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Metabolism > Nutritional Assessment > Flashcards

Nutritional Assessment Flashcards

1
Q

Name the core components of the nutritional assessment

A

A= Anthropometric values B= Biochemical markers C= Clinical signs D= Dietary intake

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2
Q

Anthropometric values

A

assessment of weight, recent wt loss/gain, linear growth velocities (in children), height, BMI, lean mass, fat mass, bone mass

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3
Q

Biochemical markers

A

markers of nutritional status: discrete nutrients in serum/tissue/urine, functional proteins, enzymes, metabolic by-products.

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4
Q

Clinical signs of nutritional compromise

A

Skin, hair, eyes, eyelids, mouth, lips, tongue, nail beds, muscle fat stores.

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5
Q

Marasmus

A

a total caloric deficit, manifests as stunted growth, severely depleted fat/muscle stores, baggy/wrinkled skin, constipation, dry/ thin/brittle hair, lethargy, pressure sores.

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6
Q

Kwashiorkor

A

a protein energy malnutrition leading to edema, dry/peeling skin, hair discoloration (red/yellow), liver enlargement/ascites, cognitive delays and mental retardation.

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7
Q

Vitamin A deficiency

A

visual loss, decreased night vision, blindness, dry eyes which may lead to xerophthalmia (dry eyes), Bitot’s spots, eye inflammation/infection, respiratory/urinary infection, compromised growth, and rough/dry skin.

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8
Q

Iron deficency

A

tired, weak, SOB, pale tongue/eyelids/nailbeds, cupping of fingernails, poor work performance

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9
Q

Vitamin D deficiency

A

signs include rickets: delayed fontanelle closures, parietal/frontal bossing, bowing of legs, enlarged wrists, rachitic rosary (knobby appearing anterior ribs), impaired mobility, pathologic fractures, immune-compromised.

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10
Q

My Plate Nutrition Guide

A
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11
Q

Mediterranean Meal Plan

A
  • Mostly plant-based foods, such as fruits, vegetables, whole grains, legumes and nuts
  • Replace butter with olive oil
  • Use herbs/spices instead of salt to flavor foods
  • Limit red meat to no more than a few times a month
  • Eat fish/poultry at least twice a week
  • Drink red wine in moderation (optional)
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12
Q

DASH Diet

A

Dietary Approaches to Stop HTN

Most successul diet in NIH studies, associated with weight loss, lower BP, improved cholesterol profile, reduced CVD, CA, and DM risk, retention of bone minerals

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13
Q

What is EAR?

A

Estimated Average Requirement; the median requirement for a group of healthy individuals

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14
Q

What is RDA?

A

Recommended Dietary Allowance; 2 standard deviations above the EAR; meets 98% of healthy individuals; used to establish dietary goals

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15
Q

What is AI?

A

Adequate Intake; meets/exceeds needs of a life stage/gender group; habitual intake at this level has low probability of inadequate intake; based on approximations of nutrient needs

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16
Q

What is UI?

A

Tolerable Upper Limit; highest average daily nutrient intake likely to pose no risk of adverse health effects for almost all in population

17
Q

What are the 3 macronutrients?

A

Carbohydrate, Fat, Protein

18
Q

What is the estimate energy requirement for a moderately active man or woman age 31-50?

A

Women: 2000 kcal/day

Men: 2400-2600 kcal/day

19
Q

What are the Acceptable Macronutrient Distribution Ranges for young children, older children/adolescents, and adults?

A
20
Q

What is the caloric content and unique constituents of FAT?

A
21
Q

What are the essential fatty acids and recommended adequate intakes?

A

N-6 fatty acids (linoleic acid)= 5-10 % kcals (all ages)

N-3 fatty acids (alpha-linolenic acid)= 0.6-1.2% kcal (all ages)

Deficiency results in scaly dermatitis, dry hair, follicular keratosis

22
Q

What is the caloric content and constituents of CARBOHYDRATE?

A
23
Q

What are the recommended weekly servings for different types of vegetables (base on a 2000 kcal diet)?

A
24
Q

What is the recommended intake for dietary fiber?

A

0.5 g fiber/kg body weight/day

11 servings of grains per day, half of which are whole grain.

25
Q

What are the recommended limits of dietary simple sugar? What are particular foods/beverages that tend to contain high amounts of simple sugar?

A

Generally recommended for sugar intake to be less than 6-10% of total energy intake, or <30-50 g per day. One 12 oz Coke contains 39 g of sugar. 1 cup of Apple Jakes has 15 g sugar.

High sugar foods to focus on eliminating are soda, energy drinks, sports drinks, fruit drinks, sweetened tea, grain-based and dairy-based desserts, ready to eat cereals, candy, honey and sugar.

26
Q

What is the caloric content and unique constituents of protein?

A
27
Q

What is the protein content for chicken/lean ground beef? Black beans? Tofu?

A

Chicken, 3 oz. = 27 g

Ground bean, 3 oz = 22 g

Black beans, 1 C = 15 g

Tofu, 3 oz = 7 g

28
Q

What are the recommendations for fluid consumption for women and men (based on an average diet)?

A

Women (2000 kcal diet): 8 x 8 oz-cups

Men (2600 kcal diet): 11 x 8 oz-cups

Note that this includes fluid in foods, not just drinking water

29
Q

What is the caloric cotent of 1 serving of beer, wine, and liquor? What are the limits for moderate and heavy/high-risk drinking?

A
30
Q

What are some general nutrition advice to give patients?

A
31
Q

What are the criteria for nutritional intervention in the hospital or a long-term care facility? What defines a signficant unintentional weight loss?

A
32
Q

How is a BMI calculated? What are the ranges for normal, overweight, and class I-III obesity?

A
33
Q

What BMI percentile for children marks overweight and obese categories?

A

Overweight = 85-94.9 %tile

Obese= >95%tile

34
Q

Define Resting Energy Expedenture (REE)

A

REE is the energy expenses in a fasting, lying down, completely relaxed, shortly after awakening, and thermo-neutral state; majority of REE is accounted for by lean body mass, 2-3% associated with breathing

Can see substantial increase if in respiratory distress/failure (25% increase), also increase with fever, decrease with sleep

35
Q

What is the RQ?

A

Respiratory Quotient: ratio of rate of CO2 production (vCO2) to rate of O2 consumption (vO2); “heat of metabolism” measured by indirect calorimetry. High VQ indicates primarily high carb meal, low RQ indicates high fat meal; also tells you about respiratory status, acid/base status, over/undereating. Can characterize hyper-metabolic stress-response to injury.

36
Q

Total Energy Expenditure; includes basal metabolic rate (50-70%), thermic effect of food (5-15%), and activity thermogenesis (20-40%)

A
37
Q

What equations are used to estimate REE for hospitalized patients? How are physical activity and stress levels accounted for?

A

Harris Benedict Equations calculate REE; increases by designated factors for physical activity, surgery, infection, trauma, and burns.

Metabolism (7 decks)

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