Review for MNT & NCP Flashcards by Sydney Perry

use of specific nutrition services to prevent or treat illness, injury, or a condition

medical nutrition therapy

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MNT involves an in depth, comprehensive assessment and individualized care using the __________

nutrition care process

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steps in the nutrition care process

nutrition assessment
nutrition diagnosis
nutrition intervention
nutrition monitoring and evaluation

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Active and reflective reasoning that integrates facts, informed opinions, active listening, and observations

Used in all steps of the NCP

critical thinking

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A systematic method for obtaining, verifying, and interpreting data in order to identify nutrition-related problems, their causes, and significance

ongoing process that involves initial data collection and continual reassessment

nutrition assessment

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medical history, psychosocial history, nutrition and diet history, NFPE, measurements and calculations, biochemical data, food-drug interactions, estimation of nutrition needs are all part of _______

nutrition assessment

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age, sex, diagnosis, symptoms, past medical history, chronic illness, treatment plan, GI function, surgical history, functional status are all part of ___________

medical history

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economic status, education level, social support, living situation, mental status, psychiatric disorders, alcohol and drug use are all ________

psychosocial data

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activities of daily living

feed, bathe, and bathroom by themselves

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A systematic head-to-toe examination of a
patient’s physical appearance and function to
help determine nutritional status by
uncovering any signs of malnutrition, nutrient
deficiencies, or nutrient toxicities

NFPE

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HAMWI male

106 plus 6lb for every inch over 5 ft

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HAMWI women

100 plus 5 lb for every inch over 5 ft

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Adjusted IBW

[(100 - %amputation) / 100] x IBW for original height

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Paraplegia adjusted IBW

5-10% subtracted

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Tetraplegia adjusted IBW

10-15% subtracted

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% IBW

(current wt / IBW) x 100

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BMI

(wt in kg) / (height in meters squared)

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classes of BMI

<18.5 (underweight)
18.5-24.9 (normal)
25-29.9 (overweight)
30-34.9 (obese class 1)
35-39.9 (obese class 2)
≥40 (extreme obese class 3)

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percent weight change

[(UBW - current wt) / UBW] x 100

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Important underlying factor that can cause or
worsen malnutrition

inflammation

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when inflammation occurs, _______ cause anorexia, increased RMR, &
increased protein catabolism

Cytokines

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inflammation may contribute to suboptimal response to nutrition intervention and increased risk of mortality
- Affects traditional ________ of nutrition status

indicators

What is this ?

Do NOT consistently or predictably change with weight loss, calorie restriction, or negative nitrogen balance

Do not typically respond to feeding interventions in the setting of active inflammatory response

Appear to better reflect the severity of _______ response rather than poor nutritional status

Relevance as indicators of malnutrition is limited

Serum albumin & prealbumin
inflammatory

Malnutrition in the context of

1) Acute Illness or Injury
e.g., _______________

2) Chronic Illness
e.g., _____________

3) Social or Environmental Circumstances
e.g., ________________

major infection, trauma, burns
cancer, chronic organ failure
pure chronic starvation, anorexia nervosa

malnutrition diagnostic criteria

1) Insufficient energy intake 2) % Weight loss 3) Loss of subcutaneous fat 4) Loss of muscle mass 5) Localized or generalized fluid accumulation that may mask weight loss 6) Diminished functional status as measured by hand- grip strength

have to have ____ or more of the malnutrition characteristics can classify as ____ or _____

2 or more nonsecure or severe

Identification and labeling of a nutrition problem that can be improved or resolved through nutrition interventions implemented by dietetics professionals

nutrition diagnosis

nutrition diagnosis involves a __________

PES format=>Problem (P), Etiology (E), Signs & Symptoms (S)

Describes alterations in the patients nutritional status

problem (diagnostic label)

examples of problem of pes statement

inadequate oral intake overweight undesirable food choices

nutrition problems related to the intake of energy, nutrients, fluids, and bioactive substances via oral diet or nutrition support (domain)

intake (NI)

nutrition problems that relate to medical or physical conditions (domain)

Clinical (NC)

nutrition problems that are related to knowledge, attitudes/beliefs, physical environment, access to food, or food safety (domain)

Behavioral-Environmental (NB)

factors contributing to the cause or existence of a problem root cause of the problem

etiology (E)

etiology is linked by the words _______ Identifying the cause of the problem will assist in determining if there is a __________ that can improve or correct the problem Target interventions at correcting the _______ of the problem whenever possible

related to nutritional intervention etiology

Objective & subjective data gathered during the assessment step that provide evidence that a nutrition-related problem exists and the severity of the problem

signs/symptoms

signs and symptoms are linked to the ______ by _____ words

etiology as evidenced by

eNCPT Diagnostic Terms

NC-4.1.1: Starvation-related malnutrition NC-4.1.2: Chronic disease or condition- related malnutrition NC-4.1.3: Acute disease or injury-related malnutrition

__________ is used to code & classify morbidity data

The International Classification of Diseases, Clinical Modification (ICD-CM)

what is the issue with ICD-CM what's being done

Discrepancy exists between Academy/ASPEN consensus statement and ICD-10-CM codes for malnutrition ICD codes do not apply to most patients seen in developed countries Academy & ASPEN have proposed revisions for malnutrition coding

malnutrition codes

E43 Unspecified severe protein-calorie malnutrition E44.0 Moderate protein-calorie malnutrition

_______________ is the overall risk of nutrition problems and is used to prioritize patient and determine frequency of follow up care

nutrition risk classification

Each patient is assigned a level of nutrition risk based on risk factors and critical thinking. What are the levels?

No nutrition risk Mild/low nutrition risk Moderate nutrition risk Severe nutrition risk

examples of nutrition risk factors

Food & nutrient intake patterns Psychological & social factors GI problems Disease states/medical conditions Medications

Documentation of nutrition risk=> state assigned _______ and _______ Example: “Patient at moderate nutrition risk due to poor appetite for 1 week with complaints of nausea.”

risk level justification

Specific activities used to address nutrition problems Examples: therapeutic diets, education & counseling, supplements, nutrition support, referrals

nutrition intervention

Planning nutrition interventions 1. Write a _________ 2. Select nutrition _______ strategies that are focused on the etiology of the problem and are evidenced-based 3. Implement & document the plan in the _____ note 4. Determine patient-centered, specific, measurable, achievable, relevant, & time- defined (______) goals

nutrition prescription intervention ADIME SMART

Patient will consume >2 servings of vegetables daily. Patient will be able to state 3 foods high in sodium. Patient will lose 1 lb per week. Patient’s serum LDL cholesterol will be WNL in 3-6 months.

nutrition goals

Which of the following is/are appropriate nutrition goals? A. Will provide education on sources of dietary protein. B. Will provide modular protein supplement BID. C. Patient will increase protein intake. D. Patient will consume >75 grams of protein daily

Used to determine the amount of progress made by nutrition interventions and whether goals are being met Select & monitor specific ___________ that are relevant to the nutrition diagnosis and nutrition goals

monitoring and evaluations indicators/outcome measures

Assess the patient/client’s progress by comparing specific nutrition outcome measures to:

Nutrition prescription Nutrition goals Previous status Reference standards

Nutrition Outcome Measures

Biochemical data n e.g., serum glucose, serum folate Nutrition-focused physical finding outcomes n e.g., muscle wasting, glossitis, edema