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CDR Exam > II A: Assessment & screening > Flashcards

II A: Assessment & screening Flashcards

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0
Q

steps of the NCP?***

A

assess, diagnose, intervene, monitor, evaluate (ADIME)

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1
Q

what is the nutrition care process?

A

STANDARDIZED, CONSISTENT structure and framework to provide nutrition care (solely standardized care = not individualized)

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2
Q

what is nutrition screening?**

A

use of PRELIMINARY NUTRITION ASSESSMENT TECHNIQUES to identify people who are malnourished or at risk

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3
Q

who can participate in nutrition screening? how long does it take?***

A
  • all health care team members

- brief 5-10 minutes

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4
Q

specificity vs sensitivity

A

specific - can you find the patients without a condition?

sensitive - can you ID those who have a condition?

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5
Q

if no emerging nutrition problem exists after nutrition screening, what should be done?

A

document that discharge from nutrition care is appropriate

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6
Q

the Joint Commission & screening***

A

identify risk within 24 HOURS OF ADM, but DO NOT MANDATE A METHOD of screening

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7
Q

types of screening tools***

A

SGA, MNA, NSI, GNRI

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8
Q

SGA - what is it? what does it stand for?***

A

SCREENING tool - Subjective Global Assessment

hx, intake, wt change, functional capacity, physical appearance, edema, ETC., but NO LABS!!

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9
Q

MNA - what is it? what does it stand for?***

A

SCREENING tool - Mini Nutritional Assessment

ELDERLY

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10
Q

NSI - what is it? what does it stand for?***

A

SCREENING tool - Nutrition Screening Initiative

ELDERLY

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11
Q

GNRI - what is it? what does it stand for?***

A

SCREENING tool - Geriatric Nutritional Risk Index

ELDERLY (serum albumin & weight changes)

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12
Q

_____ provides the basis for the nutrition diagnosis

A

assessment

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13
Q

assessment is initiated by?

A

referral/screening for nutritional risk factors

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14
Q

types of assessment data

A

food/nutrition related hx, anthropometrics, labs/medical tests, nutrition-focused physical findings, client hx

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15
Q

the 3 components of assessment are?

A

RCI review, cluster, identify - look at the pt data, cluster everything together (food hx, anthropometrics, labs, etc.), and then identify them against a standard

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16
Q

components of nutrition assessment**

A
  • food/nutrition-related history
  • anthropometrics
  • biomedical
  • nutrition-focused physical findings
  • client history
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17
Q

what are nutrition indicators?

A

clearly defined markers that can be observed and measured

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18
Q

ways to assess dietary intake?

A

diet hx, food record, 24 hr recall, FFQ

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19
Q

diet history

A

PRESENT pattern of eating, no leading Qs

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20
Q

food record

A

exact record of everything eaten in a specific period of time

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21
Q

24 hour recall

A

mental recall of everything eaten in past 24 hours; quick tool used in clinical setting

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22
Q

food frequency lists***

A

how often an item is consumed; large group of people (quick method)

