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My DOMAIN 2: Nut Care for Individuals and Groups > Topic A: Screening and Assessment > Flashcards

Topic A: Screening and Assessment Flashcards

1
Q

The Nutrition Screen process happens before

A

ADIME

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2
Q

The use of preliminary nutrition assessment technique is used to identify

A

People who are malnourished, or who at risk for malnourishment

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3
Q

Who can participate in the nutrition screening process

A

All health care members (not part of the four step)

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4
Q

During the nutrition screening you want to review

A

client history, lab results, weight, physical signs

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5
Q

From these seven screening tools which focus on older adults

  1. SGA Subjective Global Assessment
  2. MNA Mini Nutritional Assessment
  3. NSI Nutrition Screening Innitiative
  4. GNRI Geriatric Nutritional Risk Index
  5. MST Malnutrition Screening Tool
  6. NRS Nutrition Risk Screening
  7. MUST Malnutrion Risk Screening
A
  • MNA
  • NSI
  • GNRI
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6
Q

Which nutrtion assessement looks at history, intake, GI symptoms capacity, and physical appearance, edema, weight change & primary diagnosis

A

SGA

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7
Q

MNA evaluates independence, medications, number of full meals consumed each day, and ____

65 years or older

A

protein intake, fruits and vegetables, fluid, mode of feeding

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8
Q

Focus on older adults

GNRI looks at what 2 things

A

serum albumin, weight changes

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9
Q

under the age of 70

NRS includes three things:

A

% weight loss, BMI, and intake

used at medical-surgical hospitilized

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10
Q

Which screening tool looks at BMI, unintentional weight loss, effect of acute disease on intake for more than 5 days

A

MUST

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11
Q

Part A in ADIME

Dietary intake assessement, analysis includes

Nutritional status is dependent on info gathered on pt’s dietary habits

A
  1. diet history
  2. food record
  3. 24 hr recall
  4. food frequency lists
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12
Q

Diet history

A

Patterns of eating. Do not ask leading questions

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13
Q

Food Record is a food diary or

Kept by patient

A

record of everything eaten in a specific period of time

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14
Q

24 hr recall

Quick tool

A

Mental recall of everything eaten in 24 hours. Underreporting and overreporting are concerns

Clinical setting

Produces the best info when RD is involved

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15
Q

Food frequency lists

Quick way to determine intakes on large numbers of people

A

How often an item is consumed. Community setting.

Can be done without RD

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16
Q

A in ADIME

3 Assessment components

A

Review, cluster, and identify

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17
Q

If an outpatient would like to take Vit C supplements you should:

A

Ask her to keep a food diary to see where she is lacking

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18
Q

How can you increase Ca in a Hispanic woman

ex of food

A

pinto beans

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19
Q

Arm muscle area is useful in identifying

AMA

We want 80% or more

A

potential nutrition protein malnutrition

measures skeletal muscle mass (somatic protein)

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20
Q

How do calculate AMA

will be the same for somatic protien

A

use TSF and MAC (midarm circumference)

male 25.3cm; female 23.2 cm

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21
Q

Is AMA important to meausre in growing children

A

Yes

in child we use upper arm muscle area

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22
Q

A in ADIME

NFPE

A

Nutrition focused physical exam includes inspection, palpatation, and asulation

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23
Q

NFPE

Inspection includes visual assessment using ____
and hearing to observe_____

inspection= seeing

A
  • sight, sense of smell
  • textures, sizes, colors, shapes, and sounds
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24
Q

NFPE

The information from the Inspection tells you

A

obesity (fat stores), cachexia, fluid status, skin integrity, wound healing, feeding devices, jaundice, ascites

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25
Q

NFPE

Hair appears-thin, sparse, dull dry brittle
easily pluckable

what deficiency

A

vitamin C or protein deficiency

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26
Q

Eyes appear- pale, dry, poor vision

A

Consider vitamin A, zinc or riboflavin deficiencies

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27
Q

Lips appear- swollen, red, dry, cracked

A

Consider riboflavin, pyridoxine, niacin deficiencies

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28
Q

Tongue appears smooth, slick, purple, white coating

A

Consider vitamin or iron deficiencies

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29
Q

Gums appear sore, red, swollen, bleeding

A

Consider Vit C def

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30
Q

Teeth appears missing, loose, loss of enamel

A

Consider calcium deficiency, poor intake

31
Q

Skin appears pale, dry, scaly

A

Consider iron, folic acid, zinc deficiency

32
Q

Nails appear brittle, thin, spoon shaped

A

Consider iron or protien deficiency

33
Q

A in ADIME

**serum albumin **
* normal range
* function is to maintain ___
* when low what is associated with
* when above normal associated with
* can its long half-life reflect current protein intake?

