Module Assessment 1 Flashcards
What is nutritional status/importance
the extent to which an individual is meeting physiological nutrition needs
Nutrition plays a part in overall health and alterations affect body functions
What are the factors affecting under nutrition (5)
poor po intake
impaired digestion/absorption
alteration in metabolic process
increased excretion of nutrients
Results of undernutrition (7)
FTT
slow development
osteoporosis
Anemia
Poor immune function
poor wound healing
poor clinical outcome with increased risk of M&M (morbidity and mortality)
Results of overnutrition (6)
obesity, diabetes, metabolic syndrome, CVD, HTN, poor clinical outcome with increased risk of M&M
What is the nutrition Care Process (4 steps)
ADIME
Assessment and re-assesnent—> diagnosis(documentation, PES..problem, etiology, and signs and symptoms )/—->intervention——> monitoring and evaluation
A
- D—>PES = Problems/Etiology/Signs and Symptoms; Documentation for MR
(Medical Record)
- I—> Interventions (eg. Provide boost twice daily)
- M/E (weight is not monitored only intake/tolerance)
How is nutrition risk determined
There’s a screening and an assessment. Everyone is screened within 24 hours of admission in variety of ways
Identifies patients who are at nutritional risk
- Anyone can do a nutritional screening
- Every patient is screened within 24 hours of admission
- Has to be many points taken into context to determine a condition - Every facility has their own screening criteria
anyone can screen only the RD can do a full assessment
Questions asked during nutrition screening
Questions likely asked? gastric bypass, more than 10% unintentional weightloss, nausea and vomiting more than 2 weeks and chewing and swallowing problems
yes to any questions then they get a consult
What is PG-SGA vs SGA
SGA is subjective global assessment while PG-SGA is the same but filled out by patients
Information obtained from screening
filters out patients who might be at nutritional risk
information obtained includes; Ht & Wt, changes in weight and appetite, diagnosis, difficulty chewing swallowing, food allergies, labs, meds, GI symptoms, diet order, nutrition support/supplements
What should be reviewed for past and medical problems?
Nutritional status can be affected by
MR(medical record)
acute or chronic illness w/ nutrition implications
Tx that induces an increase in nutr needs or malabsorption
Sx or Dz of GI tract, liver, pancreas
ETOH, drug addiction
Meds affecting appetite, absorption, digestion
What information is obtained from nutritional assessment
All points covered in Nutr screen
in depth nutritional hx
social hx
physical exam
anthropometric measurments
medical / laboratory data
and INTERPRETATION of ALL points
Step one of the NCP involves
Anthropometrics
Biochemical
Clinical
Dietary hx
estimating energy/protein needs
TOOLS IN YOUR TOOL BOX FOR ASSESMENT
What is anthropometry
assessment of measures and proportions of the human body
they should be compared to standards or against patients previous hx
1 in =cm
1 kg=lb
2.54cm
2.2lbs
How to calculate IBW
Females: 100# for first 5’
5# per inch
Males: 106# for first 5’
6# per inch
+/- 10% for frame size
When is ABW used and what is the equation
Used for obese patients (120% of IBW)
(Actual- IBW) x .25+ IBW
Body composition tools for fat vs protein
fat: skin fold (measures subcutaneous fat over time) and BMI
Somatic protein: AMA (arm muscle area) measures somatic (skeletal) muscle. MAC (MID-ARM circumference)
BMI Equation
and interpretation
Weight (lb)/height (in) X 703
<18.5 underweight
18.25-24.9 Healthy
25-29.9 Overweight
30<35 Obese class 1
35<40 Moderately obese class 2
>40 Extreme Obesity, class 3
%IBW
what is it and how to calculate/interpret?
IMPORTANT
used to determine whether a pt is obese, underweight, or WNL (within normal limits)
ABW/IDW x100
>/=200 morbidly obese
>/=150 obese
>/=120 overweight
80-90% mild
70-79% moderate
</=69 severe underweight
%UBW
what is it and how to calculate/interpret?
IMPORTANT
Compares what the pt usually weighs with what their weight is now
ABW/UBW x100
85-90%= mild
75-80%= moderate
</= 74% =severe
%Weight Change
what is it and how to calculate/interpret?
IMPORTANT
Determines whether a significant weight loss has occurred within a specific time frame
used to diagnose malnutrition (anything above 10% is red flag)
%wt= UBW-ABW/UBW x100
Significant Severe -1 WEEK 1-2% >2% -1 MONTH 5% >5% -3 MONTH 7.5% >7.5% -6 MONTH 10% >10%
What are the terms for Nutrition support
TPN (vein)
and TF
What are Acute phase proteins? Which are positive and negative?
Acute phase proteins are proteins that change in concentration in response to inflammation
Positive ACUTE PHASE- (Liver is making)
C reactive protein
Fibrinogen
Serum Amyloid A
Negative ACUTE PHASE- (Liver is not making)
Albumin
Pre-Albumin
What is NFPE? What is it for and why is it important?
Nutrition Focused Physical Exam
useful in diagnosing malnutrition
(hollow eyes and temporal shrinkage)
Hair, skin, eyes, lips, teeth
includes visual (most common), palpation, percussion(not always used), auscultation (e.g.bowel sounds)
