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Nutrition Final--Nutrition Assessment


  
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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 out
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 measure, age
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, disease, medications, functional status...education level, economic status, literacy level
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
Specimins
 
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
Weight
 
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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