Nutritional Assessment Flashcards
nutritional screening
- purpose
- precursor to
- when is it done
- to ID individuals who may be malnourished or at risk for malnutrition
- precursor for the nutritional assessment
- is done within i24 hours of hospital admission or in ambulance
- purpose is to prompt a more detailed nutrition assessment of those who are most likely to benefit from nutrition eduction or intervention
nutritional assessment
- way to actually diagnose the nutritional problem
- comprehensive
screening tools
- malnutrition screens for elderly
- MUST (malnutrition universal screening tool), for adults, hospital and community
screening triggers
- weight change
- diet change
- chronic disease
- preexisting nutrition support
components of the nutritional assessment (ABCDE/F)
- A: anthropometry and body composition (weight, height)
- B: biochemical (blood or urine test)
- C: clinical (medical or surgical history, medications)
- Dietary: assessment, check internal (chewing, absorption) or external (religion) influences
- E/F: exercise, energy balance, functional status (handgrip dynamometry, walk test)
assessing weight
- usual weight (range)
- ideal weight (does not take frame size into account, old)
- actual weight (what weight the patient is when they come into the hospital)
assessing height
- measured by stadiometer
- surrogates include: anthropometrics (of each limb) and estimated height
what does body composition include?
- fat free mass (FFM): function of cells, tissues, organs, systems, functional status, survival
- fat mass (FM): amount/ distribution associated with morbidity and mortality (adipocytes), survival
BMI
- what
- FFM and FM
- cofounders
- measures weight for height
- correlated with FFM, FM, morbidity and mortality
- as BMI increases, FM and FFM both increase
- cofounders: insterstitial fluid, muscle mass, ascites (abdominal fluid)
ranges of BMI for
- underweight
- overweight
- obesity
- extreme obesity
- underweight: under 18.5
- overweight: 25.0-29.9
- obesity: class 1 (30-34.9), class 2 (35-39.9)
- extreme obesity: over 40
calculating BMI
weight (kg)/height (meters)
risk of obesity and waste circumference
-greater than 40 inches for men and greater than 35 inches for women indicate and increased health risk
dual c ray absortiometry
- two x ray sources of different energy passed through the body
- differential absorption by tissues
- allows quantification of bone, fat and FFM
B lab values
- measures blood and urine concentrations
- in order to ID depleted nutrient stores and physiological abnormalities
- used to assess acute illness, chronic disease, or recent dietary intakes
factors of dietary history
-includes internal and external factors
food records
- more accurate than recalls because are done in real time
- limited because you need time to prep for this
recall limitation
-limitation is that the patient needs to be able to remember what they ate
what are the 6 components of the Dietary assessment
- diet history
- food records
- recalls
- FFQ
- food supply and disappearance
- biomarkers
