Chapter 11: Nutritional Assessment Flashcards
What does nutritional status refer to?
degree of balance between nutrient intake and nutrient requirements
the balance is affected by: physiologic, psychosocial, developmental, cultural, and economic factors
etc.
What is optimal nutritional status?
Achieved when sufficient nutrients are consumed to support day-to-day body needs and any increased metabolic demands due to growth, pregnancy, or illness
Persons having optimal nutritional status are more active, have fewer physical illnesses, and live longer than persons who are malnourished
What is undernutrition?
Occurs when nutritional reserves are depleted or when nutrient intake is inadequate to meet day-to-day needs or added metabolic demands
What are the vulnerable groups who can suffer from undernutrition?
Vulnerable groups—infants, children, pregnant women, recent immigrants, persons with low incomes, hospitalized people, and aging adults—are at risk for the following:
Impaired growth and development
Lowered resistance to infection and disease
Delayed wound healing
Longer hospital stays
Higher health care costs
What is overnutrition?
Caused by consumption of nutrients, especially calories, sodium, and fat, in excess of body needs
What can overnutrition lead to?
obesity and is risk factor for the following: Heart disease and hypertension Type II diabetes Stroke Gallbladder disease Sleep apnea Certain cancers Osteoarthritis
What should we keep in mind with adulthood and nutrition?
During adulthood, growth and nutrient needs stabilize
Most adults in relatively good health
However, lifestyle factors such as cigarette smoking, stress, lack of exercise, excessive alcohol intake, and diets high in saturated fat, cholesterol, salt, and sugar and low in fiber can be factors in development of hypertension, obesity, atherosclerosis, cancer, osteoporosis, and diabetes mellitus
Adult years, therefore, are an important time for education to preserve health and to prevent or delay onset of chronic disease
What should be kept in mind with the aging adult?
As people age, a number of changes occur that make them prone to undernutrition or overnutrition
Major risk factors for malnutrition in older adults include poor physical or mental health, social isolation, alcoholism, limited functional ability, poverty, and polypharmacy
Normal physiologic changes in aging adults that directly affect nutritional status include poor dentition, decreased visual acuity, decreased saliva production, slowed gastrointestinal motility, decreased gastrointestinal absorption, and diminished olfactory and taste sensitivity
What are important nutritional features of the older years to be kept in mind?
Decrease in energy requirements due to loss of lean body mass and increase in fat mass
Socioeconomic conditions frequently have a significant effect on nutritional status
Decline of extended families and increased mobility of families reduce available support systems
Facilities for meal preparation, transportation to grocery stores, physical limitations, income, and social isolation interfere with acquisition of balanced diet
Multiple medications that have a potential for interaction with nutrients and with one another
What is to be kept in mind to maintain cultural competence with nutrition?
Foods and eating customs are culturally diverse, and each person has unique cultural heritage that may affect nutritional status
Immigrants commonly maintain traditional eating customs long after language and manner of dress of adopted country become routine
Occupation, class, religion, gender, and health awareness also have a great bearing on eating customs
Not only do food habits change to accommodate their new cultures, but also their food habits have influence on their adoptive country
What is subjective data for nutrition assessment?
Eating patterns Usual weight Changes in appetite, taste, smell, chewing, swallowing Recent surgery, trauma, burns, infection Chronic illnesses Vomiting, diarrhea, constipation Food allergies or intolerances Medications or nutritional supplements Self-care behaviors Alcohol or illegal drug use Exercise and activity patterns
What are the most common anthropomorphic measuers?
Measurement and evaluation of growth, development, and body composition
Most commonly used anthropometric measures
Height and weight, triceps skinfold thickness, elbow breadth, arm and head circumferences
Derived weight measure
Three derived weight measures are used to depict changes in body weight
Body weight as a percentage of ideal body weight
Percent usual body weight
Body mass index
Body mass index is practical marker of optimal weight for height and an indicator of obesity or protein-calorie malnutrition
What is the skinfold thickness measure?
Measurements provide an estimate of body fat stores or extent of obesity or undernutrition
Although other sites can be used (biceps, subcapsular, or suprailiac skinfolds), triceps skinfold (TSF) is most commonly selected because of its easy accessibility and because standards and techniques are most developed for this site
In preparation to measure TSF thickness
Have ambulatory person stand with arms hanging freely at the sides and back to examiner
Nonambulatory persons should lie on one side with uppermost arm fully extended and palm of hand on thigh
What can be achieved in a laboratory study?
Laboratory studies are objective and can detect preclinical nutritional deficiencies and can be used to confirm subjective findings
Use caution when interpreting test results that may be outside normal ranges, because they do not always reflect nutritional problems and because standards for aging adults have not yet been firmly established
What are the best routinely performed laboratory indicators of nutritional status?
Hemoglobin Hematocrit Cholesterol Triglycerides Total lymphocyte count Serum albumin Glucose, low- and high-density lipoproteins, prealbumin, transferrin, and total protein levels also provide meaningful information
