americans
DV: Daily Value 
DRV: Daily Reference Value
RDI: Reference Daily Intake
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20
Q

What are devout Buddhists not allowed to eat?

A
  • all meat, fish, + shellfish
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21
Q

What are devout Hindus not allowed to eat?

A
  • all meat + alcohol with restrictions on fish + shellfish
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22
Q

What are devout Jewish Orthodoxes not allowed to eat?

A
  • all meat, fish, shellfish, alcohol, leavened products, eggs + dairy
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23
Q

What are devout Muslims not allowed to eat?

A
  • all meat, alcohol, coffee + tea
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24
Q

What are devout Christians not allowed to eat?

A
  • only restrictions to meat
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25
Q

What are devout Eastern Orthodoxes not allowed to eat?

A
  • all meat, egg/ dairy + fish (shellfish is allowed)
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26
Q

What are devout Mormons not allowed to eat?

A

-alcohol + coffee/ tea

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27
Q

What are devout 7th Day Adventists not allowed to eat?

A

all meat, fish, shellfish, alcohol, coffee + tea

28
Q

What is the percentage of calories that come from fat on a Nutrition Facts Panel?

A

17%

29
Q

Motivational Interviewing

A

Facilitates change through:

  • empathy
  • developing discrepancies
  • avoid arguments
  • rolling with resistance
  • self-eficacy
30
Q

Cognitive Behavioral Therapy

A

Aims to change the thinking process through lifestyle modification

31
Q

Health Belief Model

A

Looks at the prevention of disease and its benefits

32
Q

TM

A

Trans-theoretical Model:
-pre-contemplation: aware of the problem but are not doing anything
-contemplation: thinking about changing
-preparation: preparing but not yet committed
-action
-maintenance: painting the healthy behavior
(relapse can happen at any point during progression)

33
Q

Interviewing Techniques and Questions

A
  • introduce yourself
  • maintain privacy
  • physical environment
  • eye contact (can be considered rude in some cultures)
  • time (stay with time parameters)
  • ask open ended questions
  • active-listenin/ feedback
  • avoid giving advice (want the patient to figure out their problems)
  • realistic expectations
34
Q

NHANES

A

National Health and Nutrition Exam Survey

35
Q

Factors that affect the ability to change…

A
  • socioeconomics
  • cultural competency
  • communication
  • message-framing
  • health-literacy
  • food preparation
36
Q

Randomized Control Trials

A
  • prospective; expensive
  • use of experimental placebo and the standard dose
  • compare treated and untreated groups
37
Q

What does MUST stand for?

What are the 5 steps involved?

A

Malnutrition Universal Screening Tool

  1. BMI Score
  2. Unplanned weight loss
  3. Acute disease effect score
  4. Overall risk of nutrition
  5. Management guidelines: 0 low risk ; 1 medium risk; 2> high risk
38
Q

What does MNA stand for?

What is the score range?

A

Mini Nutrition Assessment

  • 0-7 malnourished
  • 8-11 risk of malnutrition
  • 12-14 normal nutritional status
39
Q

Medical/ Health History

A 
o	Digestion/ Absorption
o	Metabolism
o	Excretion
o	Mental Health
o	Current + Past Health Status
o	Health Factors (surgery/ inabilities/ diseases)
40
Q

Medication/ Drug History

A

o Food can alter medication

o Medications can alter nutrient

41
Q

Socioeconomic Status

A

o Age // Education // Income
o Occupation // Household # // Facilities
o Access to food and transportation // Religion

42
Q

o Inspection
o Palpation
o Percussion
o Auscultation

A
  • general observation
  • touch
  • sound
  • listening to body via ear or stethoscope
43
Q

Adult HR
Adult Respiratory Rate
Adult BP

A
  • 60-100 bpm
  • ## 12-16 bpm
44
Q

Malnutrition Diagnosis Characteristic

A 
o	Weight loss
o	Inadequate energy intake
o	Loss of muscle mass
o	Loss of subcutaneous fat
o	Fluid accumulation (edema)
o	Reduced hand grip strength
45
Q

Drug
Drug-Nutrient
Food Drug Interaction
Distribution

A

o Drug: substance used in diagnosis, treatment, and prevention of disease as a component of medication
o Drug-Nutrient Interaction: changes to a drug caused by a nutrient; vice versa
o Food-Drug Interaction: effect of medication on a nutritional status
o Distribution: once the drug leaves the systematic circulation and travels around the body

46
Q

Unbound Fraction
Cytochrome P450 Enzyme System
Pharmacodynamics
Pharmacokinetics

A

o Unbound Fraction: part of the drug that produces an effect on a target organ
o Cytochrome P-450 Enzyme System: facilitates drug metabolism in the smooth ER’s phase I absorption
o Pharmacodynamics: study of biochemistry and physiological impacts of a drug
o Pharmacokinetics: study of the time it takes for a drug to travel throughout the body

47
Q

Pharmacogenetics
Excipient
pH drug interactions + absorptions

A

o Pharmacogenetics: genetic factors and reactants of how well a drug will work
o Excipient: additives in drugs
o pH drug interactions and absorption; specifically, b12: b12 combines with intrinsic factor in stomach. pH increases and the intrinsic factor decreases making absorption harder

48
Q

How drugs may impact nutritional status?

