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RD Exam: Domain 2 > Nutrition Screening > Flashcards

Nutrition Screening Flashcards

1
Q

SGA

A

Subjective Global Assessment

a nutrition screening tool that looks at history, intake GI symptoms, appearance, weight change

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2
Q

Nutrition Screening

A

using preliminary assessments to identify those who have malnutrition or are at risk of for it

all health care team can participate

to be effective, mechanism must be accurate based on SPECIFICITY & SENSITIVITY (identifying those w/o and those w/ the condition)

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3
Q

Cultural competence

A

ability to provide care to patients with diverse values, beliefs, and behaviors and tailor delivery to meet those needs

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4
Q

MNA

A

Mini Nutritional Assessment

for 65 years or older; evaluates independence, meds, # of full meals consumed, intake

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5
Q

NSI

A

Nutrition Screening Initiative

for elderly

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6
Q

GNRI

A

Geriatric Nutritional Risk Index

  • serum albumin and weight changes
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7
Q

MST

A

Malnutrition Screening Tool

for acute hospitalized adult pop
- recent wt loss, recent poor intake

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8
Q

NRS

A

Nutrition Risk Screening

for med-surg hospitalized
- % wt loss, BMI, intake, > 70 years

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9
Q

MUST

A

Malnutrition Universal Screening Tool

  • BMI, unintentional wt loss, effect of acute disease on intake for > 5 days
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10
Q

Nutrition assessment

A

makes comparisons between data collected and reliable standards

1) REVIEW data
2) Data is CLUSTERED for comparison w/ characteristics of a diagnosis:
- food/nutrition related history
- lab/medical tests
- NFPE findings
- anthropometrics
- client history
3) indicators are compared to IDENTIFIED STANDARDS

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11
Q

Diet history

A

intake assessment

present patterns of eating (do not ask leading questions)

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12
Q

Food record

A

intake assessment

record of everything eaten in a specific period of time

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13
Q

24 hour recall

A

intake assessment

mental recall of everything eaten in previous 24 hours
used in clinical settings

**underreport/overreport are concerns

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14
Q

Food frequency lists/questionnaires

A

intake assessment

how often an item is consumed
used in community settings

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15
Q

Anthropometric measurements

A

look at body structure

1) weight
2) weight change
3) triceps skinfold thickness (TSF)
4) arm muscle area (AMA)
5) BMI
6) waist circumference
7) waist/hip ration (WHR)
8) biolectrical impedance analysis (BIS)
9) bod bod / air displacement plethysmography (ADP)

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16
Q

Hamwi

A

formula that estimates desirable body weight

M: 106 lbs + 6 lbs( x additional inch over 5’)
F: 100 lbs + 5 lbs ( x additional inch over 5’)

if:
- under 5’, subtract 5lbs (F) / 6lbs (M)
- small frame: subtract 10%
- larger frame: add 10%

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17
Q

% weight change

A

assess nutritional risk

(usual wt - actual wt) / usual wt x 100

considered significant if 10% loss in 6 months

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18
Q

Triceps skinfold thickness (TSF)

A

measures body fat and calorie reserves

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19
Q

Arm muscle area (AMA)

A

measures skeletal muscle / somatic protein

uses TSF and MAC

useful in identifying malnutrition in children

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20
Q

Body mass index (BMI)

A

compares wt to ht

(wt in lbs / in^2) x 703
wt in kg / m^2

healthy: 18.5-24.9
overweight: 25-29
obesity: >30

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21
Q

Waist circumference

A

predicts central adiposity

independent risk factor for disease when out of proportio to toal body fat

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22
Q

Waist hip ratio (WHR)

A

differentiates between android (male-type) and gynoid (female-type) obesity

M: >1
F: >0.8
indicates ANDROID & increased risk for DM, HTN

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23
Q

Bioelectrical impedence analysis (BIA)

A

evaluate fat free mass and total body water

*must be well hydrated

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24
Q

Bod pod / air displacement plethysmography (ADP)

A

measures body composition by determining body density

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25
Q

Inspection

A

NFPE step

uses sight, smell, and hearing to assess pt
ex. fluid status, skin integrity, wound healing, feeding device, jaundice, ascites

