Nutrition, Feeding, Eating Flashcards
(26 cards)
five main areas of complete nutrition assessment
- anthropometry
- BMI
- IBW
- lab tests
- dietary and health history
- clinical observation
- patients’ expectations
anthropometry measurements
- height
- weight
- waist circumference
- can help to identify need for additional diagnostic tests
- dual-energy x-ray absorptiometry (DEXA)
- bioelectrical impedance analysis
- indirect calorimetry
nutrition screening tools
- objective data
- height
- weight
- recent weight change
- primary diagnosis
- risk factors
- Subjective Global Assessment Tool
- The Mini Nutritional Assessment Tool
- The Malnutrition Screening Tool
What questions do we ask during a nutritional assessment?
- Dietary intake and food preferences
- Presence of unpleasant symptoms (e.g., indigestion, reflux)
- Allergies
- Difficulties with taste, chewing, swallowing
- Change in appetite or weight
- Medications
factors that affect nutrition
- Environment
- developmental needs
- pregnancy
- lactation
how to measure a pt’s height
- use movable measuring rod attached to an upright platform scale
- ask pt to
- remove shoes
- stand upright with heels together
- look forward
- lower headboard to top of head
- align line of sight with level of headboard and read
how to weigh a pt on an upright balance-beam scale
- be sure scale is calibrated
- have pt void before weighing
- have pt
- remove personal items appropriate to setting
- stand with feet centered on platform
- adjust weight on balance beam
- record weight to nearest 0.25 lb.
how to weigh a pt on a chair scale
have pt lift feet off floor while reading
how to weigh pt on a wheelchair scale
- weigh wheelchair
- weigh pt and wheelchair
- subtract wheelchair weight from pt weight
how to weigh pt with bed scale
- follow manufacturer instructions
- zero scale with all bedding, pillows, etc. on the bed before placing pt in the bed
- center pt side to side in bed
- obtain weight from screen
how to weigh a pt with a sling or lift scale
- roll the patient to one side
- place the sling under him evenly
- attach the sling to the scale
- elevate the sling
- record the pt’s weight
When does waist circumference indicate health risk, and what does it indicate?
- > 40 in for men
- > 35 in for women
- indicates
- excess body fat
- when used with BMI, could indicate increased risk for
- DM Type 2
- CV disease
BMI formula
- weight (lb) / height (in)2 x 703
- weight (kg) / height (m)2
What does a BMI > 25 indicate in adults 20 years and older?
- upper limit of healthy weight
- increased risk for
- respiratory disease
- tuberculosis
- digestive disease
- some types of cancer
What does a BMI > 35 indicate in adults 20 years and older?
higher risk for CHD, some cancers, DM, and HTN
How is BMI calculated for children 2-19 years old?
- categorized by age and sex using a BMI-for-age percentile
- BMI calculator and percentile chart at CDC.gov
ideal body weight
refer to facility-approved chart using anthropometric measures
nutrition lab tests
- albumin (chronic conditions
- prealbumin (acute conditions)
- retinol binding protein
- transferrin
- total iron-binding capacity
- hemoglobin
- nitrogen balance (24-hr urinary urea nitrogen)
factors affecting lab tests
- fluid balance
- liver and kidney function or DZ
- alcoholism
- infection
hypoalbuminemia
- albumin < 3.5 g/dL
- associated with longer hospital stays, complications, and morbidity
pyrosis
heartburn
odynophagia
painful swallowing
pernicious anemia
- chronic macrocytic anemia marked by achlorhydria
- autoimmune
- parietal cells don’t produce enough intrinsic factor, leading to insufficient vitamin B12 absorption
- symptoms
- weakness
- sore tongue
- paresthesias of extremities
- diarrhea
- nausea
- vomiting
- pain
- severe anemia: signs of cardiac failure
- treatment: monthly B12 injections; can be given intranasally or orally in pts who respond
macrocytic
- abnormally large red blood cell
- mean corpuscular volume > 100 fL
