Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Medicine I > Nutrition Requirements and Assessment > Flashcards

Nutrition Requirements and Assessment Flashcards

1
Q

What is the nutrition screening and at which point in the hospital admission is it performed?

A

A simple & rapid first-line tool to detect px at risk of malnutrition

Within first 24-48 hrs of admission

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the nutrition care process?

A
  1. Nutrition assessment
  2. Nutrition diagnosis
  3. Nutrition intervention
  4. Nutrition monitoring and evaluation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the different processes of nutritional assessment?

A
  1. Screening for malnutrition
  2. Assessing the diet, establish presence/absence of malnutrition + causes
  3. Planning & implementing
  4. Reassessing intakes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the sources of nutrition assessment data?

A

Px interview
Direct observations and measurements
Medical record review
Referring healthcare provuder

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the important information to elicit in nutritional assessment?

A
  1. Dietary intake
  2. Anthropometric measurements
  3. Biochemical measurements of blood & urine
  4. Clinical examination
  5. Health hx elicitation
  6. Functional status evaluation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What condition is referred to deficiencies, excesses, or imbalances in a person’s intake of energy & or nutrients?

A

Malnutrition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the leading causes of malnutrition in developing countries?

A

Famine & starvation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the double burden of malnutrition?

A

Coexistence of undernutrition along w/ overweight & obesity and diet-related non-communicable diseases within individuals, households and populations throughout life.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are the diff adverse outcomes assoc w/ malnutrition?

A

Poor wound healing
Compromised immune status
Impaired organ function
INC length of hospital stay
INC mortality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the GLIm Dx Scheme for screening, assessment, Dx, & grading of malnutrition?

A
  1. Risk screening
    - At risk for malnutrition: use validated screening tools
  2. Diagnostic Assessment
    - Assessment criteria:
    -> Phenotypic: weight loss, low BMI, Reduced muscle mass
    -> Etiologic: reduced food intake/assimilation, Disease burden/inflammatory condition
  3. Diagnosis
    - Meets criteria for malnutrition diagnosis: required at least 1 PHENOTYPIC CRITERION & 1 ETIOLOGIC CRITERION
  4. Severity Grading
    - Determine the severity of malnutrition: Severity determined based on the phenotypic criterion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What is the phenotypic criteria accdg to the GLIM Diagnostic scheme?

A

Weight loss (%)
>5% within past 6 months or
>10% beyond 6 months

Low BMI (kg/m2) (Asia)
<20 if <70yrs or <18.5 if <70 yrs or
<22 if >70 yrs <20 if >70 yrs

Reduced Muscle Mass
Reduced by validated body composition measuring techniques

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the Etiologic criteria accdg to the GLIM Diagnostic scheme?

A
  1. Reduced Food Intake or Assimilation
    <50% of ER > 1 week, or any reduction for >2 wks, or any chronic GI condition that aversely inspects food assimilation or absorption
  2. Inflammation
    Acute diseases/injury
    Chronic disease-related
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is stage 2/severe malnutrition of phenotypic criteria accdg to the GLIM Diagnostic scheme?

A

Weight loss
>10% within the past 6 mons OR
>20% beyond 6 months

Low BMI
<18.5 if <70 yrs
<20 if >70 yrs

Reduced muscle mass
Severe deficit (per validated assessment methods)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How do you measure reduced muscle mass?

A
  1. Dual-energy absorptiometry = check appendicular lean mass index
  2. Body composition methods = Bioelectrical Impedance Analysis, Computed Tomography, MRI
  3. PE or std anthropometric measures = Mid-arm muscle circumference, Calf circumference
  4. Skin fold thickness & circumferences
  5. Hand-grip strength = functional assessment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What are the different nutritional disorders & nutrition-related conditions?

A

Malnutrition/Undernutrition
Sarcopenia and Frailty
Overweight and Obesity
Micronutrient abnormalities
Re-feeding syndrome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What are the different malnutrition syndromes?

A

Starvation-associated malnutrition
Chronic disease-associated malnutrition
Acute disease or injury associated malnutrition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is a comprehensive nutrition assessment that assess nutritional status based on features of the bhx and PE?

A

Subjective global assessment
- includes metabolic stress of the disease component

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are the diff body composition considered in subjective global assessment?

