Test your basic knowledge |

Nutrition Diagnosis

Subjects : health-sciences, nursing, health-fitness-nutrition

Instructions:

Answer 50 questions in 15 minutes.
If you are not ready to take this test, you can study here.
Match each statement with the correct term.
Don't refresh. All questions and answers are randomly picked and ordered every time you load a test.

This is a study tool. The 3 wrong answers for each question are randomly chosen from answers to other questions. So, you might find at times the answers obvious, but you will see it re-enforces your understanding as you take the test each time.

1. What are the assessments for Enteral Feedings?
Weight loss (5% in 1 month; 10% in 6 months) - Increased activity - dx: Parkinsons - cerebral palsy - dementia
Reports or observations of energy intake more than needs - Lower physical activity - Planned change in mobility/physical activity - Meds increasing appetite - Knowledge deficit
Based on - Patient's digestive and absorptive capabilities - Metabolic requirements - Need for fluid restriction - Done in conjunction with dietician who will calculate patients individual nutritional need and develop plan to initiate feedings
Assessment - Residuals - Weight - Lung sounds - Edema - I & O - Blood glucose monitoring - Blood chemistry

2. Malnutrition - Symptoms
Foods liquid at room or body temperature - Clear liquid plus milk - pudding - ice cream - soups - yogurt - Used to provide oral nourishment for patients - Difficulty chewing and swallowing solid foods - Commercial nutritional supplements often used
Low alb - Low BMI - Weight loss - Poor growth rate - Diet hx low PRO
Weight status and trends - BUN - creatinine - serum chemistries - proteins - Fluid status - intake and output
Serum and urine creatinine and BUN (somatic muscle protein) -ELEVATED if muscle is broken down Normal Values: -Serum Creatinine: 0.5-1.2mg/100ml -BUN: 10-20 mg/ml

3. Inadequate protein-energy intake
Weight gain - Diet hx of energy dense food intake
Food items that minimize elimination patterns by reducing fecal volume - Restricted - High fiber foods - Milk and milk products - Fried foods - Pepper - Alcohol - Heavy seasonings
Low alb - Low BMI - Weight loss - Poor growth rate - Diet hx low PRO
Prealbumin- (visceral protein status) Normal Value: 16-40 g/dl Compromised Protein status: 10-15 g/dl Possible protein malnutrition: <10 g/dl

4. Decreased nutrient needs
High BUN - High serum osmolality - High Na - Weight loss - Thirst
High AST/GGT - Blood ETOH - diet hx of > 2 drinks/day - liver dx
High chol - PO4 - GFR <90 - High BUN - Edema - Dx: kidney/liver
Weight loss (5% in 1 month; 10% in 6 months) - Increased activity - dx: Parkinsons - cerebral palsy - dementia

5. Excessive parenteral nutrition infusion
Serum Albumin- (visceral protein status) Normal Value: 3.5-5 g/dl 2.8-3.5- compromised protein status <2.4- possible protein malnutrition
Elevated BUN:creatinine ratio - Hyperglycemia - Hypercapnia - Elevated liver enzymes - Weight gain - Edema - Meds that reduce energy requirements or impair metabolism
High/low BGL - Meds (steroids) - Diet hx
Abnormal liver function tests - Abnormal levels of nutrient - Weight gain or weight loss - Edema - Nausea - Intolerance

6. What is Secondary Nutrition Risk?
Caused by disease
Weight status and trends - BUN - creatinine - serum chemistries - proteins - Fluid status - intake and output
Regular diet with attention to texture - Consistency of food can be varied according to the patient's ability to chew and swallow - Foods chopped - ground - mashed - or pureed - Patient's needs should be evaluated - Modifying consistency according to
High BGL - Weight gain - High Hgb A1C - diet hx of energy dense food intake - Excess eating away from home

