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Flashcards in Nutritional Assessment Deck (50):
1

Energy in humans

50% is lost as heat
45% is stored as energy in the body as ATP and 5% is required to convert energy to heat

2

Define calorie

Amount of heat required to raise 1 g of water by 1 degree Celsius

3

1000 calories =

1 kcal

4

Water in adult males

50-60% of lean body mass

5

Macronutrients

Water
Carbs
Protein
Lipids

6

Micronutrients

Electrolytes
Vitamins
Trace Elements

7

Carbohydrates

Simple (mono adn disaccharides)
Complex (oligo and polysaccharides
Monosaccharides (glucose, fructose, galactose)

8

Glucose

Major source of fuel through glycolysis and oxidative phosphorylation

9

Carbohydrates

Disacchardies (sucrose and lactose)
Polysaccharides are storage forms of energy

10

Diet should be

60% starch, 30% sucrose and 10% lactose

11

****All carbs provide

3.4 kcal/g of energy

12

Proteins

Linear chains of amino acids
Function as enzymes, structures and function, stabilize blood, cell signaling and immune processes
2nd largest energy source to fat

13

***All proteins provide

4 kcal/g of energy

14

As metabolic rates rise,

more protein is converted to energy and lost for other function

15

Lipids

Liquid at room temp are called oils
Lipids exist as solids at room temp are called fats

16

Unsaturated fats

Avocados, nuts, vegetable oils (olive oil)

17

***Each gram of fat contain

9 kcal/g of energy

18

To prevent essential fatty acid deficiency any nutritional plan must contain

linoleic and alpha linolenic acid

19

Define Malnutrition

An acute, subacute or chronic state of nutrition, in which varying degrees of overnutrition or undernutrition with or without inflammatory activity have led to a change in body composition and diminished function

20

Types of malnutrition

Marasmus
Kwashiorkor
Mixed
Obesity

21

Define Marasmus

- Prolonged inadequate intake or utilization of protein and calories
- Weight loss > 10% of usual body weight
Protein and fat wasting but proteins are preserved

22

Define Kwashiorkor

Inadequate protein and micronutrient intake
Preserved fat tissue but depletion of proteins
Severe hypoalbuminemia and edema can be seen

23

Define Mixed Marasmus/Kwashiorkor

- Severe protein-calorie malnutrition
- Temporal wasting (head looks like a skull)
Reduced visceral and somatic proteins and lipids
- Chronically ill, trauma, infxn and burns, immunocompromised or wound healing

24

Obesity- Overnutrition

BMI greater than 25

25

Define Nutrition Assessment

A comprehensive approach to diagnosing nutrition problems that uses a combination of the following: medical, nutrition and med history, physical exam, anthropometric measurements and lab data

26

Nutrition Assessment Goals

- ID of the presence of factors associated with increased risk
- Determine of risk of malnutrition complication
- Establishment of estimated nutrition needs
- Establishment of baseline nutrition status

27

Weight Guidelines

If they are >120% of their IBW use adjusted
If they are less than 120% of IBW use actual body weight

28

Measure for marasmus:

Muscle and fat wasting in temporal area
Loss of fat/muscle in shoulders
Loss of SC fat in hands
Tricep skin-fold thickness using a nutrition caliper
Mid-muscle circumference

29

Factors that decrease albumin

Overhydration
Edema
Kidney dysfunction
Poor dietary intake
Burns
Cirrhosis
Trauma
Sepsis

30

Factors that increase albumin

Volume depletion
Steroids
Insulin

31

Factors that decrease transferrin

Chronic infection, cirrhosis, burns, cortisone, testosterone

32

Factors that increase transferrin

Iron deficiency
Pregnancy
Hypoxia
Chronic blood loss
Estrogens

33

Transferrin Normal

250-300
Half life: 8-9

34

Albumin Normal

3.5-5
Half-life 18-20

35

Factors that decrease prealbumin

Cirrhosis
Hepatitis
Stress
Hyperthyroidism
CF
Burns

36

Factors that increase prealbumin

Kidney dysfunction

37

Prealbumin normal

15-40
Halflife 2-3 days

38

Factors that decrease total lymphocyte count

Severe malnutrition wiht loss of immune function
HIV
TB

39

Factors that increase total lymphocyte count

Volume depletion

40

Total lymphocyte count normal

>1500

41

TLC =

WBC X % Lymphocytes

42

Estimating energy requirements:

Think about physical stress not emotional

43

Indirect Calorimetry

RQ less than 0.7 = underfed
RQ > 1 = overfed

44

Urinary Nitrogen Excretion

Used to monitor protein adequacy
Measures 85-90% of total nitrogen excretion from the body

45

Other losses of nitrogen other than urinary?

Skin, fecal and respiratory

46

1 g nitrogen =

6.25 g protein

47

Adequate intake of alpha-linolenic acid for men and women

M: 1.6 g/day
W: 1.1 g/day

48

Adequate intake of linolenic acid for men and women

M: 14-17 g/day
W: 12 g/day

49

Fat should represent no more than

10-35% of calories

50

Calculating Energy and Protein Requirements

Determine weight
Estimate caloric requirements based on stress
Estimate protein requirement based on stress
Follow-up measurement to verify adequate energy and protein to avoid catabolism of proteins