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Clinical Nutrition 1 > Nutritional Assessment - Anthropometrics, Malnutrition > Flashcards

Nutritional Assessment - Anthropometrics, Malnutrition Flashcards

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1
Q

What are the 3 elements of malnutrition screening?

A

Current condition
Stable condition
Deteriorating condition

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2
Q

When assessing current condition, BMI of 18.5-20?

A

at risk of malnutrition

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3
Q

When assessing current condition, BMI less than 18.5?

A

Decreased lean mass

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4
Q

How can we assess if the patients condition is stable?

A

Assess involuntary weight loss

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5
Q

Patient has >5% involuntary loss in one month or >10-15% loss in 6 months, their risk of malnutrition is __

A

SEVERE

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6
Q

Patient has >5% involuntary loss in one month, their risk of malnutrition is ____

A

MODERATE

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7
Q

What question can we ask to determine if patients condition is deteriorating?

A

Ask if their appetite has decreased in the past few dyas

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8
Q

Compromised intake/loss of BM —> ____ –> Starvation related malnutrition

A

NO Inflammation

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9
Q

Inflammation —> Mild/Moderate —> _____

A

Chronic disease related malnutrition

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10
Q

Inflammation —> Marked/Inflammatory Response —> _____

A

Acute disease/injury related malnutrition

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11
Q

Define Nutritional Screening

A

the process of rapidly identifying individuals who may be at risk for nutritional deficiencies or problems, and would benefit from seeing a dietitian

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12
Q

Define Nutritional Assessment

A

the assessment of body compartments and the analysis of the structure and function of organ systems and their effect on metabolism

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13
Q

What are the two main goals of nutritional assessment?

A

To identify the patients needs

To establish a baseline for monitoring and evaluation of the nutritional assessment plan

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14
Q

What are the 3 additional goals of nutritional assessment?

A
  • Disease prevention
  • Identification of micro and macronutrient deficiencies
  • Assessing/preventing overall malnutrition
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15
Q

What is malnutrition associated with?

A
  • Increased morbidity (malnutrition has lots of co-morbidities)
  • Increased mortality
  • Increased hospital stay and costs
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16
Q

What are the components of nutritional screening?

A
  • Pre-existing condition causing nutrient loss
  • Condition causing increased nutrient requirement
  • Dietary intake (simple)
  • Weight-loss (any involuntary weight-loss is NOT healthy)
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17
Q

What are the components of nutritional assessment?

A

ABCDF

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18
Q

What is clinical assessment?

A

Patients medical, social and psychological history, includes the PHYSICAL signs that we can see from the development of a nutritional deficiency (muscle wasting, brittle hair, nails, eye function etc)

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19
Q

Diet inadequacy - what method?

A

dietary

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20
Q

Decreased tissue levels - what method?

A

Biochemical, not commonly used

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21
Q

Decreased bodily fluid levels - what method?

A

Biochemical, such as decreased serum ferritin

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22
Q

Decreased function within tissue - what method?

A

Anthropometric/Biochemical

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23
Q

Decreased enzymatic activity - what method?

A

Biochemical

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24
Q

Functional change - what method?

A

Behavioural/Psychological (functional assessment such as handgrip strength, walking test)

