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Lecture 1 Flashcards

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1
Q

What is nutrition?

A

Science of food,, the nutrients and other substances therein, their action, interaction and balance in relation to health and disease and the process by which the organism ingests absorbs transports utilizes and excretes food substances

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2
Q

What is dietetics?

A

The integration, application, communication of practice principles derived from food, nutrition, social, business, and basic sciences, to achieve and maintain optimal nutrition status of individuals and groups

• Taking science and putting it into a form that applicable for clients to use and understand to maintain their health

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3
Q

What is nutrition and dietetics?

A

Reflects the integration of nutrition, which encompasses the science of food, nutrients and other substances contributing to nutrition status and health, with dietetics which is the application of food nutrition and associated sciences to optimize health and the delivery of care and services for individuals and groups.

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4
Q

What are the key aspects of clinical nutrition?

A

Practical application of diet and food
Prevention and treatment of disease
Medical intervention by health care profesisonals
Impact on mental and physiological health of clients

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5
Q

What are other names for clinical nutrition?

A

Clinical dietetics
Diet therapy
Medical nutriton therapy

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6
Q

What are RDs working in clinical practice considered?

A

Experts in clinical nutriton
-they have a responsibility to determine the kind and the level of care that is effective and appropriate yet considerate of patients needs

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7
Q

What is the role of the registered dietician nutritionist ?

A

Educated and trained professionals who ca best deliver nutrition therapy though the nutrition care process (the practice of clinical nutrition)

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8
Q

What is the NCP?

A

Nutrition care process is four steps

  1. Nutrition assessment
  2. Nutrition diagnosis
  3. Nutrition intervention
  4. Nutrition monitoring and evaluation
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9
Q

What is the scope of practice framework?

A

Defines role functions repsonibilities and activities of practitioners
-practice management and advancement
-practice standards
Practice resources

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10
Q

What is competence?

A

is insider the scope of practice

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11
Q

What are competencies based on?

A

Knowledge
Skills
Behaviours

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12
Q

What is health care?

A

Defined as the prevention, treatment and or management of illness

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13
Q

Where can you find clinical nutrition team and who do they work with?

A

Acute/ Chronic health care facilities

Inpatient and outpatient
Generalized of specialized units for patients

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14
Q

What are some of the members of a healthcare team?

A 
Physician
Nurse
Pharmacist
PT
OT
RT
SLP
SW
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15
Q

What does critical thinking involve?

A 
Organization and integrate info
Identify relationships
Make inferences
Form conclusions
Make decisions
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16
Q

What is EBP?

A

Evidence based dietetic practice: the incorporation fo systematically reviewed scientific evidence into food and nutrition practice
-integrate professional expertise and judgement with client, customer and community values and evaluates outcomes

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17
Q

What is medical problem solving?

A

The ability to identify nutrition related problems and make decisions regarding the most appropriate. nutrition related solutions

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18
Q

What are guidelines?

A

Systematically developed statement based on scientific evidence to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances

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19
Q

What are the activities involved in decision making?

A

Identify and define a problem or situation
Assess all options for solving the problem
Weigh each option against a set of criteria
Test possible options
Consider the consequences of the decision
Make a final decision

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20
Q

When you are in the CDO, what is the Peer and practice assessment?

A

Random selection of 10% of RDs annually or referral by QA committee

  • sel, colleague and client evaluation
  • possinle further in-depth review if evaluation indicates it
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21
Q

When you are in the CDO, what is the Jurisprudence knowledge and assessment tool (jKAT)?

A

Mandatory online test, need 90% or more to pass

  • assist RDs in learning about laws, standard, and guidelines affecting the dietetic profession in Ontario
  • Web based learning, professional practice scenarios
  • new members have to complete in 1 year, then after that every 5 years
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22
Q

What is a practice assessment?

A

Determination of knowledge, skill, judgement, practice performance

Meet standards vs. deficient and needs remediation

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23
Q

What is the entry level of clinical reasoning?

A

Skills are at basic level

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24
Q

What is the more experienced level of clinical reasoning?

A

Ability to examine alternatives, independently and systematically, disconnecting from authority