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26
Q

If hair is thin, sparse, brittle…

A

Vit C & protein deficiency

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27
Q

If hair is easily pluckable…

A

protein deficiency

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28
Q

If eyes pale, dry, poor vision

A

Vit A, Zn, or riboflavin (B2) deficiency

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29
Q

if lips swollen, red, dry, cracked

A

riboflavin (B2) , niacin (B3) deficiency

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30
Q

if gums sore, red, swollen, bleeding

A

Vit C deficiency

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31
Q

If teeth, loss of enamel, loose

A

Ca deficiency, poor intake

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32
Q

If skin, pale, dry, scaly

A

Fe, folic acid, Zn deficiency

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33
Q

If nails, brittle, thin, spoon, shaped

A

Fe or protein deficiency

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34
Q

Palpation

A

NFPE step

gather data via touch
ex. tenderness, rigidity, edema, skin integrity, body temp

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35
Q

Auscultation

A

NFPE step

listen to bowel using stethoscope

normal: gurglin, high-pitched
hypoactive: may indicate ileus or peritonitis
hyperactive: may indicate diarrhea or obstruction

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36
Q

Percussion

A

NFPE step

search for obstruction/ascites
*not done by RD

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37
Q

Serum albumin

A

maintains fluid balance

range: 3.5 - 5 g/dl

*low albumin: edema
*high albumin: dehydration

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38
Q

Serum transferrin

A

transports Fe to bone marrow

> 200 mg/dl

*if Fe low, transferring production is high
*used to assess anemia

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39
Q

Transthyretin (TTHY)
Prealbumin (PAB)

A

picks up changes in PRO status quickly

*not useful in assessment

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40
Q

Retinol binding protein (RBP)

A

binds and transports retinol

circulates with pre-albumin

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41
Q

Hematocrit (Hct)

A

volume of packed cells in whole blood

***w/ Hgb, can evaluate Fe status

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42
Q

Hemoglobin (Hgb)

A

iron-containing pigment of red blooc cells

M: 14-18 g/dl
F: 12-16 g/dl
Pregnant: > 11

*** w/ Hct, can evaluate Fe status

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43
Q

Serum ferritin

A

indicates size of Fe storage pool

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44
Q

Serum creatinine

A

related to muscle mass
measures somatic protein

M: 0.6 - 1.2 mg/dl
F: 0.5 - 1.1 mg/dl

*w/ BUN, may indicate renal disease

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45
Q

Creatinine height index (CHI)

A

estimates lean body mass - somatic protein

80% normal

46
Q

Blood urea nitrogen (BUN)

A

related to protein intake

***alongside creatinine, indicator of renal disease

47
Q

BUN:creatinine ratio

A

Normal: 10 - 15:1

48
Q

Total lymphocyte count (TLC)

A

measures immunocompetency
decreased in protein-calorie malnutrition

> 2700 cells/cu mm

49
Q

C-reactive protein (CRP)

A

marker of acute inflammatory stress

50
Q

Free erythrocyte protoporphyrin (FEP)

A

Increased in lead poisoning

51
Q

Prothrombin time (PT)

A

evaluates clotting adequacy

11.0 - 12.5 seconds

52
Q

Assess energy requirements

A

BEE x activity factor

Mifflin St. Jeor:
M: (10 x kg) + (6.25 x cm) - (5 x age) + 5
F: “ “ - 161

***activity factors:
sedentary = x 1.2
active = x 1.3
stress = x 1.5

53
Q

Megestrol acetate

A

appetite stimulant

54
Q

Marinol

A

appetite stimulant

55
Q

Adderall

A

appetite suppressant

56
Q

Orlistat

A

decreases fat absorption by binding lipase

57
Q

Ritalin

A

can lead to anorexia, wt loss, nausea

58
Q

Statins

A

decreases LDL, TG
increases HDL

*avoid grapefruit juice

59
Q

Mineral oil / cholestyramine

A

decrease absorption of fat & fat-soluble vitamins

60
Q

Oral contraceptives

A

decrease folate, Vit B6, Vit C

61
Q

Loop diuretics

A

deplete thiamin (B1), K, Mg, Na
DEPLETES Ca

*for pts w/ sig fluid overload

62
Q

Thiazide diuretics

A

decrease K and Mg
ABSORBS Ca

*first-line tx for hypertension

63
Q

Corticosteroids

A

result to hyperglycemia, think skin, hypertension, bone fx

64
Q

Methotrexate (chemotherapy agent)

