Week 4

Question 1

Diet history and nutritional screening

Answer 1

Question 2

Nutritional Screening: Data and Assessment

Answer 2

lipid panel Total cholesterol. LDL (“bad”) cholesterol. HDL (“good”) cholesterol

Complete blood count: hemoglobin, WBC, RBC

physical signs: Skins, bruising, jaundice, turgor

Question 3

Nutritional Assessment: Signs and Symptoms

Answer 3

Question 4

what do we assess for Swallowing Evaluation?

Answer 4

Assess for dysphagia (difficulty swallowing)
Choking potential
Risk for aspiration into the lungs (aspiration pneumonia)

Question 5

What are some causes difficulty in swallowing ?

Answer 5

 aging, degenerative and non-degenerative conditions (dementia, stroke ,intubation)

Question 6

Clinical observations for swallowing evaluation

Answer 6

 alertness, able to sit upright, difficulty managing secretions,
coughing strength, Hx of aspiration pneumonia
 obtain orders for NPO, swallow evaluation, MD needs to review
medications
 water may need to be thickened and food texture modified
(ordered by ST)

Question 7

Swallow screen for dysphagia

Answer 7

Question 8

swallow screen for dysphagia 1st and 2nd oral trial

Answer 8

Question 9

How to “Advance Diet as Tolerated”

Answer 9

Must have an MD or HCP (health care professional) order
Effects of general anesthesia (nausea, constipation, sleepy)
Bowel function assessment (appetize)

Orders:
‘Advance diet as tolerated’ (progress state to stage)
o Ice chips/Clear liquids
o Full liquids
o Regular diet

‘NPO’ Absolutely nothing
or ‘NPO except ice chips’, (no water)
‘NPO except meds’ (meds with sip of water)

Question 10

Advancing diet Clear Liquid

Answer 10

Question 11

Advancing diet full liquid

Answer 11

Question 12

Advancing diet regular

Answer 12

Question 13

Types of Therapeutic Diets

Answer 13

Therapeutic diets are modified for :
1. Nutrients (ie., chronic conditions)
2. Texture (swallowing concerns)
3. Food allergies or food intolerances
** See handout

Question 14

what does therapeutic diet mean ?

Answer 14

Question 15

common reasons therapeutic diets may be ordered

Answer 15

Question 16

what are some nutrient modifications

Answer 16

Question 17

Texture modification in therapeutic diets

Answer 17

Mechanical soft diet
Puree diet

Question 18

Food allergy
Food Allery modification in therapeutic diets

Answer 18

Question 19

Food intolerance modification

Answer 19

Question 20

Clear liquid diet

Answer 20

Question 21

Full liquid diet

Answer 21

Question 22

Mechanically altered or soft diet

Answer 22

Question 23

Pureed diet

Answer 23

Question 24

Ethnic and Cultural Preferences Hispanic

Answer 24

Traditional foods prepared with lard
* High prevalence of DM; sugary drinks
* Recommend boiling, grilling, or healthier oils
* Belief in ‘hot-cold’ to provide balance

Question 25

Ethnic and Cultural Preferences Asian

Answer 25

Foods are more plant-based
* Protein consists of beans, nuts; occasionally poultry
* Lower incidence of CVD, DM, & obesity
* Prefer hot or warm water
* May be lactose intolerance

Question 26

Ethnic and Cultural Preferences Indian

Answer 26

• Prefer home-cooked foods; wide array of spices
• Meat selection based on religious preference * Muslims may not eat pork; Buddhists may be
  vegetarian

Question 27

Pallor is sign of deficiency in what

Answer 27

Iron

Question 28

Ecchymosis/petechiae (bruising) is sign of deficiency in what

Answer 28

Vitamin C

Question 29

Bone and joint tenderness is sign of deficiency in what

Answer 29

Vitamin D and calcium

Question 30

Bleeding is sign of deficiency in what

Answer 30

Vitamin K

Question 31

Brittle & fragile nails, hair loss, poor wound healing is sign of deficiency in what

Answer 31

Protein

Question 32

Cognitive deficits, weakness, sensation

Answer 32

Vitamin B12