7. What is Soft Diet?
>Moderate nutritional risk: transition from restrictive therapeutic to regular dietary intake >High Nutritional Risk: -Parenteral feeding -Tube Feeding -NPO -Clear liquids for more than 3 days
Management of malabsorption - chronic pancreatitis - gallbladder disease - Medium chain triglycerides (MCTs) utilized with high intake of CHO and protein - Easy to digest - Restricts - High fat - additional fat in cooking - Enzyme replacement may be
Foods that are easy to chew - digest - and absorb - Used during transition from liquid diets to regular or general diets - Foods low in fiber - Only lightly seasoned - Not appropriate for patients requiring mechanical soft diets
Ketone breath - Diet hx low CHO - Dx: liver - pancreas - celiac's disease

8. What is Fat-Controlled Diet?
Management of malabsorption - chronic pancreatitis - gallbladder disease - Medium chain triglycerides (MCTs) utilized with high intake of CHO and protein - Easy to digest - Restricts - High fat - additional fat in cooking - Enzyme replacement may be
High BUN - High serum osmolality - High Na - Weight loss - Thirst
Encourage patient to think/talk about food before meals - Can help stimulate flow of saliva - Aids in formation of bolus - Chewing and swallowing process - Tart or sour foods - Stimulate saliva production - Have patient lick jelly from the lips - puc
Abnormal liver function tests - Abnormal levels of nutrient - Weight gain or weight loss - Edema - Nausea - Intolerance

9. Imbalance of nutrients
Before Putting anything in - Radiography - pH of aspirated fluids - Air injection and ausculation - Visual assessment of aspiration
High chol - amylase/lipase - liver function tests - Diet hx high fat
High BUN - High serum osmolality - High Na - Weight loss - Thirst
Diet hx of high intake - Diarrhea - Constipation - GI distress

10. Excessive oral food/beverage intake
High BGL - Weight gain - High Hgb A1C - diet hx of energy dense food intake - Excess eating away from home
Indirect calorimetry measurement - Vitamin/mineral abnormalities in lab values - Inadequate weight gain - or unintentional weight loss Clinical evidence of vitamin/mineral deficiency
Low serum mineral levels - Physical signs of deficiency - Diet hx of low intake - Celiac disease - SBS - IBD
High chol - PO4 - GFR <90 - High BUN - Edema - Dx: kidney/liver

11. What are some tube-feeding complications?
TJC requires screenings within 48hrs
GI problems - Diarrhea - Nausea and vomiting - Cramping - Distention - Constipation - Mechanical complications - Tube displacement - Tube obstruction - Pulmonary aspiration - Mucosal damage
Management of malabsorption - chronic pancreatitis - gallbladder disease - Medium chain triglycerides (MCTs) utilized with high intake of CHO and protein - Easy to digest - Restricts - High fat - additional fat in cooking - Enzyme replacement may be
IV lipid emulsions - Used as a concentrated energy source and to prevent the development of essential fatty acid deficiency - Kcal density of lipid solutions is useful when volume restriction is necessary

12. What is Primary Nutrition Risk?
Low cholesterol - Weight loss - Poor dentition - Self-feeding problems - Inadequate nutrition support
Inadequate Intake
Reports or observations of energy intake more than needs - Lower physical activity - Planned change in mobility/physical activity - Meds increasing appetite - Knowledge deficit
Indirect calorimetry measurement - Vitamin/mineral abnormalities in lab values - Inadequate weight gain - or unintentional weight loss Clinical evidence of vitamin/mineral deficiency

13. How do you monitor response for enteral treatment?
Weight status and trends - BUN - creatinine - serum chemistries - proteins - Fluid status - intake and output
Dry skin - Weight loss - diet hx of low intake - dx: AIDS - TB - AN - sepsis - infection - xs ETOH
Low HDL - High TSH - High Mg - High PO4 - Diet hx of xs intake - Liver damage - GI distress
TJC requires screenings within 48hrs

14. Inadequate energy intake
Low cholesterol - Weight loss - Poor dentition - Self-feeding problems - Inadequate nutrition support
Low serum mineral levels - Physical signs of deficiency - Diet hx of low intake - Celiac disease - SBS - IBD
Low serum osmolality - Weight gain - Edema - Excess salt intake
Diet hx of low plant food intake

15. Predicted excessive energy intake
Biochemical parameters indicating suboptimal nutrient intake - Estimated intake less than needs - Cultural or religious practices - Knowledge deficit - Meds affecting appetite
Pureed - Mechanically altered - Advanced
Reports or observations of energy intake more than needs - Lower physical activity - Planned change in mobility/physical activity - Meds increasing appetite - Knowledge deficit
Pudding Thick - Consistency of applesauce or smooth mashed potatoes - Most restrictive - Used with severe levels of dysphagia in which oral intake is still allowed - May require IV hydration - Necessary to closely monitor fluid intake to prevent dehy

16. What is Enteral Nutrition based on?

17. What is Low-Residue Diet?
Common for this diet to be ordered postoperatively - Permits patient's preferences and situations to be taken into consideration - Also allows for postoperative diet progression at the patient's tolerance
Height/length -Weight -BMI -Body Measures (skin fold thickness)
High liver enzymes - Constipation - Diarrhea - CV changes - High intake of supplements/plant foods
Food items that minimize elimination patterns by reducing fecal volume - Restricted - High fiber foods - Milk and milk products - Fried foods - Pepper - Alcohol - Heavy seasonings

18. Excessive or inappropriate protein intake
Dry skin - Weight loss - diet hx of low intake - dx: AIDS - TB - AN - sepsis - infection - xs ETOH
Carbohydrate - Dextrose solutions - Available in initial concentrations of 5% to 70% - Mixed with amino acids and other nutrients to form the final solution - Protein - Mixture of essential and nonessential crystalline amino acids - Available wi
High BUN - Low GFR - Poor growth - Deranged AA ratios - diet hx high PRO or AA supplement
Technical complications - Pneumothorax - Septic complications - Local or systemic - Metabolic complications - Most common complication - Most common is hyperglycemia

19. What else do you check with biochemical tests?
Abnormal liver function tests - Abnormal levels of nutrient - Weight gain or weight loss - Edema - Nausea - Intolerance
Common for this diet to be ordered postoperatively - Permits patient's preferences and situations to be taken into consideration - Also allows for postoperative diet progression at the patient's tolerance
Weight status and trends - BUN - creatinine - serum chemistries - proteins - Fluid status - intake and output
Anthropometric data -Clinical data -Dietary intake assessment

20. What is Clear Liquid Diet?
Foods clear and liquid at room/body temperature - :Used to help prevent dehydration and keep colon contents to a minimum - -Good source of fluids and water - Inadequate in: - Protein - Fat - Energy - Fiber - Recommended for short-term use (3-5 days
Encourage patient to think/talk about food before meals - Can help stimulate flow of saliva - Aids in formation of bolus - Chewing and swallowing process - Tart or sour foods - Stimulate saliva production - Have patient lick jelly from the lips - puc
High serum vit. A -D -K - B6 - niacin - Physical signs of excess - Diet hx
Diet hx of xs fiber intake - GI distress

21. How do you manage TPN?

22. Excessive fluid intake
Weight Loss - dx: AIDS - TB - AN
Low serum osmolality - Weight gain - Edema - Excess salt intake
Ketone breath - Diet hx low CHO - Dx: liver - pancreas - celiac's disease
Foods clear and liquid at room/body temperature - :Used to help prevent dehydration and keep colon contents to a minimum - -Good source of fluids and water - Inadequate in: - Protein - Fat - Energy - Fiber - Recommended for short-term use (3-5 days

23. Excessive or inappropriate fat intake
CHO 55-60% - protein 10-20% - lipid <30% - fiber 20-35 grams - Evaluate glucose levels - serum lipids - kcalories - diet - insulin/medication
High chol - amylase/lipase - liver function tests - Diet hx high fat
Weight Loss - dx: AIDS - TB - AN
Inadequate Intake

