Domain 2 Flashcards
(22 cards)
What is Nutrition Screening?
Identifies individuals at risk for malnutrition. Must be quick, simple, and cost-effective.
Common tools: MUST, NRS-2002, MNA (for elderly), SGA.
What are the components of Nutrition Assessment?
Includes anthropometrics, biochemical data, clinical status, dietary intake, and functional status.
Anthropometrics: weight, height, BMI, growth charts. Biochemical data: labs such as albumin, prealbumin, CRP, glucose.
What are the indicators of malnutrition according to ASPEN/AND?
Unintentional weight loss, inadequate energy intake, muscle loss, fat loss, fluid accumulation, reduced functional status.
Reduced functional status can be assessed by grip strength.
What does low serum albumin indicate?
Inflammation, liver disease, overhydration.
High serum albumin indicates dehydration. It is not a reliable indicator of protein status.
What is the best lab marker for short-term protein status?
Prealbumin (transthyretin) is preferred due to its shorter half-life (2-3 days) and is affected by inflammation and kidney disease.
What are the components of a PES Statement?
P: Problem, E: Etiology, S: Signs & Symptoms.
Example: ‘Inadequate oral intake related to difficulty swallowing as evidenced by 10% weight loss in 3 months and patient report of early satiety.’
What is the preferred nutrition support decision when the GI tract is functional?
Enteral nutrition (EN) is preferred.
What are the types of enteral formulas?
Standard, elemental/semi-elemental, and disease-specific formulas.
Standard formulas contain intact protein; elemental/semi-elemental are for malabsorption.
What are key signs of Refeeding Syndrome?
Hypophosphatemia, hypokalemia, hypomagnesemia, fluid overload, cardiac arrhythmias.
How can Refeeding Syndrome be prevented?
Start nutrition at 10-20 kcal/kg/day, replete electrolytes before feeding, and monitor phosphorus, potassium, magnesium.
How do you calculate tube feeding rate?
Formula: (Desired kcal/day) ÷ (kcal/mL of formula) = mL/day.
Divide by 24 for mL/hour for continuous feeds.
What are the key goals for Diabetes MNT?
A1C goal: <7% (ADA), <6.5% (AACE). CHO counting: 45-60g/meal, 15g/snack. Encourage fiber, healthy fats, balanced meals.
What is the MNT for CKD by stage?
Stages 1-4: Low protein (0.6-0.8 g/kg), control phosphorus. Stage 5: Higher protein needs (1.2-1.4 g/kg), limit sodium and potassium.
What are the nutrition needs for Hepatic Cirrhosis?
High calorie, high protein (1.2-1.5 g/kg), small frequent meals, low sodium for ascites.
Monitor fat-soluble vitamins (A, D, E, K).
What foods are allowed for Celiac Disease?
Allowed: Rice, corn, quinoa, potatoes. Avoid: Wheat, barley, rye, malt, spelt.
Always check food labels for cross-contamination.
What is the MNT for IBD during flares?
Low fiber, high protein, high calorie.
During remission: Gradual fiber increase, balanced diet. Monitor B12, iron, calcium.
What should be considered with Warfarin and Vitamin K?
Keep vitamin K intake consistent.
High vitamin K foods include leafy greens, broccoli, Brussels sprouts.
What should be avoided with MAOIs?
Avoid aged cheese, cured meats, and fermented foods to prevent hypertensive crisis.
What is the recommendation for Phenytoin and tube feeds?
Hold tube feeds 1-2 hours before and after administration to prevent decreased absorption of folate, vitamin D, and calcium.
What is a potential issue with long-term use of Metformin?
It may lead to B12 deficiency; monitor levels and supplement if needed.