A

Muscle mass
Subcutaneous fat
ECF volume
Functional status & strength & mobility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the overall SGA?

A

SGA A = well-nourished
SGA B = moderately malnourished
SGA C = severely malnourished

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What should be asked about the body weight in nutritional assessment hx & PE?

A

Usual weight, peak weight, & deliberate weight loss

Identify significant weight loss
- 4.5kg (10lb) weight loss over 6 months
- weight loss of >10% of usual body weight
- prognostic of clinical outcomes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the formula for % weight change?

A

% weight change = [(previous weight - current weight)/(previous weight)] x 100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What should be taken note for weight loss?

A

Non-volitional weight loss
10% wt loss over 6 mons
30% wt loss over 6 mons = severe, life-threatening

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What are the diff diseases w/ severe acute inflammatory response?

A

Critical illness, major infection/sepsis, ARDS, severe burns, systemic inflammatory response syndrome, major abdominal surgery, multi trauma, closed head injury

24
Q

What diseases have mild to moderate chronic inflammatory response?

A

CVS, CHF, CF, Neuromuscular dis, solid tumors, DM, etc

25
Q

What are the diff indications or approach to BMI?

A

<18.5 = screen for malnutrition
<15 = INC mortality
>25 = INC body fat
<20 - DEC MM & Body fat
11-13 = incompatible w/ life
17 = Protein energy malnutrition

26
Q

What is the normal BMI from WHO & Asia-Pacific?

A

WHO: 18.5-24.9
Asia-Pacific: 18.5-22.9

27
Q

How do you measure height of a frail olde rperson?

A

Measuring knee height using a caliper device

28
Q

What is the formula for estimating height from knee height?

A

Female:
Ht in cm = 84.88 - (0.24 x age) + (1.83 x knee ht)

Male:
Ht in cm = 64.19 - (0.04 x age) + (2.02 x knee ht)

29
Q

What are 2 other methods to estimate a px’s height?

A

Ulna length
- measure betw the point of the elbow (olecranon process) and the midpoint of the prominent bone of the write (styloid process) -> L side

Demispan (DABEST)
- measure distance from the middle of the sternal notch to the tip of the middle finger (L arm)

30
Q

What is the formula for estimating ht from demispan?

A

Female
Ht in cm = (1.35 x demispan (cm)) + 60.1

Male
Ht in cm = (1.40 demispan (cm)) + 57.8

31
Q

What are the 8 PE seen to assess nutritional disorders?

A

Temporal muscle wasting
Subcutaneous fat loss
Muscle wasting @ clavicular area
Mid-upper arm circumference
Skinfold thickness
Mid-arm muscle circumference
Waist & hip circumference
Calf circumference

32
Q

How do you measure the mid-upper arm circumference?

A
  1. bend the L arm
  2. Find the mark with a pen the acromion process & olecranon process
  3. mark the midpoint betw these 2 marks
  4. with the arm hanging straight down, wrap a tape measure around the midpoint
  5. measure the nearest 1cm
33
Q

What are the major determinants of mid-upper circumference?

A

Muscle & subcutaneous fat

34
Q

What are the 4 sites used to measure skinfold thickness?

A
  1. Biceps skinfold - front side of the middle upper arm
  2. Suprailiac skinfold - above the upper bone of the hip
  3. Subscapular skinfold - under the lowest point of the shoulder blade
  4. Triceps skinfold - back-side of the middle upper arm
35
Q

How many times should skinfold thickness be measure?

A

3 times

36
Q

What is the formula of the mid-arm muscle circumference?

A

MAMC (cm) = MUAC (cm) - [3.14 x TSF (cm)]

37
Q

What are the std adult values of mid-arm muscle circumference?

A

Triceps skinfold in mm
Male: 12.5
Female: 16.5

MUAC (cm)
M: 29.3
F: 28.5

MAMC (cm)
M: 25.3
F: 23.2

38
Q

What is used to measure risk for meatbolic complications? What is the measurement site?

A

Waist & Hip circumference

Site: circumference around the hips and butt
- highest pt of iliac crest

39
Q

What are the WHO cut-off points & risk of metabolic complications?

