Nutrition Assessment & Screening Flashcards
4 steps of Nutrition care process
Assessment
Diagnosis
Intervention
Monitoring and Evaliation
ABCDH of Nutritional Assessment
Anthropometrics Biochemical labs Clinical findings Diet History
% weight change
-stresses significance of change in weight
= (UBW-ABW) / (UBW) x100
Measure of skeletal muscle mass (somatic protein
AMA= arm muscle area
- use TSF and Arm circumference
- male: 25.3 cm, female: 23.2 cm
- useful in growing children
- useful in identifying possible pro-energy malnutrition
Normal range BMI for healthy adult
18.5-24.9
HIGH Waist to hip ratio (WHR) for men and women
-indicative of android obesity
>/= to 1.0 for men and >/= to 0.8 for women –> increased risk for obesity related diseases (i.e. diabetes, HTN)
Clearly defined markers that can be observed and measured; compared against nutrition care criteria
indicators
Food frequency lists
community setting; quick way to determine intakes on large numbers of people
Amputations
- Entire leg: 16% of BW
- lower leg with foot: 6% of BW
- entire arm: 5% of BW
- forearm with hand: 2.3% of BW
Formula for Estimated IBW with amputations
(100-%amputation)/100 x IBW for original ht
Triceps skinfold thickness (TSF)
Measures body fat reserves and calorie reserves
-male: 12.5 mm, female: 16.5 mm
Waist Circumference
- independent risk factor for disease when out of proportion to total body fat
- M > 40, F > 35
Hair: thin, sparse, easily pluckable
protein deficiency
Pale dry scaly skin
iron, folic acid, zinc deficiency
Pale, dry eyes, poor vision
vitamin A, zinc, or riboflavin deficiency
Visceral protein markers
serum albumin
serum transferring
transthyretin -shorter half life
prealbumin - shorter half life
Best visceral protein marker
transthyretin (TTHY)
-norm range: 16-40 mg/dL
Albumin
- 5-5 g/dL
- high levels likely due to dehydration
- does NOT reflect current protein intake –> long half life
Serum ferritin
indicates size of iron STORAGE pool
Serum creatinine
- related to muscle mass
- measures somatic protein
- high: renal disease
- low: muscle wasting
- lean body mass; somatic protein
Blood urea nitrogen
10-20mg/dL
- related to protein intake; and best indicator for renal disease
- BUN:Creat ratio 10-15:1
- renal pts should keep BUN under 100
Total lymphocyte count
> 2700 cells/cu mm
- measures immunocompetency; ability to fight off infection
- decreased in protein-energy malnutrition
C-Reactive protein
marker of acute inflammatory stress
-indicates when nutritional therapy would be beneficial as it declines
Free Erythrocyte Protoporphyrn (FEP)
Increased during lead poisoning
-lead depletes iron leading to anemia; displaces Ca in bone leading to Zn deficiency