Nutrition Final--Nutrition Assessment

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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
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 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
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
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