A

Waist circumference
M: >94cm
F: >80cm
Increased risk of metabolic complications

Waist circumference
M: >102 cm
F >88 cm
Substantial INC of metabolic complications

Waist-hip ratio
M: >0.90cm
F: 0.85cm
Substantial increased risk of metab complications

40
Q

What are the cut-off points of WHC of Europoids, South Asians, Chinese & Japanese?

A

Europoids
M: >94cm
F: >80cm

SA, Ch, Japs
M: >90cm
F: 80cm

41
Q

How do you measure calf circumference? What popu is this used commonly?

A

To measure the ht from the heel up to below the knee

To get the widest point to measure calf circumference

42
Q

What is used to measure weakness/loss of strength?

A

Hand grip dynamometer - used to measure hand grip strength

43
Q

What condition is indicated if there is lower extremity deficiency?

A

Thiamine deficiency

44
Q

What is the grading of pitting edema?

A

+1 = <2mm; slightly pitting; disappears rapidly
+2 = 2-4mm, somewhat deeper pit; disappears after 15 secs
+3 = 4-6mm, pit is noticeably deep; may last for >30sec
+4 = 6-8mm, v deep pit; >60 sec rebound

45
Q

What are the diff hair findings & its corresponding nutrient deficiency?

A

Hair loss = CHON, Vit B12, Folate
Brittle hair = Folate
Color change = Zinc
Dry hair = Vit A&E
Easy pluckability = CHON, Biotin, Zinc
Coiled, corkscrew = Vit A&C

46
Q

What are the clin manifestation of Biotin deficiency?

A

Dermatitis & Alopecia

47
Q

What are the diff skin findings & its nutrient deficient?

A

Desquamation = Riboflavin
Petechiae = Vit A & C
Perifollicular hemorrhage = Vit C
Ecchymosis = Vit C & K
Xerosis, Bran-like desquamation = Essential FA
Pigmentation, Cracking, Crusting = Niacin
Acneiform lesions, Follicular keratosis, Xerosis = Vit A
Acro-orificial dermatitis, Erythematous, Vesiculobullous, and Pustular = Zinc

48
Q

What are the ocular findings and its corresponding nutrient deficiencies?

A

Bitot’s spots, Xerosis, Difficulties with night vision/Night blindness = Vit A

Angular palpebritis = Riboflavin

49
Q

What is Bitot’s sports?

A

white, foamy area of keratinizing squamous metaplasia of bulbar conjunctiva, seen in vit A def

50
Q

What are diff perioral findings and nutrient deficiencies?

A

Angular stomatitis = B complex, Iron, Protein
Glossitis = Niacin, Folate, Vit B12
Magenta tongue = Riboflavin
Bleeding gums, Gingivitis, Tooth loss = Vit C

Riboflavin def = Cheilosis, Angular stomatitis, Glossitis, Seborrheic dermatitis

Scurvy = Vit C def, impaired wound healing

51
Q

What are the extremity findings and its corresponding nutrient deficiencies?

A

Arthralgia = B complex, Iron, & CHON
Calf pain = Thiamine

52
Q

What are the MSE findings and its corresponding nutrient deficiencies?

A

Opthalmoplegia & foot drop = Thiamine
Paresthesia = Thiamine, Vit B12, Biotin
Depressed vibratory & position senses = Vit B12
Bleeding gums, gingivitis, tooth loss = Vit C
Anxiety, Depression & Hallucinations = Niacin
Memory disturbance = Vit B12
Hyporeflexia, loss of lower extremity DTRs = Thiamine, Vit B12
Wernicke-Korsakoff syndrome = Severe thiamine def

53
Q

What are the different thiamine deficiency?

A

Non-specific symptoms:
Anorexia, Weight loss, Mental changes, Muscle weakness

Severe def:
Wet beriberi = Cardiac failure and edema
Dry beriberi = Neurological changes & muscle weakness
Wenicke-Korsakoff syndrome w/ delirium = Ophthalmoplegia including Nutrition coma & possible death

54
Q

What are the diff functional assessment?

A

Gait
Chair stands
Stair steps
Balance
Neurological status, coordination, and strength
Time gait, chair stands and stair

55
Q

What is SOAP?

A

Subjective
Objective
Assessment
Plan

Medicine I (8 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions