Wk 7 Nutrition and fluid balance

Question 1

Nutritional assessment

Answer 1

Screening assessment: performed to determine deficiencies

Focused nutritional assessment: after deficiency have been determined

Question 2

Screening tools

Subjective Global Assessment (SGA)

Answer 2

Overall information from the medical history ad physical examination to evaluate a clients nutritional status

Question 3

Screening tools

The Mini Nutritional Assessment (MNA)

Answer 3

Developed for older adult but can used for all ages identifies nutritional risks

Question 4

Nutritional physical exam

Answer 4

General survey: V/S, height, weight, overall impression

Integumentary: skin turgor, dry skin, edema

Head/Neck: mouth, teeth, gums

Cardiovascular: V/S, heart, pulse (bounding pulse could be fluid overload, fever and hypertension)

Abdominal: enlarge may indicate ascites- fluid in abdominal cavity from liver malfunction

Musculoskeletal: swelling, kyphosis, joint pain

Neurological: ability to perform independent task

Signs of severe malnutrition: reduced activity, chronically ill, cancer HIV, COPD

Question 5

IBW

Answer 5

Ideal body weight- provides an estimate of what the person should weigh

Question 6

BMI

Answer 6

Body mass index- assess body composition

Question 7

BMI categories

Answer 7

<18.5 underweight
18.5-24.9 normal
25-29.9 overweight
30+ obesity

Question 8

Describe process of feeding patient

Answer 8

Preserve dignity
Assess for aspiration
Position correctly (90 degree)
Check for comfort
Actively involve patient if possible
Allow significant time
Protect clothing
Make it social activity
Feed in timely manner
Talk with patient
**only wear gloves if needed

Question 9

Aspiration interventions

Answer 9

Position client upright, seated at 90 degree
Observe carefully
NPO status until aspiration is excluded
Frequent oral care
Weight daily
Monitor for malnutrition
Place food in the strong side of mouth
Referral request

Question 10

Clear liquid diet

Answer 10

Water
Fruit juices
Carb. drinks, including dark sodas
Gelatin
Tea/coffee
**no milk, bits of fruit, seeds or nuts

Question 11

Full liquid diet

Answer 11

Strained creamy soups
Tea
Juice
Jello
Milkshakes
Pudding
Popsicles
Ice cream

Question 12

Renal pt juices/snacks

Answer 12

Fruit juices
Pop (NO COKE)
Popsicles
Sherbet
Graham crackers
Toast w/ margarine