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47 Cards in this Set
- Front
- Back
Steps to the Nutrition Care Process |
Assess, Diagnose, Monitor and Evaluate
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First step of Nutrition Care Process
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Nutrition Assessment
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Purpose of Nutrition Assessment in NCP
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obtain adequate information in order to identify potential/possible nutrition related problems
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Initiation of Nutrition Assessment occurs from
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Referral/screening of individuals or groups for nutritional risk factors
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Critical thinking skills include
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Observe verbal/nonverbal cues
Determine appropariate data to collect Select tools & procedures and apply in valid, reliable ways Validate, organize and categorize data |
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Documentation of Nutrition Asessment
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Date/Time
Pertinent data with comparison standards Partions perceptions, values and motivation related to problem Changes in patients understandings, behaviors and outcomes |
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Nutritional Screening is a _____-_______ measure
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Nutritional Screening is a COST-EFFECTIVE measure.
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Who can participate in Nutrition Screening?
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All health care team members can participate.
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SCREENING IS NOT A PART OF THE 4 STEP NUTRITION CARE PROCESS.
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Because all health care team members can participate.
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Objects for review in Nutrition Screening
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Client's history, Lab results, weight, Physical Signs
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Effective screening is based on a mechanicism of SPECIFICITY and SENSITIVITY
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Specificity - Can ID patients without a condition
Sensitivity - can ID those who have the condition |
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Types of Nutritional History Asessments
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Diet History
Food Record 24-hour Recall Food Frequency List |
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Diet History
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Usual food habits and present patterns of eating
-Watch out for leading questions |
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Food Record
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Exact record of everything eaten ina specific period of time.
-Kept by Patient |
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24 Hour Recall
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Mental recall of everything eaten in previous 24 hours
-Best information when dietitian is involved (to help clarify) |
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Food Frequency Questionaire |
How often an item is consumed
-Do not need dietitian's help |
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Anthropometrics measure the body
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they include height and weight
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Desirable Body Weight - Females
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Medium Frame - 105 lbs for first 5'
-add/subtract 5 lbs for each additional inch Small/Large Frame - add/subtract 10% |
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Desirably Body Weight - Females
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Medium Frame - 100 lbs for first 5'
-add/subtract 5 lbs for each additional inch Small/Large Frame - add/subtract 10% |
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Weight change formula
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[(usual weight - actual) / usual] x 100
stresses significance of weight change. Used to assess potential nutritoin risk of drug/alcohol abuse |
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Triceps Skinfold Thickness - TSF
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measures body fat reserves
measures calorie reserves Male: 12.5mm Female: 16.5mm |
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Arm Muslce Area - AMA
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measures skeletal muscles (somatic protein)
Important for growing children Possible Protein/Energy Malnutrition Male: 25.3cm Female: 23.2cm |
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Body Mass Index - BMI
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Weight to height
Health for adults 18.5 - 24.9 Healthy for Elderly 24 - 29 |
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Waist to Hip Ratio
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1.0 or greater in Men
0.8 or greater in Women Increased risk of obesity-related diseases |
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Waist Circumference
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<40 Males
<35 Females independent risk factor for disease when accompanied by total body fat (BMI) |
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Nutrition Focused Physical Exam
HAIR |
IF thin, sparse, dull dry
COULD BE: chemotherapy, vitamin C protein Deficiency |
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Nutrition Focused Physical Exam
IF HAIR IS EASILY PLUCKABLE |
Protein Deficiency
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Nutrition Focused Physical Exam
EYES |
IF: pale, dry, poor vision
COULD BE: vitamin A, zinc or riboflavin deficiencies |
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Nutrition Focused Physical Exam
LIPS |
IF: swollen, red, dry, cracked
COULD BE: riboflavin, pyridoxine, niacin deficiencies |
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Nutrition Focused Physical Exam
TONGUE |
IF: smooth, slick, purple, white coating
COULD BE: Vitamin or Iron deficiencies |
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Nutrition Focused Physical Exam
GUMS |
IF: sore, red, swollen, bleeding
COULD BE: Vitamin C deficiency |
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Nutrition Focused Physical Exam
TEETH |
IF: missing, loose, loss of enamel
COULD BE: Calcium, deficiency or poor intake |
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Nutrition Focused Physical Exam
SKIN |
IF: pale, dry, scaly
COULD BE: iron, folic acid and zinc deficiency |
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Nutrition Focused Physical Exam
NAILS |
IF: birtle, think, spoon-shaped
COULD BE: iron or protein deficiency |
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Biochemical measures are the most...
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accurate means of measuring nutritional status
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Serum Albumin |
3.5 - 5 g/dl Visceral (blood organ) protein
High in dehydration |
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Serum Transferrin |
>200 mg/dl Visceral protein
Shorter half life than albumin Rises with Iron deficiency Deteremined from TIBC |
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TTHY Transthyretin, PAB (prealbumin), Retinol-Binding Protien RBP
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19 - 43 mg/dl
VISCERAL with short half lifes (2-3 days) Transthyretin best for evaluation protein status |
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Hematocrit
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Volume of packed cells in whole blood
Men 44% Women 38% Pregnant 33% |
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Hemoglobin
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Iron-containing pigment of red blood cells
Men 14 - 17 gm/dl Women 12 - 15 gm/dl Pregnant <11 |
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BUN - Blood Urea Nitrogen
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10 - 20 mg/dl
related to protein intake Indicator of renal Disease Renal patient should be less than 100 |
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Serum Creatinine |
0.6 - 1.4 mg/dl
Related to muscle mass (SOMATIC protein) May indicate muscle wastage or renal disease |
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Urinary Creatinine Clearance
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Measures GFR
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Creatinine Height Index
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Estimates lean body mass
Ratio of excreted creatinine in 24 hours to height |
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Total Lymphocyte Count - TLC
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2000 - 3500 cell/cu mm
Measures immunocompetency |
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C-Reactive Protein
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Maker of acute infalmmatory stress
As it declines, Nutritional therapy is beneficial |
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BEE Activity Factors
Sedentary Active Stressed |
1.2 - Sedentary
1.3 - Active 1.5 - Stressed |