Nutrition Diagnosis

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 is 'Diet as Tolerated'?


2. Less than optimal parenteral infusion
Diet hx of aberrant CHO intake - Steroids - DM - Inborn errors
Diet hx of low plant food intake
High/low BGL - Meds - Insulin use -
Abnormal liver function tests - Abnormal levels of nutrient - Weight gain or weight loss - Edema - Nausea - Intolerance


3. How long does TJC require resident screenings to be done during admission?
Biochemical parameters indicating suboptimal nutrient intake - Estimated intake less than needs - Cultural or religious practices - Knowledge deficit - Meds affecting appetite
TJC requires screenings within 48hrs
Low cholesterol - Low Ca - High PTT - Low Cu/Zn/Fe - Weight loss - Dehydration
Diet hx of high intake - Diarrhea - Constipation - GI distress


4. Inadequate fat intake
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
Weight Loss - dx: AIDS - TB - AN
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
Food items that minimize elimination patterns by reducing fecal volume - Restricted - High fiber foods - Milk and milk products - Fried foods - Pepper - Alcohol - Heavy seasonings


5. Inadequate vitamin intake
Reports or observations of energy intake more than needs - Lower physical activity - Planned change in mobility/physical activity - Meds increasing appetite - Knowledge deficit
High chol - amylase/lipase - liver function tests - Diet hx high fat
Low serum vitamin levels - Physical signs of deficiency - Diet hx of low intake
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


6. Excessive enteral nutrition infusion
Elevated BUN:creatinine ratio - Hyperglycemia - Hypercapnia - Elevated liver enzymes - Weight gain - Edema - Meds that reduce energy requirements or impair metabolism
High BUN - High BGL - High liver enzymes - Weight gain - Edema
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
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


7. How do you monitor response for enteral treatment?
High BUN - Low GFR - Poor growth - Deranged AA ratios - diet hx high PRO or AA supplement
Diet hx of xs fiber intake - GI distress
A- Anthropometric approach B- Biochemical Tests C- Clinical Observations D- Diet Evaluations (Kcal - 24 hr recall etc)
Weight status and trends - BUN - creatinine - serum chemistries - proteins - Fluid status - intake and output


8. What is Fat-Controlled Diet?
Provides essential nutrients in blenderized form - Clients who are unable to chew or swallow - Can be used long-term
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
Ketone breath - Diet hx low CHO - Dx: liver - pancreas - celiac's disease
Dry skin - Weight loss - diet hx of low intake - dx: AIDS - TB - AN - sepsis - infection - xs ETOH


9. What is Soft 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
High/low BGL - Meds - Insulin use -
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
Low cholesterol - Low Ca - High PTT - Low Cu/Zn/Fe - Weight loss - Dehydration


10. Symptoms of Intakes - Increased energy expenditure
Diet hx of high intake - Diarrhea - Constipation - GI distress
Food allergy diet - Common: nuts - eggs - cow's milk - shellfish - wheat - Gluten-restricted diet - Celiac disease (malabsorption syndrome) - Omits wheat - rye - barley - oats - buckwheat - malt - Allows rice and corn - Lactose-restricted - Primary i
Weight loss (5% in 1 month; 10% in 6 months) - Increased activity - dx: Parkinsons - cerebral palsy - dementia
Allows body to heal -To prepare diagnostic test -To prepare Surgical Procedure


11. Inadequate intake
14 days of admission
Diet hx of low plant food intake
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
>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


12. Inadequate protein-energy intake
Diet hx of high intake - Diarrhea - Constipation - GI distress
Low alb - Low BMI - Weight loss - Poor growth rate - Diet hx low PRO
Diet hx of low fiber intake - Constipation/low stool volume
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


13. What are some other Restricted Diets?


14. Excessive intake
Provides essential nutrients in blenderized form - Clients who are unable to chew or swallow - Can be used long-term
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
High liver enzymes - Constipation - Diarrhea - CV changes - High intake of supplements/plant foods
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


15. Excessive vitamin intake
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
High serum vit. A -D -K - B6 - niacin - Physical signs of excess - Diet hx
Dry skin - Weight loss - diet hx of low intake - dx: AIDS - TB - AN - sepsis - infection - xs ETOH
High BUN - High serum osmolality - High Na - Weight loss - Thirst


16. What is Low-Residue Diet?
Food items that minimize elimination patterns by reducing fecal volume - Restricted - High fiber foods - Milk and milk products - Fried foods - Pepper - Alcohol - Heavy seasonings
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 serum osmolality - Weight gain - Edema - Excess salt intake


17. Inappropriate intake of types of carbohydrates
Serum Albumin- (visceral protein status) Normal Value: 3.5-5 g/dl 2.8-3.5- compromised protein status <2.4- possible protein malnutrition
Low HDL - High TSH - High Mg - High PO4 - Diet hx of xs intake - Liver damage - GI distress
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/low BGL - Meds (steroids) - Diet hx


18. What is the long-term nutritional biochemical analysis? What are the values?
Low cholesterol - Weight loss - Poor dentition - Self-feeding problems - Inadequate nutrition support
Serum Albumin- (visceral protein status) Normal Value: 3.5-5 g/dl 2.8-3.5- compromised protein status <2.4- possible protein malnutrition
Prealbumin- (visceral protein status) Normal Value: 16-40 g/dl Compromised Protein status: 10-15 g/dl Possible protein malnutrition: <10 g/dl
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