Biochemical analysis, diagnostic tests

measures visceral protein (blood and organs)

A

a. 3.5-5.0 g/dl
b. colloidal osmotic pressure
c. hypoalbuminemia associated with edema, surgery
d. likely due to dehydration
e. no

high serum albumin= dehydration

34
Q

When levels of albumin are low, water in the plasma moves into the ____

A

interstitial spaces

AKA edema

35
Q

A patient can have high normal serum albumin (5.0 g/dl) when they have had

A

low calories and low fluids

36
Q

Serum creatinine is related to____, measures ___, and may indicate ____ or ____
M: 0.6-1.2 mg/dl
F: 0.5-1.1

released by muscle cells and secreted by the kidney

A
  • muscle mass
  • measures somatic protein
  • may indicate renal disease or muscle wastage

serum creatinine and creatinine clearance measure somatic protien

37
Q

What serum creatinine level indicates immediate dialysis tx.

A

anything above 5

38
Q

BUN Blood Urea Nitrogen
* range
* related to
* indicator of

Normal BUN:Cr ratio- 10-15:1

A

a. 10-20 mg/dl
b. protein intake
c. renal disease

39
Q

A low BUN:Cr ratio indicates

A

inadequate protien intake

40
Q

urinary creatinine clearance
* range
* mesures
* estimate includes

A

a. 115 (+ or -) 20ml/minute
b. GFR - glomerular filtration, renal function
c. body surface area (height and weight)

height and weight is used to determine urinary creatinine clearance

41
Q

FEP

Free erythrocyte protoporphyrin is a direct measure of toxic effects of ____
* It is increased during ___
* Indicating ___ and ____ compete at plasma membrane for transport.

A

lead on heme synthesis (leading to anemia). Increased in lead poisoning.
Lead and calcium

Lead depletes iron leading to anemia

42
Q

Medication Management

Tyramine causes HTN if taken with

Restrict aged, fermented, dired, pickled, smoked spoiled foods

A

MAOI (monoamine oxidase inhibitor)

43
Q

tyramine

How do MAOI elevate blood pressure

A

by releasing norepinephrine

44
Q

Tyramine

What should you avoid if taking MAOI

A

hard, aged cheese (cheddar, Swiss), sauerkraut, some sausages, luncheon meats, tofu, miso, Chianti wine, tomatoes

Limit sour cream, yogurt, buttermilk.

45
Q

Tyramine

What is OK to eat when taking MAOI

A

cottage cheese, cream cheese, uncured cheese (cottage, ricotta)

Good advice: buy, cook, eat fresh foods

46
Q

Medication Management

lithium carbonate causes

antidepressant

Maintain consistent sodium and caffeine to stablaize levels

A

increased appetite, weight gain

47
Q

Decreasing sodium on lithium carbonate causes

Strict 2g Na diet

A

retention of lithium to toxic levels

lithium and sodium are reabsorbed at the same site at the kidneys

If sodium or caffeine are restricted, lithium excretion decreases, leading to toxicity.

48
Q

Drug

megestrol acetate is a

A

appetite stimulant

49
Q

Vitamin B6 and protein decrease

Pyridoxine (protien)

A

L-dopa (levodopa) which controls symptoms of Parkinson’s disease

Take drug in morning with limited protein (less than 10g)

competes with drug for absorption sites

50
Q

Parkisons Disease

Protein intake recommendation when on L-dopa (levodopa)

A

Minimize protein at breakfast and lunch; add to dinner

51
Q

cyclosporine (immunosuppressant) can cause

A

hyperlipidemia, hyperglycemia, hyperkalemia, hypertension

52
Q

Drug

Loop Diuretics decreases what 5 nutrients

A

thiamin, potassium, magnesium, calcium, sodium

53
Q

Drug

Methylphenidate (Ritalin) causes

A

anorexia, weight loss, nausea

54
Q

Nutrition assessment of populations and community needs assessment

population by age, ethnic groups, sex, birth rates, deaths, socioeconomic stratification census data, housing statistics are all included in the

A

demographics

included in community assessments

55
Q

Prevalence of Food Insecurity

strategies that strengthen local food systems:

A

(1)** farmer’s markets** - increased access to fresh produce
(2) food recovery and gleaning programs - collect excess wholesome foods that would otherwise be thrown away (from farms, packing houses, caterers, cafeterias, restaurants) for delivery to hungry people
(3) PPFPs - Prepared and Perishable Food Programs

56
Q

Which nonprofit program links sources of unused, cooked and fresh foods with social service agencies that serve the hungry

A

PPFP

57
Q

NSI

Nutrition Screening Initiative includes

promotes nutrition and improve nutritional care for the elderly to identify nutritional problems early

A

a. DETERMINE checklist
b. LEVEL I screen
c. LEVEL II screen

58
Q

NSI- elder years above age 80

which form identifies factors placing people at nutritional risk
-disease, tooth loss, economic hardship, reduced social contact, multiple medications, involuntary weight loss/gain, needs assistance in self-care

Highlights warning signs of poor nutrition status

Would be filled out at congregate meal site

A

DETERMINE checklist

increases awareness of factors that influence nutritional health

59
Q

NSI

which screening tool identifies those who need more comprehensive assessments

A

LEVEL I Screen

60
Q

NSI

which screening provides more specific diagnostic info on nutritional status

RDNS most involved here

A

LEVEL II Screen

more serious nutrition problems

61
Q

Nutrition Status and Nutrition-Related Health Measurements

PedNSS- Pediatric Nutrition Surveillance System
* includes low income, high risk children, birth - 17 years, emphasis on ____
* height, weight, birth-weight, ____
* monitors growth, nutritional status, and

USDHHS ages 0-17

A

a. birth-5 years
b. hematocrit, hemoglobin, cholesterol, breast-feeding
c. infant-feeding practices

sex and age needed to determine nutrition status

62
Q

National Health and Nutrition Examination Survey

NHANES ongoing (repeated) survey to obtain info on

CDC

NHANES III for adults 65 and older

A

health of American people

63
Q

Fresh Fruit and Vegetable Program

FFVP
* introduces children to ___
* help develop eating habits that improve ____
* free to children at

USDA

Focus is to provide fresh fruits and vegetables

A

a. fresh fruits and vegetables
b. health, prevent obesity and subsequent chronic disease
b. eligible elementary schools who operate the NSLP

NSLP- Nationa School Lunch Program

64
Q

What We Eat in America

WWEIA
* includes ___with times of eating occasions and sources of foods
* who is in charge of conducting over-sampling of adults ≥60, African Americans, Hispanics?

dietary intake component of NHANES

also known as National Food and Nutrition Survey NFNS

A

(1) two days of 24 hour dietary recall
(2) USDA

all about food consumption

65
Q

Special Supplemental Nutrition Program for Women, Infants, and Children

WIC is for ____and provides provides food for low income mothers at ____

USDA

Priorities: pregnant, breastfeeding, infants up to 1 yr

A

a. for pregnant, postpartum, breast-feeding women; infants and children up to 5
b. nutritional risk (abnormal weight gain, history of high risk, LBW, underweight, overweight, anemia)

provides food, education, and referrals for other agencies

66
Q

Nutrition risks WIC looks for

Health exam is required

must meet income standards, be at nutritional risk, and in need of foods offered

A

weight, height, head circumference in infants, hemoglobin, hematocrit

expected outcome: less anemia, increased HgB and Hct in women

Will tell you about prenatal problems in the community

67
Q

Not an entitlement program

Foods offered by WIC

provides food with certain nutrients and teaches good nut. practices

No cooking classes

A

-iron-fortified formula, cereal, milk, cheese, fruit juice

EBT electronic benefits transfer card

WIC FMNP Farmers’ Market Nutrition Program: coupons to purchase fresh,
locally grown foods at farmers’ markets

68
Q

USDA

EFNER- Expanded Food and Nutrition Education Program
* provides grants to ____
* trains nutrition aides to____
* works with small groups; teaches ____

does not provide food * only education, focus is teaching

(how to budget, meal planning, shop, cook)

A

a. universities that assist in community development
b. educate the public
c. skills needed to obtain a healthy diet

69
Q

NSIP

Nutrition Services Incentive Program includes the

AoA Administration on Aging

USDHHS Title Ill

A

OAA Older Americans Act Nutrition Program

formerly ENP Elderly Nutrition Program)

*affluent = well off

70
Q

USDHHS Title Ill

OAA Older Americans Act Nutrition Program provides
* how many hot meals a day, 5 days/week, which meets ___ recommended intake?
* ____ - ambulatory; transportation essential for rural elderly
* Home delivered meals - Meals on Wheels - must be ____
* counseling, nutrition education, referrals, and ____

eligibility: all aged 60 and older plus spouse, regardless of income

A

(1) one hot meal each day and 1/3 recommended intake
(2) Congregate Meals
(3) homebound
(5) social interaction

71
Q

USDA

Which program supports public and non-profit food service programs for family day care centers, neighborhood houses, homeless shelters, nonresidential adult daycare centers
b. Which organization reimburses operators for meal costs, provides commodity foods and nutrition education materials

provides food and education at centers

meals must meet guidelines; must offer free or reduced-price to eligible

A

CACFP- Child and Adult Care Food Program
USDA

eligibility standards same as NSLP (1/3)

72
Q

USDHHS - county

Which program
a. introduces new foods, teaches good food habits
b. child’s participation in food activities is important

helps low income children; ages 3 through 5

A

Headstart

73
Q

SFMNP

Which program provides
a. cash grants from ____to states to provide low-income seniors (≥ 60 years) with coupons to be exchanged for eligible foods at farmers’ markets, roadside stands, community supported agriculture programs (CSA)
b. may be limited to specific and locally grown foods
c. nutrition education and information are provided (how to select, store, prepare)

Focus is to provide fresh fruits and vegetables

USDA

A

Senior Farmers’ Market Nutrition Program
USDA

If qualifies for SFMNP = qualifies for Meals on Wheals

fresh, nutritious, unprepared fruits, vegetables, herbs and honey

74
Q

Community resources and nutrition-related programs

Feeding America is the

Non-goverenmental Agency

A

the largest domestic hunger relief organization in the US (food banks, shelters, soup kitchens)

provides food

My DOMAIN 2: Nut Care for Individuals and Groups (5 decks)

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