Module 7 Pt.3:Nutritonal Assessment Flashcards
What is nutritional status
Degree of balance between nutritional intake and nutritional requirements.
What does nutritional status depend on
- Genetic predisposition
- Income
- education
- physical and social environment
- nutritional literacy
- Acces to protective foods
What is undernutrition
- Nutrient reserves become depleted/inadequate intake
- Impaired growth, lowered resistance
- delayed wound healing
What is over nutrition
- Excess of requirements
- Can cause: Diabetes type 2, heart disease, hypertension, stroke, gallbladder, sleep apnea and cancer
What are the developmental considerations for an infant
- birth to 4mo is rapid growth
- beast feed for first 6 months of life
- need vitamin D
What are the developmental considerations for adolescence
Rapid physical growth and hormones
What are the developmental considerations for Pregnancy
- Need calories, proteins, vitamins, minerals,
- need folic acid
What are the developmental considerations for adulthood
Growth and nutritional requirements stabilized
What are the developmental considerations for older adults
Poor physical or mental health. Isolation, alcoholism, poverty, mobility issues
-need vitamin D so don’t develop osteoporosis
Who is likely to have food insecurity
- Related to income: Aboriginal or ppl in rural communities.
- Lower socioeconomic status
- occupation, religion, gender, health awareness and socioeconomic status , immigration status
What 5 elements does canadas food guide contain
1) Produce
2) Grain product
3) Milk and alternative
4) Meat and alternative
5) Oil and fats
What is a nutritional assessment
- Method of collecting and evaluating data to make decisions about a nutrition based concern or diagnosis
- assessment data is compared to evidence-informed standards for evaluation
- provides the framework for monitoring and evaluation
What subjective questions are in a nutritional assessment
- Med history
- Symptoms
- Dietary intake
- Psychosocial, behavioural, functional factors
- Knowledge
- Readiness for potential change
What is the purpose of a nutritional assessment
- to identify the individual nutrient requirements
- provide information for designing a nutritional plan of care that will optimize nutrients and meet individual nutrition requirements
- establish a baseline data for evaluating the efficacy of nutritional care
What happens in nutritional screening (the 1st step)
- identify those at risk
- weight + weight history
- diet info
- medical history
- routine lab data
- malnutrition screening tool
Ways to gather diet history
24hr recall(most common), food frequency questionnaire, food diary, and direct observation
What are the problems with the 24hr recall method of diet history
- Might not remember
- this day may be atypical
- might alter the truth
- snacks, condiments go unreported
What is the food frequency questionaire
you ask someone about specific foods and then how many times per week month ect. that they eat them
What are the problems with a food diary way of collecting diet history
- 3 days
- non compliance
- inaccurate
- atypical days
- concious alteration of diet
What is the direct observation way of collecting diet history
-It detects more accurately
What us a dietary reference intake
4 nutrient based reference values used to assess and plan diets of healthy individuals. Designed for health maintenance, not restorative
What are the 15 subjective subheadings for a comprehensive nutritional assessment
1) Positive self management behaviours- Exercise, self monitoring of glucose and nutrition label reading
2) eating patterns
3) usual weight, or recent changes
4) Changes in appetite, taste, smell, chew or swallow
5) Chronic conditions
6) Nausea, vomit, diarrhea, constipation
7) Recent surgery, trauma, burns, infection
8) Food allergies, intolerances
9) Medications, nutritional supplements
10) Alchohol or drug use
11) Exercise and activity patterns
12) family history
13) Psychological symptoms
14) Physical impairments that limit ability to independently consume foods or liquids
Additional info to collect for infants and children
- Generally obtained through the parent or guardian
- Ask the parents to do a 24hr recall
- ask about:
- Gestational nutrition *Birthweight, Compications, maternal weight gain
- Infant and child nutrition
Additional info to collect for adolescence
1) Weight -how they feel about it
2) Use of anabolic steroids -or other agents to improve physical performance
3) Snacks
4) Age of menstuation
Additional info for pregnant women
- Any cravings
- how many times they’ve been pregnant
Additional info for older adults
How does your diet now differ from your 40s-50s diet
What are the main 4 Objective tests for nutrition
1) Anthropomorphic measures
2) Derived Weight measures
3) Body Mass index
4) Waist Hip ratio
What are anthropomorphic measures
measurements and evaluation of growth, development and body composition