19. What is Enteral Nutrition based on?


20. What are the Carb and Protein Parenteral Nutrition Solutions?
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
Diet hx of low plant food intake
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
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


21. Predicted excessive energy intake
Reports or observations of energy intake more than needs - Lower physical activity - Planned change in mobility/physical activity - Meds increasing appetite - Knowledge deficit
Ketone breath - Diet hx low CHO - Dx: liver - pancreas - celiac's disease
High chol - amylase/lipase - liver function tests - Diet hx high fat
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


22. What is the assessment of nutritional risk approach? (abcd)
Kcal count -24 hr recall -Food records
A- Anthropometric approach B- Biochemical Tests C- Clinical Observations D- Diet Evaluations (Kcal - 24 hr recall etc)
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


23. Excessive or inappropriate protein intake
High AST/GGT - Blood ETOH - diet hx of > 2 drinks/day - liver dx
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
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 BUN - Low GFR - Poor growth - Deranged AA ratios - diet hx high PRO or AA supplement


24. What are the confirmations of tube placement?
High serum vit. A -D -K - B6 - niacin - Physical signs of excess - Diet hx
CHO 55-60% - protein 10-20% - lipid <30% - fiber 20-35 grams - Evaluate glucose levels - serum lipids - kcalories - diet - insulin/medication
Before Putting anything in - Radiography - pH of aspirated fluids - Air injection and ausculation - Visual assessment of aspiration
Provides essential nutrients in blenderized form - Clients who are unable to chew or swallow - Can be used long-term


25. What are some tube-feeding complications?
Pureed - Mechanically altered - Advanced
GI problems - Diarrhea - Nausea and vomiting - Cramping - Distention - Constipation - Mechanical complications - Tube displacement - Tube obstruction - Pulmonary aspiration - Mucosal damage
Inadequate Intake
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


26. Inadequate energy intake
Allows body to heal -To prepare diagnostic test -To prepare Surgical Procedure
Low cholesterol - Weight loss - Poor dentition - Self-feeding problems - Inadequate nutrition support
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 status and trends - BUN - creatinine - serum chemistries - proteins - Fluid status - intake and output


27. What is Enteral Nutrition? Why preferred over Parenteral Nutrition?
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
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
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
Diet hx of low plant food intake


28. Excessive energy intake
Socioeconomic status -comorbid disease states -Age adults: =< 75 children<5 PHYSICAL -stress and trauma- metabolic demands -mechanical ventilation-unable to eat -therapeutic bowel rest
Inadequate Intake
Elevated BUN:creatinine ratio - Hyperglycemia - Hypercapnia - Elevated liver enzymes - Weight gain - Edema - Meds that reduce energy requirements or impair metabolism
Weight gain - Diet hx of energy dense food intake


29. Inconsistent carbohydrate intake
High/low BGL - Meds - Insulin use -
Food items that minimize elimination patterns by reducing fecal volume - Restricted - High fiber foods - Milk and milk products - Fried foods - Pepper - Alcohol - Heavy seasonings
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
Diet hx of high intake - Diarrhea - Constipation - GI distress


30. Imbalance of nutrients
High AST/GGT - Blood ETOH - diet hx of > 2 drinks/day - liver dx
Diet hx of low fiber intake - Constipation/low stool volume
Poor nutrition prevents or delays recovery from injury.
Diet hx of high intake - Diarrhea - Constipation - GI distress


31. Inadequate carbohydrate intake


32. Inadequate fluid intake
Low serum mineral levels - Physical signs of deficiency - Diet hx of low intake - Celiac disease - SBS - IBD
High BUN - High serum osmolality - High Na - Weight loss - Thirst
Anthropometric data -Clinical data -Dietary intake assessment
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


33. Excessive oral food/beverage intake
High BGL - Weight gain - High Hgb A1C - diet hx of energy dense food intake - Excess eating away from home
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
Inadequate Intake
Diet hx of high intake - Diarrhea - Constipation - GI distress


34. Excessive parenteral nutrition infusion
Diet hx of low intake
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
Elevated BUN:creatinine ratio - Hyperglycemia - Hypercapnia - Elevated liver enzymes - Weight gain - Edema - Meds that reduce energy requirements or impair metabolism
Before Putting anything in - Radiography - pH of aspirated fluids - Air injection and ausculation - Visual assessment of aspiration


35. What is the Parenteral Nutrition?
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
Technical complications - Pneumothorax - Septic complications - Local or systemic - Metabolic complications - Most common complication - Most common is hyperglycemia
Method of feeding clients who do not have a functioning GI tract - Clinical disease (malabsorption) - surgical intervention - trauma/stress - malignancies - Energy and nutrients provided intravenously - Total parenteral nutrition (TPN) - Infused into


36. What is Primary Nutrition Risk?
Inadequate Intake
High chol - amylase/lipase - liver function tests - Diet hx high fat
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
Abnormal liver function tests - Abnormal levels of nutrient - Weight gain or weight loss - Edema - