Nutrition, Feeding, Eating

Question 1

five main areas of complete nutrition assessment

Answer 1

• anthropometry
• BMI
• IBW
• lab tests
• dietary and health history
• clinical observation
• patients’ expectations

Question 2

anthropometry measurements

Answer 2

• height
• weight
• waist circumference
• can help to identify need for additional diagnostic tests
  
  • dual-energy x-ray absorptiometry (DEXA)
  • bioelectrical impedance analysis
  • indirect calorimetry

Question 3

nutrition screening tools

Answer 3

• objective data
  
  • height
  • weight
  • recent weight change
  • primary diagnosis
  • risk factors
• Subjective Global Assessment Tool
• The Mini Nutritional Assessment Tool
• The Malnutrition Screening Tool

Question 4

What questions do we ask during a nutritional assessment?

Answer 4

• 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

Question 5

factors that affect nutrition

Answer 5

• Environment
• developmental needs
• pregnancy
• lactation

Question 6

how to measure a pt’s height

Answer 6

• 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

Question 7

how to weigh a pt on an upright balance-beam scale

Answer 7

• ​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.

Question 8

how to weigh a pt on a chair scale

Answer 8

have pt lift feet off floor while reading

Question 9

how to weigh pt on a wheelchair scale

Answer 9

• weigh wheelchair
• weigh pt and wheelchair
• subtract wheelchair weight from pt weight

Question 10

how to weigh pt with bed scale

Answer 10

• 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

Question 11

how to weigh a pt with a sling or lift scale

Answer 11

• 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

Question 12

When does waist circumference indicate health risk, and what does it indicate?

Answer 12

• > 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

Question 13

BMI formula

Answer 13

• weight (lb) / height (in)² x 703
• weight (kg) / height (m)²

Question 14

What does a BMI > 25 indicate in adults 20 years and older?

Answer 14

• upper limit of healthy weight
• increased risk for
  
  • respiratory disease
  • tuberculosis
  • digestive disease
  • some types of cancer

Question 15

What does a BMI > 35 indicate in adults 20 years and older?

Answer 15

higher risk for CHD, some cancers, DM, and HTN

Question 16

How is BMI calculated for children 2-19 years old?

Answer 16

• categorized by age and sex using a BMI-for-age percentile
• BMI calculator and percentile chart at CDC.gov

Question 17

ideal body weight

Answer 17

refer to facility-approved chart using anthropometric measures

Question 18

nutrition lab tests

Answer 18

• albumin (chronic conditions
• prealbumin (acute conditions)
• retinol binding protein
• transferrin
• total iron-binding capacity
• hemoglobin
• nitrogen balance (24-hr urinary urea nitrogen)

Question 19

factors affecting lab tests

Answer 19

• fluid balance
• liver and kidney function or DZ
• alcoholism
• infection

Question 20

hypoalbuminemia

Answer 20

• albumin < 3.5 g/dL
• associated with longer hospital stays, complications, and morbidity

Question 21

pyrosis

Answer 21

heartburn

Question 22

odynophagia

Answer 22

painful swallowing

Question 23

pernicious anemia

Answer 23

• 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

Question 24

macrocytic

Answer 24

• abnormally large red blood cell
• mean corpuscular volume > 100 fL

Question 25

achlorhydria

Answer 25

• Absence of free hydrochloric acid in the stomach
• associated with
  
  • gastric carcinoma
  • gastric ulcer
  • pernicious anemia
  • adrenal insufficiency
  • chronic gastritis