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25
What is the highest level if clinical reasoning?
Involves analysis of the entire situation, accountability for decisions and contour quality of care
26
How can you improve health status through nutrition care?
Nutrition interventions promote appropriate caloric balance and physical activity
27
When trying to improve the health status through nutrition care, what is the continuum of care?
Totally healthy Acute illness Chronic disease/condition Terminal Illness
28
What is nutritional status based on?
``` Human biology factors Lifestyle factors Food and nutrient factors Environmental factors System factors ```
29
What are some human biological factors that can determine the nutritional status of a person?
``` Biological (sex, age, genetics) Physiological phases (growth, pregnancy, lactation, aging) Pathological factors (disease, trauma, altered organ function, metabolism) ```
30
What are some lifestyle factors that can determine the nutritional status of a person?
Attitudes/beliefs Knowledge Behaviour
31
What are some food and nutrient factors that can determine the nutritional status of a person?
Intake/composiiton Quantity Quality
32
What are some environmental factors that can determine the nutritional status of a person?
Social (cultural food practices and beliefs, parenting, peer influences) Economic (household finances, economy of country) Food safety and sanitation (contaminated or unwholesome food, unsafe food handling) Food availability/access
33
What are some system factors that can determine the nutritional status of a person?
Health care system Educational System Food supply system
34
What is the purpose of providing nutrition care?
To restore a state of nutritional balance by influencing factors contributing to the imbalance of nutritional status Accurately determining the underlying cause of the problem will permit the selection of the most appropriate nutrition intervention
35
What is the nutrition care process?
Systematic problem solving method used to critically think and make decisions to address nutrition related problems and provide safe, effective high quality nutrition care
36
Why do we use standardized nutrition language?
Uniform terminology used to describe professional practice Provides a common language for documentation and communication
37
Why do we use the NCP to improve quality of care?
Consistent structure and framework Provides high quality care which addresses: - process of care - content of care Which all helps to aid critical thinking
38
What helps to improve the quality of care and health status of a patient?
Content of care (best evidence, scientific principles, protocols) + Process of care (nutrition care, process model) = Improved quality of care and health status
39
What is the nutrition care process model?
At the centre is the relationship between the client and the RD (individualized and patient/client entered) Outside is the environmental factors impacting client ability ro review and benefit from nutrition care and processional strengths of the dietician The furthest ring is supported by other systems - screening and referral systems - outcomes management systems
40
How can you critically think during the nutrition assessment in the NCP?
* Observe for nonverbal and verbal cues to prompt effective interviewing methods * Determine appropriate data to collect * Select assessment tools and procedures * Apply assessment tools in valid and reliable ways * Distinguish relevant from irrelevant data * Distinguish important from unimportant data * Validate the data * Organize and categorize the data in a meaningful framework that relates to nutrition problems
41
How can you critically think during the nutrition diagnosis in the NCP?
* Find patterns and relationships among the data and possible causes * Make inferences (“If this continues to occur, then this is likely to happen”) * State the problem clearly and singularly * Suspend judgment (be objective and factual) * Make interdisciplinary connections * Rule in/rule out specific diagnoses * Prioritize the relative importance of problems * Determine when a problem requires consultation with or referral to another provider
42
How can you critically think during the nutrition intervention in the NCP?
* Set and prioritize goals * Define the nutrition prescription or basic plan * Make interdisciplinary connections * Initiate behavioral and other interventions * Match intervention strategies with client needs, diagnoses, and values * Choose from among alternatives to determine a course of action * Specify the time and frequency of care
43
How can you critically think during the nutrition monitoring and evaluation in the NCP?
* Select appropriate indicators/measures * Use appropriate reference standards for comparison * Define where patient/client is now in terms of expected outcomes • Explain variance from expected outcomes * Determine factors that help or hinder progress * Decide between discharge or continuation of nutrition care
44
What are you suppose to obtain in the nutrition assessment?
* Obtain and verify appropriate data * Cluster and organize assessment data * Evaluate data using reliable standards
45
What are you suppose to obtain in the nutrition diagnosis?
• Direct link between nutrition assessment and nutrition intervention • Describes a problem for which nutrition-related activities provide the primary intervention -Not a medical diagnosis • Three domains -Intake, clinical, and behavioral–environmental • PES statement
46
What is a PES statement?
• Problem: Diagnostic label that describes in a general way an alteration in the client’s nutritional status • Etiology: Factors related to cause or existence of problem • Signs and symptoms: Defining characteristics obtained from the subjective and objective nutrition assessment data
47
How is a PES statement created?
• Evaluate nutrition assessment -Find patterns and relationships among data and causes • Identify the problems -Focus on those that can be treated by nutritional intervention • Validate and confirm the existence of problems -Use signs and symptoms • Explore the etiology -Focus on a nutrition-related cause
48
How is a PES statement evaluated?
• Problem -Can a dietetics practitioner impact it? • Etiology • Is it the root cause? • Is there an intervention that can address it? • Signs and symptoms -Are they specific enough to be measured? -Are they sensitive to the intervention? -Will measuring these indicate if the problem is resolved or improved?
49
What is the relationship of nutrition diagnosis to the other steps in NCP?
Links assessment to intervention Uses data to quantify and qualify problem S&S become the basis for setting measurable goals in part 3 of nutrition intervention Outcome measures are used to monitor an devalue progreee toward goals as part of step 4
50
When you are relating nutrition diagnosis to the other steps in NCP what are the 2 kids of data that can be used to quantify the problem?
* Subjective: something that patient tells you, symptoms that they have been having * Objective: looking at chart and getting blood sugar values
51
What are you supposed to do in the nutrition intervention?
* Prioritize the nutrition diagnoses * Write the nutrition prescription * Set goals * Select the nutrition intervention * Implement the nutrition intervention
52
What are you supposed to do in the nutrition monitoring and evaluation?
• Monitor progress - Monitor, measure, and evaluate on a planned schedule • Measure outcomes - Nutrition outcomes, clinical and health status outcomes, patient- /client-centered outcomes, and health care utilization • Evaluate outcomes - Create outcomes management system - Contribute to the body of evidence-based research
53
When documenting what should you remember to do?
* Standardized language * Should be relevant, accurate, and timely * Variety of formats are acceptable
54
What are the kinds of diets in hospital?
Regular/standard/normal/house/general diet Modified diets
55
What are the different kinds of menus in hospitals and LTC?
Cyclical menu Room service Selective and non-selective
56
What is the definition of a modified diet?
Diets in which the composition, texture, consistency and/or presentation of food has been modified/adjusted/changed to maximize the patients health, thereby preventing and/or helping in treatment of an illness, or to allow testing & diagnosis of a disease.
57
What are 3 of the modified consistency diets?
Clear liquid Blenderized liquid Dysphagia
58
What are some of the modified consistency diets?
``` Lactose controlled GF Fat saturated Fibre restricted High Fibre High energy/protein ```
59
What are some examples of diet mods?
``` Controlled-energy Pureed Restricted Na Test diet Kosher Veg Pediatric ```
60
What are some of the nutrition supports?
Oral supplementation Special routes of alimentation -enteral feeding -parenteral feeding (nutrition solution goes right into the vein)

Clinical I (17 decks)

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