24. What is Dysphagia Nutritional Therapy?
IV lipid emulsions - Used as a concentrated energy source and to prevent the development of essential fatty acid deficiency - Kcal density of lipid solutions is useful when volume restriction is necessary
Provides essential nutrients in blenderized form - Clients who are unable to chew or swallow - Can be used long-term
Foods that are easy to chew - digest - and absorb - Used during transition from liquid diets to regular or general diets - Foods low in fiber - Only lightly seasoned - Not appropriate for patients requiring mechanical soft diets
Individualized diets based on swallowing ability and food preference - Evaluate ability to swallow solids and liquids: often done by speech therapist who can also aid in teaching the patient swallowing techniques - Features of food to consider and mo

25. How long does TJC require resident screenings to be done during admission?
TJC requires screenings within 48hrs
High BUN - Low GFR - Poor growth - Deranged AA ratios - diet hx high PRO or AA supplement
Diet hx of high intake - Diarrhea - Constipation - GI distress
Elevated BUN:creatinine ratio - Hyperglycemia - Hypercapnia - Elevated liver enzymes - Weight gain - Edema - Meds that reduce energy requirements or impair metabolism

26. What is 'Diet as Tolerated'?

27. What is Dysphagia? What are some of the acute/progressive causes?

28. Excessive vitamin intake
Serum and urine creatinine and BUN (somatic muscle protein) -ELEVATED if muscle is broken down Normal Values: -Serum Creatinine: 0.5-1.2mg/100ml -BUN: 10-20 mg/ml
High BUN - Low GFR - Poor growth - Deranged AA ratios - diet hx high PRO or AA supplement
GI problems - Diarrhea - Nausea and vomiting - Cramping - Distention - Constipation - Mechanical complications - Tube displacement - Tube obstruction - Pulmonary aspiration - Mucosal damage
High serum vit. A -D -K - B6 - niacin - Physical signs of excess - Diet hx

29. Increased nutrient needs

30. What are some other Restricted Diets?

31. What is Pureed Diet?
High/low BGL - Meds - Insulin use -
Ketone breath - Diet hx low CHO - Dx: liver - pancreas - celiac's disease
Provides essential nutrients in blenderized form - Clients who are unable to chew or swallow - Can be used long-term
Weight loss (5% in 1 month; 10% in 6 months) - Increased activity - dx: Parkinsons - cerebral palsy - dementia

32. Excessive carbohydrate intake
Biochemical parameters indicating suboptimal nutrient intake - Estimated intake less than needs - Cultural or religious practices - Knowledge deficit - Meds affecting appetite
Regular diet with attention to texture - Consistency of food can be varied according to the patient's ability to chew and swallow - Foods chopped - ground - mashed - or pureed - Patient's needs should be evaluated - Modifying consistency according to
Diet hx of aberrant CHO intake - Steroids - DM - Inborn errors
Weight loss (5% in 1 month; 10% in 6 months) - Increased activity - dx: Parkinsons - cerebral palsy - dementia

33. What is the short-term nutritional biochemical analysis? What are the values?
Renal disease or liver disease - Limit protein - Limit potassium - phosphorus - Sodium and Fluid restrictions - Emphasizes high biologic value - Minimum level of CHOs needed to spare protein
Collecting food in the mouth - Spitting out food - Inability to control tongue - Coughing before or after swallowing - Choking - Excessive drooling - Regurgitation of food or liquid through nose - mouth or trach tube - Increased time required to eat
Used when patient has functioning GI tract - Used when patients unable to orally consume adequate nutrients and kcal - Preferred over parenteral nutrition - Physiologically beneficial in maintaining the integrity and function of the gut - Short-term
Prealbumin- (visceral protein status) Normal Value: 16-40 g/dl Compromised Protein status: 10-15 g/dl Possible protein malnutrition: <10 g/dl

34. Inadequate enteral nutrition infusion
Monitor patient's nutritional status - Monitor I&O - Fluid balance - lung sounds - s/s dehydration - etc. - Monitor IV - Change solution bag every 24 hours to decrease infection rate - CVC dressing change q 72 hours - Monitor Blood Chemistry - Fluid
Low cholesterol - Low Ca - High PTT - Low Cu/Zn/Fe - Weight loss - Dehydration
Poor nutrition prevents or delays recovery from injury.
High BGL - Weight gain - High Hgb A1C - diet hx of energy dense food intake - Excess eating away from home