*Height, weight, waist hip ratio & waist circumference, Head circumference
What are derived weight measures
Percent usual body weight & recent weight change
- %Usual body weight = current weight/ usual weight X 100
- weight change = usual weight - current weight divide by usual weight times one hundred
What is body mass index
Optimal weight for height (An indicator of obesity) -weight in kg / height in m^2 -25+ is overweight under 18.5 is under weight 39.9+ is obesity 40+ is extreme obesity
What is waist hip ratio
- reflects body fat distributions as an indicator of health risk
- bottom =gynoid obesity
- top = android obesity
How often to measure pregnant women
monthly
how much height will older generations lose
Men will lose 2.9cm, women 4.9
What are lab studies used for and what are some common ones
- Detect preclinical nutritional deficiencies to confirm of support findings
- Hemoglobin, Hematocrit, cholesterol, triglycerides, blood glucose and monitoring, total lymphocyte count, TLC, skin testing, serum proteins, nitrogen balance (indicates protein nutritional status)
What is a serial assessment
a nutritional assessment of those who are malnourished or at risk
What things to promote for a healthy diet
- variety of food groups
- assure nutrient adequecy
- recommended amts of fruit and veg, whole grains, low fat, dairy
- limit uptake of saturate, transfers, added sugars, starch, cholesterol, salt and alcohol
- match calorie intake with calories burnt
- 30-60 mins of exercise most days
- food safety guidelines
What are some chronic diseases that cause metabolic syndrome
- Abdominal obesity
- Hypertension
- Dyslipidemia ( abnormal amt. of lipids in blood)
- insulin resistance and dysglycemia
Important nutrients in fruit and veg
Carb, Fiber, VitB6, VitC, VitA, Mg, K
Important nutrients in grain products
Protein, carb, fiber, thiamin, niacin, zinc, iron
Important nutrients in milk and alternatives
Protein, fat, carb, riboflavin, B12, Vit A, Vit D, Calcium, Zinc, Magnesium, K
Important nutrients in Meat and alternative
Protein, fat, thiamin, niacin, iron, magnesium, B6, B12, K
what is an unacceptable waist circumference for men and women
102+cm for me, 88+ cm for women
Obtaining a dietary history (FASTCHECK)
Food Practices Allergies Symptoms Twenty four hour recall Chewing and swallowing Hunger Elimination process Chemical substances Knowledge
When do you need to screen someone for nutritional status
24hrs after admitted to hospital
or every 14 days in longterm care
What is digestion
absorption, and elimination
What is optimal nutritional status
Consumption of nutrients in amounts that support daily growth and any increased metabolic demands
What are the 6 different nutrients
Carbs, Protein, fat, water, vitamins, minerals
What are carbohydrates good for
recommended MAIN source of energy in diet
main source of fuel is glucose, for brain, skeletal muscles, during exercise and blood cell production
What are simple carbohydrates
Monosaccharides and disaccharide like sucrose, lactose, maltose, fructose
What are complex carbs
Polysaccharaides like starch, glycogen
What are proteins for
Essential for tissue growth, maintenance and repair
Whats an incomplete protein
lack one or more essential amino acids
what is a complete protein
Has all 9 essential amino acids (chicken, fish)
Protein is our only source of nitrogen, so what does it have full control over?
nitrogen balance
What is important about fats and lipids
most calorically dense, provides fuel, cushions organs,, lubricates body tissue, insulates and protects cell membranes
What is cholesterol
Deposits in blood vessels, can cause atherosclerosis ( plaque hardens and narrows the arteries)
What is bad about trans fatty acids
Snack food, margarine.
Increased risk for coronary artery disease and diabetes, increased LDL and decreased HDL
What does water do
makes up 60-70% of body weight.
Regulates temp, solvent for nutrients and wastes
infants have greatest percent body weight and older adults have least
What are vitamins about
Essential for normal metabolism
some are antioxidants, some are fat soluble (can be easily stored) and some are water soluble (harder to be stored)
What are minerals
inorganic elements essential to the body for chemical reactions
What are macro minerals
Calcium, sodium, potassium, phosphorus, magnesium, sulphur, chloride
What are micro minerals
Iodine, iron, fluoride, zinc, copper, selenium, mg
What is glycemic index and is high or low better
You want a low glycemic index. Which is 55 or less, medium is 56-69, and high is 70+. Carbs effect blood glucose levels the most. No more than 10% of calories a day from added sugars
When lab studies are done for different age groups
Infants: Only done if abnormality is suspected
Adolencense: Hgb,Hct, urinalysis for glucose
Pregnant: Hgb,Hct, urin for proteins and glucose
Older: must take into consideration that renal efficiency is declining and hydration status.
