T3 - Malnutrition Obesity (Josh)

Question 1

When is a nutrition screening supposed to be done?

Answer 1

within first 24 hrs of admission

Question 2

What is formula for calculating change in weight?

Answer 2

Usual weight MINUS current weight DIVIDED BY usual weight

then MULTIPLY by 100 for a percentage

Question 3

What is formula for BMI?

Answer 3

Weight (kg) DIVIDED BY height (meters) squared

Question 4

What would be considered significant weight loss?

Answer 4

anything greater than 10 percent within 6 months

Question 5

BMI:

— is underweight

— is normal weight

— is overweight

— is obese

— is morbidly obese

Answer 5

less than 18.5

18.5 - 24.9

25 - 29.9

30 or more

40 or more

Question 6

What is PEM (aka: PCM) and how many forms are their?

Answer 6

Protein-Energy Malnutrition (PEM)

or

Protein-Calorie Malnutrition (PCM)

3 Forms:

• Marasmus
• Kwashiorkor
• Marasmus-kwashiokor

Question 7

PEM:

There are three forms.

Which form is a lack of calories where protein and body fat are wasted?

Answer 7

Marasmus

Question 8

PEM:

There are three forms.

Which form has adequate calories, but lacks protein quality and quantity?

Answer 8

Kwashiorkor

***K has the Kalories, but not the protein

Question 9

PEM:

There are three forms:

Which form is a combined protein and calorie (energy) malnutrition?

Answer 9

Marasmus-Kwashiokor

Question 10

What unintentional weight loss is diagnostic for malnutrition?

Answer 10

5 percent or more over 30 days

10 percent of more over 6 mths

Question 11

What lab is best indicator of malnutrition?

Why?

What is normal?

Answer 11

Prealbumin

it has a shorter half life

normal values are 15-36 mg per dL

Question 12

What cholesterol levels are diagnostic for malnutrition?

Answer 12

less than 160

Question 13

What Total Lymphocyte Count indicates malnourishment?

Answer 13

less than 1500

Question 14

What are normal Albumin levels?

Answer 14

3.5 - 5

Question 15

What are normal Prealbumin levels?

Answer 15

15-36

Question 16

What is a symptom of Refeeding Syndrome?

Answer 16

hypophosphatemia

Question 17

What is a contraindication for TEN (Total Enteral Nutrition)?

Answer 17

low BP that isn’t perfusing GI tract

Question 18

Why is bacteria a concern with TPN?

Answer 18

you’re infusing glucose which bacteria love

Question 19

What should you have ready if you run out of TPN?

Answer 19

10 percent glucose

Question 20

With TPN, what are you doing regularly?

Answer 20

accuchecks

Question 21

Central obesity is measured how?

Answer 21

Waist Circumference

Question 22

What waist circumference is obese?

Answer 22

men: greater than 40
women: greater than 35

Question 23

What is WHR?

Answer 23

Waist to Hip Ratio

0. 95 or greater in men is obese
1. 8 or greater in women is obese

Question 24

Which shape is more of a risk factor for CV disease?

Answer 24

apple shaped

Question 25

Which obesity med can be used to block the absorption of fat to help you lose weight?

Answer 25

Orlistat Rx: 120 mg TID OTC: 60 mg

Question 26

What are the official names for Lab Band surgery?

Answer 26

Laparoscopic Adjustable Gastric Band (LAGB) or Laparascopic Sleeve Gastrectomy (LSG) ***people do gain weight back with these

Question 27

What is the official name for Gastric Bypass?

Answer 27

Roux-en-Y Gastric Bypass (RNYGB)

Question 28

What type of surgery is Gastric Bypass? What type of surgery is Lab Band?

Answer 28

Malabsorption - decreases amount of absorption by limiting stomach space Restriction - restricts amount of food entering stomach

Question 29

With --- surgery, they will need supplements for the rest of their lives.

Answer 29

Gastric Bypass

Question 30

What is priority care after Bariatric Surgery?

Answer 30

Airway management Abdominal Binder Sequential compression or Heparin Skin Assessment Absorbent padding Removal of Foley within 24 hrs

Question 31

What are special considerations after Bariatric Sugery?

Answer 31

Ambulate asap Monitor abdominal girth 6 small feeds Prevent Dehydration Watch for Dumping Syndrome

Question 32

What is Dumping Syndrome?

Answer 32

after bariatric surgery, client gets food too quickly and gets tachycardia, nausea, abdominal cramping, and rapid bowel emptying

Question 33

What are signs and symptoms of Vit A deficiency?

Answer 33

Conjunctival xerosis Dry skin Follicular hyperkeratosis Purple tongue