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23
Q

FFQ can be done in what kind of setting? how?**

A

COMMUNITY- done by THEMSELVES

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24
desirable body weight for women***
HAMWI - 100 lbs + 5 (for each inch past 5') [subtract 5 for each inch under 5']
25
desirable body weight for men***
HAMWI - 106 lbs + 6 (for each inch past 5') [subtract 6 for each inch under 5']
26
desirable/ideal body weight for a small frame? large frame?***
subtract (small) or add (large) 10%
27
amputations & desirable body weight***
(100- % amputation)/100 x IBW
28
amputation for entire leg***
16%
29
amputation for lower leg with foot (BKA)***
6%
30
amputation for entire arm***
5%
31
amputation for forearm with hand***
2.3%
32
% weight change formula***
(usual weight - actual weight) / usual weight x 100
33
what is the % weight change formula used to assess?***
potential NUTRITION RISK!
34
what does the triceps skinfold thickness (TSF) measure?
body fat and calorie reserves
35
arm muscle area (AMA) is important to measure in whom?***
growing children
36
arm muscle area measures what?
skeletal muscle mass (somatic protein)
37
how is AMA (arm muscle area) determined?
TSF & AC (arm circumference)
38
healthy BMI****
18.5-24.9 (BMI is AKA Quetlet's index)
39
when do BMI for age charts begin to be used?
age 2 (once you can obtain an appropriate height/stature)
40
BMI equation
weight (kg) / height (m) SQUARED OR weight (lbs) / height (in) SQUARED x 703
41
healthy BMI for most elderly
24-29
42
waist circumference - risk for disease #***
>40 M, >35 F
43
waist-hip-ratio (WHR)- risk for disease #***
>1.0 M; >0.8 W
44
type of obesity that correlates with an increased risk for co-morbidities of obesity
android- apple shaped/men (abdominal obesity)
45
if hair is thin, sparse, dull/dry/brittle, or easily pluckable, what should be considered in the nutritional focused physical exam?***
vitamin C or protein deficiency
46
eyes: pale, dry, poor vision- what could be the cause?
vitamin A, zinc, or riboflavin deficiencies
47
lips: swollen, red, dry, cracked- what could be the cause?
riboflavin, pyridoxine, niacin deficiencies
48
tongue: smooth, slick, purple, white coating- what could be the cause?
vitamin or iron deficiencies
49
gums: sore, red, swollen, bleeding- what could be the cause?
vitamin C deficiency
50
teeth: missing, loose, loss of enamel- what could be the cause?
calcium deficiency, poor intake
51
skin: pale, dry, scaly- what could be the cause?
iron, folic acid, zinc deficiency
52
nails: brittle, thin, spoon-shaped- what could be the cause?
iron or protein deficiency
53
serum albumin- appropriate lab value?***
3.5-5.0 g/dL
54
what is serum albumin?***
VISCERAL protein - blood and organs
55
hypoalbuminemia is associated with?***
edema or surgery
56
hyperalbuminemia is associated with?***
dehydration
57
half life of serum albumin?** what does this indicate?**
long half life...does NOT reflect current protein intake
58
what is transferrin?
protein that transports iron in the blood stream; serum level controlled by iron storage pool
59
what happens to the lab value tranferrin with iron deficiency?
RISES
60
transferrin can be determined from what lab value?
TIBC- total iron binding capacity, or the amount of iron capable of being bound to serum proteins
61
prealbumin is AKA**
transthyretin (TTHY)
62
half life of PAB? what does this indicate?***
SHORT- picks up changes in PRO status quickly
63
what is retinol-binding protein?
- shortest half-life, circulates with PAB | - binds & transports retinol
64
appropriate levels of Hct (hematocrit) for men and women***
M 42-52% | W 35-47%
65
Hct level for pregnant women***
33%
66
what is Hct? what is Hgb?***
- Hct= volume of packed cells in the blood | - Hgb= iron-containing pigment of RBCs
67
where are RBCs produced?
bone marrow
68
Hgb levels for men and women***
M 14-17 g/dL; W 12-15 g/dL
69
Hgb level for pregnant women***
<= 11
70
what is ferritin?
storage form of iron
71
appropriate level of serum creatinine?***
0.6-1.4 mg/dL
72
what is serum CRT related to?** what may it indicate?**
r/t MUSCLE MASS
73
what does serum CRT measure?***
SOMATIC PROTEIN
74
what may abnormal serum creatinine indicate?**
may indicate RENAL DISEASE or muscle wastage
75
what is the creatinine height index?***
ratio of creatinine excreted / 24 hours ro height
76
what does the creatinine height index (CHI) estimate?***
SOMATIC protein
77
appropriate BUN levels?***
10-20 mg/dL
78
appropriate BUN:creatinine ratio***
10-15:1
79
BUN is related to what nutrient's intake?
protein
80
BUN is an indicator of what disease?
renal
81
what does urinary creatinine clearance measure?
GFR- glomerular filtration & renal function
82
what is TLC? what does it measure?
total lymphocyte count: measures immunocompetency (immune system)
83
normal levels of TLC***
(total lymphocyte count) = >2700 cells/cu mm
84
how is lab value of TLC affected with protein-energy malnutrition?
DECREASES
85
what is CRP?***
C-reactive protein = MARKER OF INFLAMMATORY STRESS (NOT nutritional status)
86
relationship between CRP and PAB
inverse: when elevated CRP decreases (aka progressing towards a less inflamed state), PAB increased
87
what is FEP?
free erythrocyte protoporphyrin
88
what does FEP measure?***
toxic effects of lead on heme synthesis; INCREASED IN LEAD POISONING
89
relationship between lead and iron
lead depletes iron --> anemia
90
normal lab value for prothrombin time***
11.0-12.5 seconds
91
what can prolong prothrombin time?
anticoagulants
92
what is prothrombin time?
evaluates clotting adequacy
93
changes in ____ intake will alter rate of prothrombin time
vitamin K
94
hair analysis is useful for?
measuring intake of toxic metals (NOT for nutritional assessment)
95
activity factors
BEE x AF | 1.2 = sedentary, 1.3 = active, 1.5 = stressed
96
what is PAL?
physical activity levels

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