A

decrease folate

65
Q

Antidepressants / lithium carbonate

A

increased appetite, weight gain
maintain consistent Na and caffeine intake

66
Q

Anticoagulant / Warfarin

A

antagonizes Vitamin K

  • avoid Ginkgo biloba, garlic, ginger since it may interfere with blood clotting
  • avoid high dose of vit A and E
67
Q

Propofol

A

administired in oil
*provides 1.1 kcals/ml

68
Q

Phenobarbital

A

decreased folic acid, Vit b12, D, K, B6

69
Q

Cyclosporine / immunosuppresant

A

lead to hyperlipidemia, hyper glycemia, hyperkalemia, hypertension

70
Q

Elavil / antidepressant

A

weight gain
increased appetite

71
Q

Tyramine

A

if taken w/ monamine oxidase inhibitor (MAOI), can result to hypertension

*avoid: hard, aged cheese, sauerkraut, feremented foods, lujncheon meats, sour cream, yogurt, miso
*okay: cottage cheese, cream cheese

72
Q

Health Risk Appraisal (HRA)

A

survey categorizing population’s GENERAL HEALTH STATUS

73
Q

Morbidity rates

A

disease rates

74
Q

Mortality rates

A

death rates

75
Q

Infant morality rate

A

Number of deaths under 1 yo per 1000 live births

76
Q

Incidence

A

number of new cases over a period of time / total at risk

77
Q

Prevalence

A

proportion of people with a disease during a period of time

78
Q

PPFPs

A

Prepared and Perishable Food Programs

links sources of unused, cooked and fresh food with social service agencies that serve the hungry

79
Q

Nutrition survey

A

CROSS-SECTIONAL examination of a population

80
Q

Nutrition surveillance

A

CONTINUOUS

identifys problem, sets baseline, sets priorities, detects changes in trends

81
Q

NSI

A

Nutrition Screening Initiative

promote nutrition and improve nutritional care for OLDER ADULTS to identify nutrition problems early

Level 1: screen identifies who needs more assessments; referrals
Level 2: screen provides more diagnostic info on nutrition status: most RDNs are involved in this

82
Q

NNMRRP

A

National Nutrition Monitoring and Related Research Program

all data collection and analysis activities of federal government related to nutritional status, food consumption, attitudes about diet and health

ran by DHHS and USDA

83
Q

PedNSS

A

Pediatric Nutrition Surveillance System

  • low-income, high risk CHILDREN
  • monitors growth and nutritional status

ran by DHHS

84
Q

PNSS

A

Pregnancy Nutrition Surveillance System

  • low-income, high risk PREGNANT women
  • identify and reduce pregnancy-related health risks

ran by DHHS

85
Q

NHANES

A

National Health and Nutrition Examination Survey

  • ongoing survey to obtain infor on health of American people
  • evaluates, clinical, chemical, anthropometric, and nutritional data

ran by CDC

86
Q

NFNS

A

National Food and Nutrition Survey

  • dietary intake component of NHANES
  • aka WWEIA - What We Eat in America
87
Q

NFCS

A

Nationwide Food Consumption Surveys

  • obtain food intake of individuals and households in US
  • evaluates 7 nutrients: PRO, Ca, Fe, thiamin, riboflavin, Vit C, Vit A

ran by USDA

88
Q

BRFSS / YRBSS

A

Behavioral Risk Factor Surveillance System
Youth Risk Behavior Surveillance System