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25
Clinical Symptoms/Anatomical signs - what method?
Clinical (final stage of nutrient deficiency)
26
Anthropometrics =
measurements are done through body size, shape, circumferences, weight and proportions
27
Body composition =
measurement of body compartments (i.e. fat-free, fat and bone mass)
28
Put the following in order of increasing % compostion in a normal, 70 kg man: - Viscera - Plasma proteins - Fat - Skeleton,skin - Skeletal muscle - Exrtacellular
- Fat - Skeletal Muscle - Extracellular - Viscera - Skeleton, skin - Plasma proteins
29
Name two ways skeletal muscle can be assessed
- Arm muscle circumferences | - CHI (Creatinine height index)
30
How many kg of protein found in a 70 kg man?
12 kg
31
How many kcal of fat in a 70 kg man?
160,000 kcal
32
How is standing height measured?
Standiometer, shoulders and heels against wall. Patient should be barefoot and Frankfurt plan parallel to the wall
33
How is knee height measured?
Knee at 90 degree angle on bed, use calliper to measure top of knee to heel
34
Who is armspan not recommended for?
Usually not accurate in most, but especially asians, african americans and those with spinal deformities
35
How is wrist circumference measured? what does it determine?
height(cm)/wrist circumference (cm) | measures FRAME size
36
What is weight?
sum of all components at each level of body composition
37
Equation to adjust for amputation calculation, will it increase or decrease?
current weight / (100 - %loss) x 100 | Will INCREASE
38
head ?
7%
39
arm?
6.5%
40
forearm?
2.3%
41
hand?
0.8%
42
calf?
7.1%
43
leg?
18.6%
44
foot?
1.8%
45
BMI of <18.5
underweight
46
BMI of 18.6-24.9
normal
47
BMI of 25-29.9 - what classification and HBW?
Overweight | BMI of 25 for HBW
48
BMI of 30-34.9 - what classification and HBW?
Obese Class I | BMI of 25-28 for HBW
49
BMI of 35-40 - what classification and HBW?
Obese Class II | BMI of 25-28 for HBW
50
BMI of >40 - what classification and HBW?
Obese Class III | BMI of 30 for HBW
51
Name some limitations of BMI
- does not determine body composition | - not accurate in athletes
52
BMI 21 for person over 65
May be associated with some health risks (<24)
53
BMI of 26 for person over 65
Healthy for elderly (24-29)
54
BMI of 29 for person over 65
Healthy for elderly (24-29)
55
BMI of 32 for person over 65
May be associated with some health problems (>29)
56
What does MAC measure?
Mid-upper arm circumference: Bone, muscle and sub fat
57
What does MAMC measure?
Mid-upper arm muscle circumference: Muscle and bone
58
How is MAMC calculated?
MAC(mm) - (pi x TSF)
59
What is TSF?
Tricep skinfold thickness
60
What is the preferred/more accurate way to measure muscle and bone?
MAMA
61
What does MAMA measure?
Mid-upper arm muscle area: Muscle and bone (more sensitive to changes than MAMC)
62
How is MAMA calculated?
MAMC^2/4pi
63
What is cMAMA?
Corrected mid-upper arm muscle area: Muscle only
64
Is cMAMA valid in elderly/obese?
NO
65
How is cMAMA calculated in MEN?
MAMA - 10
66
How is cMAMA calculated in WOMEN?
MAMA - 6.5
67
What is MAFA?
Mid-upper arm fat area: reflects subcutaneous adipose stores, more accurate than skinfold thickness
68
(T/F) Tricep skinfold thickness is more accurate than measuring the mid-upper arm fat area
False, MAFA is more accurate
69
MAMA is in the <5th percentile?
Muscle deficit
70
MAFA is between 5-15th percentile?
Below average
71
MAMA is between 15-85th percentile?
Average
72
MAFA is >85th percentile?
Excess fat
73
What tool estimates fat-mass, fat-free mass and body water?
Bioelectrical impedence
74
How does BIA work?
Measures the impedence (electrical current resistance) throughout the body, and then the resistance is plugged into a regression equation
75
What are some limitations of BIA?
- influenced by hydration status - less precise in atypical bodies - little reference data
76
Which tool measures bone and soft tissue mass?
DXA
77
How does DXA work?
Machine that measures the density of each body tissue
78
What tissues are the most dense?
Bone --> Lean mass --> fat-free mass
79
What are limitations of DXA?
Expensive, some exposure to radiation, must assume normal hydration status
80
What tool measures lean and fat body mass?
BOD POD
81
How does BOD POD work?
Measures the displacement of air once the individual enters the machine, based off the principle that pressure is inversely related to volume

Clinical Nutrition 1 (30 decks)

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