35. What are some swallowing aids?
Low cholesterol - Weight loss - Poor dentition - Self-feeding problems - Inadequate nutrition support
Encourage patient to think/talk about food before meals - Can help stimulate flow of saliva - Aids in formation of bolus - Chewing and swallowing process - Tart or sour foods - Stimulate saliva production - Have patient lick jelly from the lips - puc
Low cholesterol - Low Ca - High PTT - Low Cu/Zn/Fe - Weight loss - Dehydration
High/low BGL - Meds (steroids) - Diet hx

36. Excessive intake
High/low BGL - Meds (steroids) - Diet hx
CHO 55-60% - protein 10-20% - lipid <30% - fiber 20-35 grams - Evaluate glucose levels - serum lipids - kcalories - diet - insulin/medication
Weight gain - Diet hx of energy dense food intake
High liver enzymes - Constipation - Diarrhea - CV changes - High intake of supplements/plant foods

37. Inadequate fiber intake
Low cholesterol - Weight loss - Poor dentition - Self-feeding problems - Inadequate nutrition support
Diet hx of low fiber intake - Constipation/low stool volume
Diet hx of high intake - Diarrhea - Constipation - GI distress
Dry skin - Weight loss - diet hx of low intake - dx: AIDS - TB - AN - sepsis - infection - xs ETOH

38. How long should Nutritional screenings be done to residents being admitted?
Diet hx of aberrant CHO intake - Steroids - DM - Inborn errors
14 days of admission
Allows body to heal -To prepare diagnostic test -To prepare Surgical Procedure
Kcal count -24 hr recall -Food records

39. Inadequate fat intake
Designed to attain or maintain optimal nutritional status in those who do not require modified or therapeutic diets - Used to promote health and reduce risks for developing chronic diet-related diseases
Weight Loss - dx: AIDS - TB - AN
Pudding Thick - Consistency of applesauce or smooth mashed potatoes - Most restrictive - Used with severe levels of dysphagia in which oral intake is still allowed - May require IV hydration - Necessary to closely monitor fluid intake to prevent dehy
Foods clear and liquid at room/body temperature - :Used to help prevent dehydration and keep colon contents to a minimum - -Good source of fluids and water - Inadequate in: - Protein - Fat - Energy - Fiber - Recommended for short-term use (3-5 days

40. Less than optimal parenteral infusion
High BUN - High serum osmolality - High Na - Weight loss - Thirst
Allows body to heal -To prepare diagnostic test -To prepare Surgical Procedure
Abnormal liver function tests - Abnormal levels of nutrient - Weight gain or weight loss - Edema - Nausea - Intolerance
Foods liquid at room or body temperature - Clear liquid plus milk - pudding - ice cream - soups - yogurt - Used to provide oral nourishment for patients - Difficulty chewing and swallowing solid foods - Commercial nutritional supplements often used

41. Inadequate parenteral nutrition infusion
Dry skin - Weight loss - diet hx of low intake - dx: AIDS - TB - AN - sepsis - infection - xs ETOH
Indirect calorimetry measurement - Vitamin/mineral abnormalities in lab values - Inadequate weight gain - or unintentional weight loss Clinical evidence of vitamin/mineral deficiency
High serum vit. A -D -K - B6 - niacin - Physical signs of excess - Diet hx
Assessment - Residuals - Weight - Lung sounds - Edema - I & O - Blood glucose monitoring - Blood chemistry

42. What are the 3 levels of Dysphagia?
High BGL - Weight gain - High Hgb A1C - diet hx of energy dense food intake - Excess eating away from home
Used when patient has functioning GI tract - Used when patients unable to orally consume adequate nutrients and kcal - Preferred over parenteral nutrition - Physiologically beneficial in maintaining the integrity and function of the gut - Short-term
Pureed - Mechanically altered - Advanced
Low serum osmolality - Weight gain - Edema - Excess salt intake