*can monitor changes in health risk behaviors over time and can better target health promotyion efforts to populations most at risk

ran by DHHS

89
Q

FSANS

A

Food Safety and Nutrition Survey

  • assess consumer awareness, knowledge, reported behaviors related to food safety and nutrition topics`

ran by FDA

90
Q

TANF

A

Temporary Assistance for Needy Families

  • helps needy families achieve self-sufficiency; foster economic security/stability

ran by states

91
Q

CSFP

A

Commodity Supplemental Food Program

  • low-income, >60 years, (may require nutritional risk)
  • provides monthly commodity canned or packaged foods

ran by USDA, administered by states

92
Q

TEFAP

A

The Emergency Food Assistance Program

  • low-income households
  • short-term hunger relief
  • distributions of commodity foods by local, public or private nonprofit, food banks, pantries

ran by USDA

93
Q

NSLP

A

National School Lunch Program

  • entitlement program to improve nutrition of children, especially from low-income families
  • implements DGA
  • lunch must provide 1/3 of recommended intake for PRO, Vit A and C, Fe, Ca

ran by USDA FNS

94
Q

NSBP

A

National School Breakfast Program

  • entitlement program
  • breakfast must rpovide: 1/4 of recommended levels of PRO, Vit A and C, Fe, Ca

ran by USDA

95
Q

ASP

A

Afterschool Snack Program

  • provides cash subsidies for each snack served
  • same eligibility as NSLP

ran by USDA

96
Q

SMP

A

Special Milk Program

  • provides milk to children in schools who DO NOT participate in other federal meal programs

ran by USDA

97
Q

SFSP

A

Summer Food Service Program

  • low-income areas when school is out
  • entitlement program

ran by USDA
administered by FNS

98
Q

CACFP

A

Child and Adult Care Food Program

  • provides commodity foods and nutrition education for family day care centers, neighbhood food houses,
  • eligibility same as NSLP

ran by USDA

99
Q

FFVP

A

Fresh Fruit and Vegetable Program

  • introduces children to fresh fruits and vegetables
  • elementary schools who operate NSLP

ran by USDA

100
Q

WIC

A

Special Supplemental Nutrition Program for Women, Infants, and Children

  • NOT AN ENTITLEMENT PROGRAM
  • provides food (ex. Fe-fortified cereals), nutrition ed, referrals
  • for pregnant, post-partum, breastfeeding; infants and children up to 5 who meet income standards, be at nutritional risk, and in need
  • health exam required

ran by USDA

101
Q

EFNEP

A

Expanded Food and Nutrition Education Program

  • provides grants to universities to assist in community development
  • educate public on skills needed to obtain a healthy diet
  • does not provide food
102
Q

Maternal and Child Health Block Grant

A

fosters public health nutrition programs at state and local levels

ran by DHHS

103
Q

Healthy Start

A
  • in communities with high infant mortality rates

ran by DHHS

104
Q

NSIP

A

Nutrition Services Incentive Program

  • develop services to foster independent living

ran by AoA (Admin on Aging

105
Q

OAA

A

Older Americans Action Nutrition Program

  • provide 1 hot meal each day, 5 days/week, provide 1/3 recommended intake
  • also nutrition ed, counseling, referrals, socialization
  • all >60 yo + spouse, regardless of income
  • congregate meals (ambulatory), home delivered meals (must be homebound)

ran by DHHS

106
Q

SNAP

A
  • largest entitlement, food assistance program that provides monthly benefits for food to to those with low income (at or below certain poverty level)
  • adjusted to reflect Thrifty Food Plan
  • education through SNAP-Ed

ran by USDA

107
Q

HeadStart

A
  • introduces new foods, teaches good food habits; participation important
  • for low-income children (3-5 yo)

ran by DHHS

108
Q

NETP

A

Nutrition Education Training Program

  • provides nutrition education training to teachers and school food service personnel

ran by USDA

109
Q

SFMNP

A

Senior Farmers Market Nutrition Program

  • provide coupons to be exchanged for eligible foods at farmers markets, CSA’s
  • nutrition education provided
  • for low income seniors (>60 years)
110
Q

Quasi-governmental agencies

A

receive both feeral and private funds

ex. American Red Cross

111
Q

Non-governmental agencies

A

includes hunger relief organizations, voluntary health agencies like non-profits, and professional organizations

ex. Feeding America, AHA, AND

112
Q

International agencies

A

increase efficiency of production and distribution of foods globally

RD Exam: Domain 2 (4 decks)

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