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NUTR 468 Clinical > Nutrition Assessment: Dietary Intake Assessment > Flashcards

Nutrition Assessment: Dietary Intake Assessment Flashcards

1
Q

What are the components of the nutrition care process?

A
  1. Nutrition assessment
  2. Nutrition diagnosis
  3. Nutrition intervention
  4. Monitoring and Evaluation
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2
Q

What is required for success in the nutrition care process?

A
  • Dietetics knowledge
  • Skills and competencies
  • Critical thinking
  • Collaboration
  • Communication
  • Evidence-based practice
  • Code of Ethics
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3
Q

What precedes the nutrition assessment?

A

nutrition screening
* quickly identifies clients/ groups at risk of malnutrition (under/ over) who may require nutrition intervention
* Compares specific client characteristics to cut-off points of factors associated with nutrition risk

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4
Q

What is an important aspect of nutrition screening?

A

involves interdisciplinary collaboration
* interaction with other professionals –> OTs, PTs, social workers etc.

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5
Q

What does nutrition screening ask?

A
  1. What is the condition now?
  2. Is the condition stable?
  3. Will the condition get worse?
  4. Will the disease process accelerate nutritional deterioration?
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6
Q

Why assess nutrition status in the hospital?

A

Identify patients with malnutrition
* associated with poor outcomes, longer hospital stays etc.

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7
Q

Define malnutrition

A

Malnutrition is an acute, sub-acute or chronic state of nutrition, in which varying degrees of overnutrition or undernutrition with or without inflammatory activity have led to a change in body composition and diminished function (ASPEN 2010)

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8
Q

Diagnosis for malnutrition

A
  • starvation-related
  • chronic disease-related
  • acute disease or injury-related
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9
Q

What is malnutrition in hospital patients associated with?

A
  • complications
  • nosocomial infections
  • hospital costs
  • mortality rates
  • LOS in hospital
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10
Q

What is latrogenic malnutrition?

A

HCP induced malnutrition
* Treatment can have more of an effect on nutritional status than disease/condition itself, HCPs need to be aware of what might compromise nutrtional status (diet restrictions).

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11
Q

How does disease/condition affect nutritional requirements?

A
  • Metabolic rate –> increases so need more calories
  • Food intake –> typically condition reduces intake
  • Losses: fluids, nutrients, electrolytes
  • Malabsorption –> gut that doesnt work
  • Fever –> level of inflammation may lead to hyper-metabolic rate
  • Catabolism
  • Food/Nutrient intolerances
  • Medication effects –> can interfere with important cycles
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12
Q

How does a change in metabolic rate affect nutritional requirements?

A

primary organs affected by disease start to overwork and require more caloric intake to continue but this is usually difficult because symptoms of of disease typically lower caloric intake

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13
Q

What is the nutrition assessment process?

A
  • obtain/ collect important and relavent information
  • analyze/ interpret collected data with evidence-based standards
  • document
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14
Q

What is the purpose of the nutrition assessmnent?

A
  • Identifies individuals at risk
  • Provides justification for the nutrition care plan (the why)
  • Forms the basis for evaluating the nutrition care plan (see if condition improves)
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15
Q

describe

Identifies individuals at nutrition risk

A
  • Assessment often preceded by screening for individuals with specific risk factors
  • objective measures of nutritional status (serum albumin, weight loss)
  • subjective information provided by patient or caregivers (appetite, living environment, functional status)
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16
Q

Describe

Provides justification for the nutrition care plan

A

Basis for the formulation of goals, each with a specific action plan
* made with patient/client, family, health care team
* realistic and measureable
* ongoing monitoring required
* outcome based

17
Q

Describe

Forms the basis for evaluating nutrition care plans

A
  • Baseline measures to compare goals and outcomes to
  • need to compare changes for individuals - improvements rather than “normal” values
18
Q

What information is collected in the nutrition assessment?

A
  • patient history (medical, social, dietary)
  • biochemical data, medical tests and procedures
  • anthropometry and body composition
  • nutrition-focused physical findings
  • food/nutrition related history
  • Estimation of energy, protein and fluid requirements
19
Q

What medical history information should be collected?

A

Thorough medical history should be obtained upon admission to hospital and found in chart and verified with pt/ family
* diagnosis if known - new or old (if relevant); primary and secondary
* All diseases over lifetime (emphasis on most recent/ relevant)
* All surgical procedures undergone (emphasis on recent)
* All symptoms pt is experiening (may or may not be related to diagnosis)
* cover all systems in body

20
Q

What social history information should be collected?

A
  • living arrangements
  • cooking and shopping abilities
  • religion (food restrictions) –> RESPECT
  • socioeconomic status/ food security
21
Q

What does method of diet history collection depend on?

A
  • capabilities of pt
  • time constraints
  • information from secondary source
22
Q

What are some coomon dietary assessment methods?

A
  • 24 hour recall
  • food records (i.e. 3 day)
  • FFQ
  • direct observation
  • in hospital
23
Q

features of 24 hr recall

what? pros/cons?

A

retrospective for previous 24 hrs
* pros: quick, inexpensive, low client burden
* cons: likely not usual intake
* memory dependant

24
Q

Features of food records

what? pros/cons?

A

prospective for set time period which considers actual intake through recording (or weighing) of food intake
* pros: ↑ accuracy with ↑ time period, can be used in hospital
* cons: higher client burden, eating behaviour may change

25
Q

Features of FFQ

what? pros/cons?

A

Retrospective food intake over specific time period typically using a food list, consumption frequency, portion size
* pros: considered usual intake, can examine specific nutrients
* cons: not good in clinical → better for assessing groups

rarely used in clincal; usually for population research studies

26
Q

Features of direct observation

A

Prospective done by watching patients eat whether independantly or with assistance
* pros: low client burden
* cons: only in controlled setting, likely not usual intake

27
Q

When is direct observation typically used?

A

frequently used in hospital setting when concerned about pt’s intake

28
Q

How is dietary history typically collected in hospital?

A

combination of methods → A usual intake history of what they usually eat during the week and the weekend and approximate times

29
Q

Why is dietary history important to collect?

A

diet history needs to determine any changes to diet with disease/symptom onset
* e.g omitting food groups, decrease or increase in total intake, changes in pattern of eating

30
Q

What is a dietary assessment evaluation?

A

Determine missing food groups/ nutrients by comparing to reference values (DRIs)
* comparing to CFG to get approximate quality of intake
* Nutrient analysis through food composition tables or software and compared

31
Q

What are the DRIs?

A
  • RDA - Recommended Dietary Allowance
  • EAR - Estimated Average Requirement
  • AI - Adequate Intake
  • UL - Tolerable Upper Intake Level
32
Q

Describe the RDA

A

Recommended Dietary Allowance (RDA)
* amount that is adequate for 97-98% of healthy population

33
Q

Describe the EAR

A

Estimated Average Requirement (EAR) → Does not mean you are deficient just assesses relative risk
* estimated average requirement adequate in 50% of the population
* MAY be used to assess diets of individuals and groups
* would be used as reference values for nutrition analysis programs

34
Q

Describe the AI

A

Adequate Intake
* Used when no RDA or EAR exists due to lack of evidence
* MAY be used to assess diets of individuals and groups
* Would be used as reference values for nutrient analysis programs when no EAR exists

35
Q

Describe the UL

A

Tolerable Upper Intake Level
* Maximum nutrient intake NOT associated with side effects

NUTR 468 Clinical (34 decks)

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