Nutritional assessment *** Flashcards
Why is a complete nutritional assessment necessary?
To name the nutritional problem, and to determine its severity through subjective and objective parameters.
Which nutritional assessment tool includes information on a medical history (weight loss; dietary intake change; gastrointestinal and functional impairment) and physical examination (loss of subcutaneous fat; muscle wasting; ankle edema, sacral edema, and ascites)?
The Subjective Global Assessment (SGA).
How can a patien be classified in the Subjective Global Assessment (SGA)?
- Well nourished (SGA A).
- Moderately or suspected of being malnourished (SGA B).
- Severely malnourished (SGA C).
Which concept describes the body compartments, such as fat mass, fat-free mass, muscle mass, and bone mineral mass, depending on the body composition model used?
Body composition.
The assessment of which parameter is relevant in order to identify changes in diverse body compartments?
Body composition.
What is the relation between the nutritional status and the different ranges of BMI?
- 20-25: Normal.
- 25-30: Overweight.
- > 30: Obese.
- 18.5-20: Possible undernutrition/malnutrition.
- <18.5: Undernutrition/Malnutrition.
Mention some examples of standardized methods of measuring food intake in the dietary asessment that provide semi-quantitative information:
- 24 h food recall.
- Food frequency questionnaires.
- Food diaries from 3 to 7 days.
- Direct observation.
What percentage of hospitalized patients will have malnutrition?
20-50%
Acute, subacute or chronic state of nutrition, in which a combination of varying degrees of undernutritions with or without inflammatory activity have led to a change in body composition and diminished function:
Malnutrition
How is a nutrition risk identified?
Reduced intake or body mass.
What type of nutrition risk is present with no inflammation?
Starvation-related malnutrition: Pure chronic starvation, anorexia nervosa.
What type of nutrition risk is present with mild to moderate inflammation?
Chronic disease-related malnutrition: Organ failure, pancreatic cancer, RA, sarcopenic obesity.
What type of nutrition risk is present with marked inflammation?
Acute disease- or injury-related malnutrition: Major infection, burns, trauma, closed head injury.
What are the three etiology-based nutrition diagnoses in adults?
- Starvation-related malnutrition.
- Chronic disease-related malnutrition.
- Acute disease- or injury-related malnutrition.
When is malnutrition classifed as chronic?
When it lasts 3 months or more.
What are the criteria used in the Malnutrition Screen Tool (MST)?
- Unplanned weight loss.
- Appetite
What are the criteria used in the NRS?
- Unplanned weight loss.
- BMI
- Age
- Disease severity.
- Impaired physical condition.
What are the criteria used in the MUST?
- Unplanned weight loss.
- BMI
- Disease severity.
- Food intake.
What are the criteria used in the MNA?
- Appetite
- GI issues.
- Unplanned weight loss.
- Mobility
- BMI
- Stress
What are the clinical characteristics necessary to diagnose malnutririon according to AND/ASPEN?
- Insufficient energy intake.
- Weight loss.
- Loss of muscle mass.
- Loss of subcutaneous fat.
- Localized or generalized fluid accumulation.
- Diminished functional status (measured by hand grip strength).
*Dx needs a minimum of 2 characteristics.
**The last 4 are evaluated in the nutrition focused physical exam (NFPE).
What is the most frequently used NFPE technique?
Inspection
Observations of details (color, shape, texture, size) using the sense of sight, smell, and hearing:
Inspection
Tactile exam using fingertips to feel pulsations and vibrations and assess body structures:
Palpation
Tapping fingers against body surface to evoke sounds from underlying tissue, and assess organ border, shape and position:
Percussion
Use of ears or bell or diaphragm of the stethoscope to listen for body sounds:
Auscultation