43. What is Nutritional risk?
Potential to become malnourished
Abnormal liver function tests - Abnormal levels of nutrient - Weight gain or weight loss - Edema - Nausea - Intolerance
CHO 55-60% - protein 10-20% - lipid <30% - fiber 20-35 grams - Evaluate glucose levels - serum lipids - kcalories - diet - insulin/medication
Encourage patient to think/talk about food before meals - Can help stimulate flow of saliva - Aids in formation of bolus - Chewing and swallowing process - Tart or sour foods - Stimulate saliva production - Have patient lick jelly from the lips - puc

44. Less than optimal enteral nutrition
Monitor patient's nutritional status - Monitor I&O - Fluid balance - lung sounds - s/s dehydration - etc. - Monitor IV - Change solution bag every 24 hours to decrease infection rate - CVC dressing change q 72 hours - Monitor Blood Chemistry - Fluid
High serum vit. A -D -K - B6 - niacin - Physical signs of excess - Diet hx
Low cholesterol - Weight loss - Poor dentition - Self-feeding problems - Inadequate nutrition support
Abnormal liver enzymes - Fatty liver - Weight gain/loss - Edema

45. Inadequate fluid intake
Serum and urine creatinine and BUN (somatic muscle protein) -ELEVATED if muscle is broken down Normal Values: -Serum Creatinine: 0.5-1.2mg/100ml -BUN: 10-20 mg/ml
High BUN - High serum osmolality - High Na - Weight loss - Thirst
Inadequate Intake
Designed to attain or maintain optimal nutritional status in those who do not require modified or therapeutic diets - Used to promote health and reduce risks for developing chronic diet-related diseases

46. Excessive alcohol intake
Low alb - Low BMI - Weight loss - Poor growth rate - Diet hx low PRO
Foods liquid at room or body temperature - Clear liquid plus milk - pudding - ice cream - soups - yogurt - Used to provide oral nourishment for patients - Difficulty chewing and swallowing solid foods - Commercial nutritional supplements often used
High BUN - High serum osmolality - High Na - Weight loss - Thirst
High AST/GGT - Blood ETOH - diet hx of > 2 drinks/day - liver dx

47. Inappropriate intake of types of carbohydrates
High/low BGL - Meds (steroids) - Diet hx
Prevents aspiration - Thickener added to liquids to created required thickness - Nectar/Syrup thick - Consistency of heavy syrup in canned fruit - Least restrictive - Cream based soups and most nutritional supplements - Honey thick - Consistency of h
Assessment - Residuals - Weight - Lung sounds - Edema - I & O - Blood glucose monitoring - Blood chemistry
Anthropometric data -Clinical data -Dietary intake assessment

48. What is the other biochemical analysis and values?
Foods liquid at room or body temperature - Clear liquid plus milk - pudding - ice cream - soups - yogurt - Used to provide oral nourishment for patients - Difficulty chewing and swallowing solid foods - Commercial nutritional supplements often used
Serum and urine creatinine and BUN (somatic muscle protein) -ELEVATED if muscle is broken down Normal Values: -Serum Creatinine: 0.5-1.2mg/100ml -BUN: 10-20 mg/ml
Low HDL - High TSH - High Mg - High PO4 - Diet hx of xs intake - Liver damage - GI distress
Reports or observations of energy intake less than needs - Projected change in ability to procure or consume adequate energy - Knowledge deficit - Projected increase in physical activity

49. What is Mechanically Altered Diet?

50. What are the feeding modalities?
>Moderate nutritional risk: transition from restrictive therapeutic to regular dietary intake >High Nutritional Risk: -Parenteral feeding -Tube Feeding -NPO -Clear liquids for more than 3 days
TJC requires screenings within 48hrs
Low serum osmolality - Weight gain - Edema - Excess salt intake
High/low BGL - Meds (steroids) - Diet hx