Unformatted text preview:

EXAM 1 STUDY GUIDE DIE 4244 Medical Nutrition Therapy Spring 2014 1 The Nutrition Care Process a What is the Nutrition Care Process NCP Established by the Academy of Nutrition and Dietetics as a standardized process for the provision of nutrition care There are 4 steps in the NCP called ADIME b What are the steps of the NCP and what is involved in each step The 4 steps are nutrition assessment nutrition diagnosis nutrition intervention and monitoring and evaluation 1 Nutrition Assessment Gathering evaluation of data to make professional judgment s about nutritional status Involves evaluating an individual s current status by comparing actual figures to expected normal values 2 Nutrition diagnosis Problem identification Identify prioritize and document problems in medical record Nutrition diagnosis includes problem etiology and symptoms PES in a clear and simple statement standardized formats 3 Nutrition intervention Should be targeted at etiology If not able to target etiology then signs and symptoms Should include patient centered goals Translate assessment data into strategies or actions to meet established objectives Two steps planning and implementation 4 Monitoring and Evaluation Measures impact of interventions Determine indicators to monitor they should match signs and symptoms in assessment Goal is to meet nutritional needs of patient c What are nutrition risk factors and how do they affect an individual s nutrition status Intake Psycho social Physical condition Biological make up labs biochemistry Food medication interactions d What are nutrition screening and assessment and why are they done Nutrition Screening and Assessment A process that identifies those who would benefit from a full nutrition assessment Patients should be rescreened at regular intervals during hospitalization Assessment occurs when screening has identified a patient at risk e What are the ABCDs of assessment Anthropometric Biochemical Clinical Dietary i What is used to measure height and weight and how are these interpreted e g IBW percent weight change etc You should know these calculations significant weight changes etc Calculating IBW Men 106 lbs for first 5 feet of ht and 6 lbs per inch over 5 feet or 6 lbs subtracted for each inch under 5 ft Women 100 lbs for first 5 feet of ht and 5 lbs per inch over 5 feet or 5 lbs subtracted for each inch under 5 feet ideal body weight IBW Current weight IBW x 100 usual body weight UBW Current weight UBW x 100 weight change UBW current weight UBW x 100 Significant weight loss 5 in 1 month 7 5 in 3 months 10 in 6 months BMI weight kg height m 2 Normal range 18 5 24 9 Underweight 18 5 Overweight 25 29 Obese 30 ii Labs what are they used for types of labs etc Clinical chemistry panels Basic metabolic panel to assess kidneys electrolyte and acid base balance blood sugar and calcium levels Glucose calcium sodium potassium CO2 chloride BUN creatinine Comprehensive metabolic panel Add serum albumin total protein ALP AST ALT Bilirubin Complete blood count RBCs hemoglobin hematocrit MCV MCH MCHC WBC Differential Stool testing Tested for blood pathogens and gut microflora Urinalysis To detect substances or cellular material associated with metabolic and kidney disorders Hydration status Na BUN serum osmolality specific gravity of urine iii What is involved in clinical assessment Physical signs Equipment may include a stethoscope a flashlight a tongue depressor scales a reflex hammer calipers a tape measure a blood pressure cuff and an ophthalmoscope Examination techniques inspection general observation using sight smell and hearing palpation percussion and auscultation Handgrip dynamometry Strength correlates with nutrition and health Handgrip standards are 35 kg for males and 23 kg for females iv What are the ways in which dietary intake information can be collected and assessed e g exchange list Daily food record or food diary Food frequency questionnaire 24 hour recall Diabetic Exchange List Tables Computer Programs v How are nutritional requirements estimated Know Mifflin equation dietary guidelines protein and fluid requirements etc You do not need to memorize EER for children and adolescents or activity and injury factors these will be provided Dietary Guidelines Adults 55 CHO 15 Protein 30 Fat 1 3 year olds 45 65 CHO 5 20 protein 30 40 fat 4 18 year olds 45 65 CHO 10 30 protein 25 35 fat Mifflin St Jeor equation Males kcal d 10 x wt in kg 6 25 x ht in cm 5 x age in yrs 5 Females kcal d 10 x wt in kg 6 25 x ht in cm 5 x age in yrs 161 Protein Requirements RDI 1 5 g kg bw day for infants 1 1 g kg bw day for 1 3 y 0 95 g kg bw day for 4 13 y 0 85 g kg bw day for 14 18 y 0 8 g kg bw day for adults 1 1 g kg bw day for pregnant using pre pregnancy weight and lactating women Estimating fluid requirements in Adults Method 1 Method 2 Method 3 Method 4 30 35 mL kg body weight 1 mL kcal consumed First 10 kg body weight Second 10 kg bw Remaining kg bw in ages 50 Remaining kg bw in ages 50 Age in years 16 30 active 20 55 55 75 75 100 mL kg 50 mL kg 20 mL kg 15 mL kg 40 mL kg 35 mL kg 30 mL kg 25 mL kg f What is a nutrition diagnosis what does each letter stand for in a PES statement and how are they written Understand how to prioritize and evaluate them Problem Nutrition diagnosis label use diagnosis terminology and code Etiology Cause reason for problem The focus of the intervention Signs and symptoms Evidence from assessment The focus of monitoring and evaluation Written as Problem related to Etiology as evidenced by Signs and Symptoms Evaluating prioritizing your PES statement Can the RD resolve or improve the nutrition diagnosis Can your intervention address the etiology and thus resolve it or improve the problem Or can your intervention address the signs and symptoms When all things are equal and there is a choice between two nutrition diagnoses from different domains consider the intake domain diagnosis as the one more specific to the role of the RD g What are the major diet modifications discussed in class and why would they be used Change in consistency Liquid soft pureed low fiber high fiber Increase or decrease energy value Increase or decrease type of food or nutrient Sodium restricted high fiber Eliminate specific foods Allergies gluten free 2 The Digestive System a What is the gastrointestinal tract GIT and system what are their features and what does it do Serves as a physical and immunologic barrier Has the greatest surface area and the greatest number of


View Full Document

FSU DIE 4244 - The Nutrition Care Process

Download The Nutrition Care Process
Our administrator received your request to download this document. We will send you the file to your email shortly.
Loading Unlocking...
Login

Join to view The Nutrition Care Process and access 3M+ class-specific study document.

or
We will never post anything without your permission.
Don't have an account?
Sign Up

Join to view The Nutrition Care Process 2 2 and access 3M+ class-specific study document.

or

By creating an account you agree to our Privacy Policy and Terms Of Use

Already a member?