A 
o	Taste/Smell 
o	Gastrointestinal 
o	Appetite
o	Organ Toxicity
o	Metabolic Effects
49
Q

Common Excipients

A

o Alcohol (ethanol): solvent; CNS depressant; many drug interactions; possible problems for alcoholics
o Lactose: common filler; problems for lactose intolerance
o Mannitol/ Sorbitol: sugar alcoholics; improves taste; may cause diarrhea
o Starch: wheat, corn, potatoes; filler, binder, diluent; concern for celiac disease + allergy
o Vegetable Oil: soy, sesame seed, corn, cotton seed, peanut; fat diluent, fat absorption, lubricant; concern for allergies

50
Q

Anthropometric Assessment Techniques

A

o Nonambulatory
o Demi Span: in between two fingers to middle of chest
o 1/2 Arm Span: tip of finger to middle of chest
o Ulna Span: usually used in children; wrist to elbow
o Diurnal changes: shift in weight due to time of day and fluid retention

51
Q

IBW

A

weight= lbs/ 2.2 kg = kg
Height= “ x 2.54cm= cm / 100 = m
-Female: 5 ft= 100# Male: 5 ft= 106#
“ Over 5 ft= 5# “ over 5 ft= 6#

52
Q

IBW range

A

+/- 10% of IBW.. Round to 1 dp

  • Small Frame: subtract 10% from your IBW to get your starting range
  • Large Frame: add 10% to your IBW to get your starting range
53
Q

IBW %

A

actual weight / IBW x 100… Round to 1 dp

*Greater than 120% is obese!

54
Q

UBW%

A

actual weight/ UBW x 100… round to 1 dp

55
Q

BMI

A

weight in kg / (height in m) 2

56
Q

Amputations

A
  • # x (% x 100) = # + old #= new

- then calculate IBW and IBW %

57
Q

BMI Classifications

A

Underweight 40 kg/ m2

58
Q 
ADL
Dx
HTN
IBD
IBS
PN
PTA
Rx
TF
A 
ADL	        Activities of Daily Living
Dx	        Diagnosis
HTN	Hypertension
IBD	        Inflammatory Bowel Disease
IBS	        Irritable Bowel Syndrome
PN	        Parenteral Nutrition (IV tube)
PTA	        Prior to Arrival ; Prior to Admission
Rx	        Prescription 
TF	        Tube Feeding
59
Q 
WNL
AEB
C/O
Ca
GERD
NPO
PO
Pt
R/O
R/T
A 
WNL	Within Normal Limits
AEB	        As Evidenced By
C/O 	Complains Of
Ca	        Calcium ; cancer
GERD	Gastroesophageal Reflux Disease
NPO	Nothing By Mouth
PO	        By Mouth 
Pt	        Patient 
R/O	        Rule Out; not 100% sure yet
R/T	        Related To
60
Q 
Carcinoma
Colostomy
Diverticulosis
Endoscopy
Enteropathy
Esophagitis
A

Carcinoma carcin + toma
(cancerous) (tumor)

Colostomy col + stomy
(large intestine/ colon) (new opening)

Diverticulosis divert + cul + losis
(turning aside) (pouch) (disease)

Endoscopy endo + scopy
(within) (visual examination)

Enteropathy entero + pathy
(small intestine) (disease)

Esophagitis esophagi + itis
(esophagus) (inflammation)

61
Q 
Ileostomy	
Vagotomy 	
Cholangitis	
Cholecystectomy	
Cholelithiasis
Cirrhosis	
Dysguesia
A

Ileostomy ile + stomy
(ileum) (new opening)

Vagotomy vag + tomy
(vagus nerve) (process of cutting)

Cholangitis cholang + itis
(bile duct) (inflammation)

Cholecystectomy chol + cyst + ectomy
(bile/ gall) (bladder/ bag) (surgical removal)

Cholelithiasis chol + lith + iasis
(bile/gall) (stone) (abnormal condition)

Cirrhosis cirrh + sis
(orange/ yellow) (disease)

Dysguesia dys + gues+ ia
(bad)(taste)(disease/ abnormal condition)

62
Q

Corticosteroids

A

Strong anti-inflammatory drug that can be used to suppress immune system and prevent rejection for organ transplant. Can also help with low blood pressure.
FOOD: take with food or milk.
-avoid simple sugars
-avoid large quantities of CHO d/t risk for impaired glucose tolerance
-limit citrus intake
EXAMPLE: Prednisone
SUPPLEMENTS: decrease Na
-increase Ca, Vit. D +/or protein
MONITORING: increased appetite; hyperglycemia; hyperlipidemia; wt. gain over long usage.
Avoid alcohol.

63
Q

Diuretics

A

Prevents body from absorbing too much salt. Treats fluid retention (edema).
FOOD: take on an empty stomach
EXAMPLES: Foursemide (Lasix)
Hydrochlorothiazide (HCTZ)
SUPPLEMENTS: increase Ca, K, + Mg if there is a decrease (individualistic)

64
Q

Anticoagulants

A

Reduces blood clots.
FOOD: limit Vit. K consumption.
EXAMPLE: Warfarin (Coumadin)
SUPPLEMENT: do not exceed UL for Vit. A or E
-limit supplemental garlic, ginger, ginseng, saw palmetto, gingko, + horse chestnut

65
Q

H2 Receptor Antagonists + Proton Pump Inhibitors (for stomach medications)

A

Relieves pain and irritation caused by gird. FOOD: take with or without food but with 8 ozs. of water.
-caffeine may cause irritation
EXAMPLES: H2: Cimetidine (Tagamet)
Ranitidine (Zantac)
Famotidine (Pepcid)
PPI: Omeprazole (Prilosec)
SUPPLEMENTS: take 2 hours before iron or antacid supplement
-increase B12 absorption on an individualistic level
Avoid alcohol.

Nutrition Assessment (3 decks)

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