Nutrition Final--Nutrition Assessment


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Side ASide B
Nutrition Intake
Food intake, disease, medication, economics, behavior, emotions, cultural influences, knowledge 
Nutrition absorption
Disease Psychological stress Mechanical problems
After surgery
Patient=NPO=nothing by mouth After anesthesia, muscles are not working and digestive tract is in peristalysis Food could aspirate or not go to stomach
Weight loss in hospital
no exercise--muscle atrophy; Not eating by mouth; Medications side effects; Blood loss from surgery; Skipping meals for blood test; Dislike hospital food
Nutrient requirements
Growth, psychological stress, maintenance infection, disease, stress
Stages of nutrition deficiency
1. Requierments are not met--poor intake, low absorption, increased losses 2. Stores/tissue depletion 3. Clinical signs and symptoms 4. morbidity/mortality
Stages to responding to nutrition deficiency
1. Diet analysis 2. Biochemical/psychological measures 3. Clinical examination 4. Vital statistics
Nutrient screening and assessment
Provides basis for reducing incidence of nutrition related health problems Improving quality of life Reducing health care costs
Medical nutrition therapy
Use of specific nutritional interventions to treat an illness, injury, or condition Physician makes a diet, often in hospitals, doctor then gives orders to dietician who figures it...
Medical nutrition therapy stages
1. assessment: looking at high risk factors, etc. 2. treatment
Nutritional screening
Identify characteristics associated with nutrition problems Identify high risk individuals and provide early identificaiton  Focuses warning signs
Ways to administer nutritional screening
Tools should be simple to administrator Cost effective Uses data routinely collected Includes relevant data
Goals of nutrition assessment
To confirm or rescind the presence of malnutrition To assess severity of malnutrition To establish baseline data
Four Parameters (ABCD)
Anthropomorphic measures--weight, height, etc Biochemical indices Clinical evaluation Dietary data
Patient data is collected from
Medical record; Patient interview; Laboratory test; Anthropomorphic measurements All data should be interpreted in ligh of: client's health satus, limitations of...
Nutrition history
Economics, culture, physical activity, lifestyle (home, work), education, appetite, recent weight change, food attitudes, body image, food allergies, dental/oral health, GI health,...
24-hour recall
List all that you ate in the past 24 hours Did you eat/drink...? How many times/days/weeks/months...? Alcohol, snacks, desserts
Diet Diary
Daily record, requires instruction, can be used as an educational tool, Reliability may be questionable, requieres literacy
Food observation
must recognize that food history may be subjective can do chemical analysis
Food measurement and analysis requirements
must be timely, accurate, costly
Biochemical indices
most objective measure Special attention to disease/health condition
Serum, plasma, red and white blood cells, urine, feces, tissue samples
Measure of protein status
Nitrogen balance visceral protein: albumin, transferrin, retinal binding protein, creatinine
Measure of iron status
Hemoglobin--first line Hematocrit--first line Total iron binding capacity Ferritin--indicates storage
Anthropomorphic measures
height, weight, skin fold thickness (subcutaneous fat, may come up with different measures), head circumference 
Ideal weight, actual weight, weight by height, percent weight change, current weight % of usual weight, desired weight Compare weight to BMI and look at weight change
Percentage weight change
Usual weight-actual weight   = percent weight change       usual weight
Percent usual body weight
Actual body weight*100 = %body weight Usual body height
Classification of overweight and obese by BMI
<18.5=underweight 18.25-24.9=normal 25-29.9=overweight Obesity I 30-34.9; II 35-39.9; III >40.0
Body composition
how much fat, how much muscle
Clinical examination
Physical examination of body, hair, skin, eyes, teeth, oral cavity, gums, tongue

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