Nutrition Flashcards
Purpose of Nutritional Assessment
- Assess and identify those at nutritional risk
- Provide data to develop nutrition plan
- Identify the need and referral to registered dietician (RD)
- Establish baseline from which to evaluate changes
Nutritional Status
The degree of balance between intake and nutrition requirements
Optimal Nutritional Status
Meets the day-to-day demand needs and any increase metabolic demands due to growth pregnancy
Malnutrition
Undernutrition less calorie intake to meet the demand
Over-nutrition consumptions of more calorie intake and portion than we need
Obesogenic
- Dietary intake (high in fat, cholesterol, salt, sugar & low fiber)
- Physical inactivity
- Lifestyle factors (tobacco use, stress, excessive alcohol intake)
Risk factors of obesity
- Genetic predisposition
- Obesogenic environment
- Dietary intake (high in fat, cholesterol, salt, sugar & low fiber)
- Physical inactivity
- Lifestyle factors (tobacco use, stress, excessive alcohol intake)
Subjective data for Nutrition
Eating patterns
Changes in appetite, taste, smell, chewing, swallow
Nutritional supplements
Drinks (fluid status, liquid calories)
Usual weight, recent change in weight
Health issues
Recent surgery, trauma, burns, infection food allergies
Chronic illnesses
Medications
GI tract issues
Nausea, vomiting, diarrhea, constipation
Self-care behaviors
Alcohol or illegal drug use
Exercise and activity patterns
Family history
Anthropometric Measurements
Body Mass Index
Body Mass Index (BMI)
Indicator of optimal weight for height
Indicator of obesity for undernutrition
BMI: weight (kg)/height(meters) squared
Underweight BMI
<18.5
Normal weight BMI
18.5-24.9
Overweight BMI
25.5-29.9
Obese BMI
> 30
Morbidly Obese
> 40
Fasting
8-10 hours of not eating
Fasting Total cholesterol (HDL + LDL + trig)
<200 mg/dl
Fasting High Density Lipoprotein (HDL)
> 60 mg/dL
Fasting Low Density Lipoprotein (LDL)
<100 mg/dL
< 70 for patients with cardiovascular diseases
Fasting Triglycerides
<150 mg/dL
Fasting Fasting Blood Glucose
<100 mg/dL
Metabolic Syndrome
Cluster of biological factors
Increase the risk of many chronic disorders (3 of the 5)
HTN: BP ≥ 120/80
Prediabetes: fasting blood glucose >100
Hyperlipidemia: Low HDL, High triglyceride, LDL & cholesterol, high risk ratio
Obesity: BMI ≥ 30
Elevated Waist Circumference: ≥ 88 cm for women and ≥ 102 cm for men
skin signs of malnutrition
dry, flaking, scaly skin
petechiae (Tiny round brown-purple spots due to bleeding under the skin,)
purpura (A rash of purple spots due to small blood vessels leaking blood into the skin, joints, intestines, or organs)
ecchymoses:Blood or bleeding under the skin due to trauma of any kind
follicular hyperkeratosis (dry bumpy skin)
cracks/ lesions
Hair signs of malnutrition
dull, dry, sparse, brittle hair, corkscrew hair
Nail signs of malnutriton
brittle, ridged or spoon-shaped
Mouth Malnutrition
Inflammation and bleeding of gums
poor dentition
cheilosis (cracks in lips & corners of mouth)
glossitis (beefy red tongue)
Eyes Malnutrition
Bitotspots (plaques on sclera/conjunctivae)
xerophthalmia (dry eye)
pale/red conjunctivae
Muscoskeletal Malnutrition
muscle atrophy, weakness
prominent protrusions over bony areas, poor posture
joint pain
Rickets
Neurologic Malnutrition
mental status changes, cognition decline, irritability
peripheral neuropathy
hyporeflexia/hyperreflexia
Calorie Count (in-patient)
Direct observation for 3 days
Document percentage of solid foods
Document mL of liquids
Laboratory tests for malnutrition
- hemoglobin and hematocrit (H&H)
- iron panel (Iron, ferritin, transferrin, TIBC)
- protein level (albumin, prealbumin, total protein count)
- total lymphocyte count (TLC)
- electrolytes (K, Mg, PO4, glucose, Na, Ca)
- vitamins (A,B,C,D,E,K)
Culture affects on diet
1.definition of food
2.number of meals per day
3.amount and types food groups in each meal
forbidden foods
4.religious dietary beliefs & practices (fasting rituals)
Culture must be considered when providing dietary education and recommendations
Always start by asking and learning
Nutritional needs and age: Infants, Children, Adolescence
rapid period of growth and development
increased nutritional requirements
Nutritional needs and age:Pregnancy and Lactation
increased nutritional requirements
Nutritional needs and age: Adulthood
growth and nutrient needs stabilize
Aging adults are a high risk for nutrition imbalance due to
1.Cognition Changes
2.Social Factors
3.Psychological Factors
4.Economic Factors
5.Physical & Physiological Changes
Medications
Health promotion
Encourage long-term (gradual) weight loss
Individualized plan
Realistic goals
Regular physical exercise
4 to 5 times a week for 30 minutes
Eating a low calorie, low fat diet
Caloric intake 1400 to 1500 kcal/day
Low fat intake 20% to 25% of total calories
Monitoring daily food intake
Food diary
Portion size
DASH Diet (Dietary Approach to Stop HTN)
Low saturated fat, Na, cholesterol
High complex carbs (fiber)
peas, beans, whole grains, and vegetables
TLC (Therapeutic Lifestyle Changes)
tobacco cessation
reduce alcohol intake
increase physical exercise
