Nutritional assessment Flashcards
What is the primary energy source of the body? What organ can ONLY use these?
Carbohydrates
brain
Basic building blocks of cells.
Proteins
Used for energy storage, maintaining blood sugar, producing hormones and vitamins.
Lipids
What are the different primary nutrients?
Carbs, proteins, lipids, vitamins and minerals, supplements, water, electrolytes
What are some health promotion topics related to food safety?
Proper cooking, refrigeration and canning practices
What are some tips on eating fruit for travellers?
If you can’t peel it, don’t eat it
What is the oral rehydration recipe?
salt and water for electrolytes for adequate hydration
What are some immunization health promotion topics for those considering travel?
Dukarol vaccine
publically funded rotavirus vaccine
Who is someone we can refer patients too if they have food insecurity?
Dietician or nutritionist
How do medications affect nutrition?
Can change the absorption of nutrients, cause nausea, diarrhea, constipation.
can also affect fluid balance.
What are some ways that lifestyle choices impact nutrition?
Choosing to eat fast food vs. vegetables
alcohol consumption, smoking
How does smoking affect appetite?
suppresses it
How do geographical areas impact nutrition?
Some areas make it more expensive or difficult to get healthy food.
How does education level impact nutrition?
People may not have the education required to understand nutrition
When is breast feeding best?
What do we need to supplement these infants with?
first 4-6 months
need to supplement with
400 international units of vitamin D per day
If mother’s choose not to breast feed their children, how much formula should they get?
150mL/kg/day
When should solids be introduced (roughly)? What should be introduced first? Last?
At around 6 months
introduce proteins first
vegetables and fruits should be introduced last
What is the only real food to avoid giving to children before they reach the age of 1?
Honey - because there can be bacteria
What type of milk should children aged - have? Why?
1-2 years
Whole milk
lots of calories to help with brain development
What macronutrient to adolescents need more of? Why?
Proteins to support rapid growth
What does the SCOFF questionaire investigate?
Adolescent’s relationship with food
What is the best way to bring up someone’s weight?
Bring up concern when discussing it, but ask them permission to discuss weight first.
All women of childbearing years should take _____ ______ supplement (___mg) to reduce incidence of neural tube defects.
These should be taken __-___ months before conception.
folic acid
0.4mg
3-6
How many extra calories do women need in their second trimester?
Third?
2nd - 350
3rd - 450
If there is a history of spina bifida, what dose is recommended?
1.5mg
What are some methods to help with nausea and vomitting in pregnancy?
eat more frequently and smaller meals
ginger
Diplectin - B vitamin and anti-histamine
What hormone causes vomitting and nausea in pregnancy?
Beta-hCG
What are food to avoid during pregnancy? Why?
Unpasteurized cheese and deli meats - Listeria
tuna - high mercury content
What is counterintuitive if tuna is contraindicated in pregnancy?
Fish is recommended 2-3 times/week
What is motherisk?
Institution from Toronto that has the most up to date evidence on different substances and how they affect pregnancy
How does dementia impact nutrition?
Can impact the feeling of being hungry or thirsty
e.g. old ladies who only have tea and bread with jam
How should cultural considerations be integrated in the discussion of nutrition?
some cultures believe in food’s healing properties, some cultures require fasting or abstaining from certain foods
What is the emphasis of Canada’s food guide?
Emphasis on encouraging variety and reducing the intakes of fats, sugars and sodium
If you feel unsure of your abilities to complete a nutritional assessment, what should you do?
Get help from other members of the inter-professional team
What are the different components of the nutrition screening assessment?
Risk assessment
focused history of common symptoms
fluid and intake patterns
Psychosocial profile
What are the components of the physical examination for nutritional data?
calculated measurements
Serial laboratory values
What are concerning weight loss percentages?
1-2% in a week
5% in a month
7.5% in 3 months
10% in 6 months
What are some risk factors for nutritional issues?
Food allergies/intolerances
Medical history
GI symptoms
Psychological symptoms
How can medications impact nutrition?
Sometimes they have to be taken with food, or can impact absorption of food
What is the CAGE questionaire for?
Alcohol consumption
What are the components of the CAGE questionaire?
C - has anyone told you to CUT down
A - are you ANNOYED about other’s criticism
G - Guilty about drinking
E - have you used an eye opener - i.e. alcohol to get over a hangover
What are some tools that practitioners can use to get a better sense of normal food intake?
Food diaries
24 hour recall
3 day food diary
Which fat region tends to be the most insulin resistant?
Extra-adipose region in the central region of the abdomen.
Why is it good to inspect to oral cavity?
Issues here will affect food intake
What is the problem with BMI?
doesn’t account for muscle mass or bone structure/genetics
Weight calculations are always done with what unit?
Kg
What waist sizes are issues for men and women? (i.e. predispose for issues)
102cm+
88cm+
What are some signs and symptoms of malnutrition?
Change in hair, skin nails issues with wound healing weight loss and body changes edema muscle wasting LOC changes
How are lymph nodes affected by malnutrition?
Become enlarged - lymphadenopathy
What are the serum proteins measured in lab?
Albumin
What is the purpose of hemoglobin and hematocrit evaluation?
assess for anemia
What is dyslipidemia?
Abnormal amount of lipids in the blood
What is the purpose of measuring blood creatinine levels?
Can indicate kidney issues
True or false: People who take anticoagulants should be taught to increase their intake of dark green leafy foods?
False - dark, leafy green foods can decrease the effects of some anti-coagulants (e.g. warfarin)
Term used to describe the balance of the input and output of fluids in the body to allow metabolic processes to function correctly
Fluid balance
What percentage of the male body is water? Female?
60%
50%
How much water is lost from the body due to insensible loss?
500mL/day
1500-2800 on slide, but probs wrong
What are insensible loses?
Perspiration, exhalation, talking, evaporation
Need a minimum of _______ per day to cover for metabolic waste, not accounting for other external factors such as temperature, exercise, altitude and humidity
1500 mL
How does fever impact water loss?
increased metabolic demand and thus water loss
How do burns increase water loss?
skin no longer impermeable
How can fistulas cause water loss?
Connection between parts of body an open and cause water loss
What are some diseases affecting water retention?
DM - increased frequency of peeing
IADH - inappropriate ADH secretion
What are the first organs affected by dehydration?
Kidneys
Dehydratoin can ultimately lead to what?
Hypovolemic shock, organ failure
How does fluid overload affect the body?
Causes dyspnea due to fluid in lungs
pitting edema
Fatigue since heart and lungs get overwhelmed
What counts for liquid intake?
Anything fluid at room temperature
anything given by IV as well
What are some examples of output for fluid?
urine, emesis, watery diarrhea, wound drainage
discharge from tube or wounds
menstruation apparently too
