Nutrition

Question 1

Purpose of Nutritional Assessment

Answer 1

1. Assess and identify those at nutritional risk
2. Provide data to develop nutrition plan
3. Identify the need and referral to registered dietician (RD)
4. Establish baseline from which to evaluate changes

Question 2

Nutritional Status

Answer 2

The degree of balance between intake and nutrition requirements

Question 3

Optimal Nutritional Status

Answer 3

Meets the day-to-day demand needs and any increase metabolic demands due to growth pregnancy

Question 4

Malnutrition

Answer 4

Undernutrition less calorie intake to meet the demand

Over-nutrition consumptions of more calorie intake and portion than we need

Question 5

Obesogenic

Answer 5

1. Dietary intake (high in fat, cholesterol, salt, sugar & low fiber)
2. Physical inactivity
3. Lifestyle factors (tobacco use, stress, excessive alcohol intake)

Question 6

Risk factors of obesity

Answer 6

1. Genetic predisposition
2. Obesogenic environment
3. Dietary intake (high in fat, cholesterol, salt, sugar & low fiber)
4. Physical inactivity
5. Lifestyle factors (tobacco use, stress, excessive alcohol intake)

Question 7

Subjective data for Nutrition

Answer 7

Eating patterns
Changes in appetite, taste, smell, chewing, swallow
Nutritional supplements
Drinks (fluid status, liquid calories)

Usual weight, recent change in weight

Health issues
Recent surgery, trauma, burns, infection food allergies
Chronic illnesses
Medications

GI tract issues
Nausea, vomiting, diarrhea, constipation

Self-care behaviors
Alcohol or illegal drug use
Exercise and activity patterns

Family history

Question 8

Anthropometric Measurements

Answer 8

Body Mass Index

Question 9

Body Mass Index (BMI)

Answer 9

Indicator of optimal weight for height
Indicator of obesity for undernutrition

BMI: weight (kg)/height(meters) squared

Question 10

Underweight BMI

Answer 10

<18.5

Question 11

Normal weight BMI

Answer 11

18.5-24.9

Question 12

Overweight BMI

Answer 12

25.5-29.9

Question 13

Obese BMI

Answer 13

> 30

Question 14

Morbidly Obese

Answer 14

> 40

Question 15

Fasting

Answer 15

8-10 hours of not eating

Question 16

Fasting Total cholesterol (HDL + LDL + trig)

Answer 16

<200 mg/dl

Question 17

Fasting High Density Lipoprotein (HDL)

Answer 17

> 60 mg/dL

Question 18

Fasting Low Density Lipoprotein (LDL)

Answer 18

<100 mg/dL

< 70 for patients with cardiovascular diseases

Question 19

Fasting Triglycerides

Answer 19

<150 mg/dL

Question 20

Fasting Fasting Blood Glucose

Answer 20

<100 mg/dL

Question 21

Metabolic Syndrome

Answer 21

Cluster of biological factors

Increase the risk of many chronic disorders (3 of the 5)

HTN: BP ≥ 120/80
Prediabetes: fasting blood glucose >100
Hyperlipidemia: Low HDL, High triglyceride, LDL & cholesterol, high risk ratio
Obesity: BMI ≥ 30
Elevated Waist Circumference: ≥ 88 cm for women and ≥ 102 cm for men

Question 22

skin signs of malnutrition

Answer 22

dry, flaking, scaly skin

petechiae (Tiny round brown-purple spots due to bleeding under the skin,)

purpura (A rash of purple spots due to small blood vessels leaking blood into the skin, joints, intestines, or organs)

ecchymoses:Blood or bleeding under the skin due to trauma of any kind

follicular hyperkeratosis (dry bumpy skin)

cracks/ lesions

Question 23

Hair signs of malnutrition

Answer 23

dull, dry, sparse, brittle hair, corkscrew hair

Question 24

Nail signs of malnutriton

Answer 24

brittle, ridged or spoon-shaped

Question 25

Mouth Malnutrition

Answer 25

Inflammation and bleeding of gums poor dentition cheilosis (cracks in lips & corners of mouth) glossitis (beefy red tongue)

Question 26

Eyes Malnutrition

Answer 26

Bitotspots (plaques on sclera/conjunctivae) xerophthalmia (dry eye) pale/red conjunctivae

Question 27

Muscoskeletal Malnutrition

Answer 27

muscle atrophy, weakness prominent protrusions over bony areas, poor posture joint pain Rickets

Question 28

Neurologic Malnutrition

Answer 28

mental status changes, cognition decline, irritability peripheral neuropathy hyporeflexia/hyperreflexia

Question 29

Calorie Count (in-patient)

Answer 29

Direct observation for 3 days Document percentage of solid foods Document mL of liquids

Question 30

Laboratory tests for malnutrition

Answer 30

1. hemoglobin and hematocrit (H&H) 2. iron panel (Iron, ferritin, transferrin, TIBC) 3. protein level (albumin, prealbumin, total protein count) 4. total lymphocyte count (TLC) 5. electrolytes (K, Mg, PO4, glucose, Na, Ca) 6. vitamins (A,B,C,D,E,K)

Question 31

Culture affects on diet

Answer 31

1.definition of food 2.number of meals per day 3.amount and types food groups in each meal forbidden foods 4.religious dietary beliefs & practices (fasting rituals) Culture must be considered when providing dietary education and recommendations Always start by asking and learning

Question 32

Nutritional needs and age: Infants, Children, Adolescence

Answer 32

rapid period of growth and development | increased nutritional requirements

Question 33

Nutritional needs and age:Pregnancy and Lactation

Answer 33

increased nutritional requirements

Question 34

Nutritional needs and age: Adulthood

Answer 34

growth and nutrient needs stabilize

Question 35

Aging adults are a high risk for nutrition imbalance due to

Answer 35

1.Cognition Changes 2.Social Factors 3.Psychological Factors 4.Economic Factors 5.Physical & Physiological Changes Medications

Question 36

Health promotion

Answer 36

Encourage long-term (gradual) weight loss Individualized plan Realistic goals Regular physical exercise 4 to 5 times a week for 30 minutes Eating a low calorie, low fat diet Caloric intake 1400 to 1500 kcal/day Low fat intake 20% to 25% of total calories Monitoring daily food intake Food diary Portion size

Question 37

DASH Diet (Dietary Approach to Stop HTN)

Answer 37

Low saturated fat, Na, cholesterol High complex carbs (fiber) peas, beans, whole grains, and vegetables

Question 38

TLC (Therapeutic Lifestyle Changes)

Answer 38

tobacco cessation reduce alcohol intake increase physical exercise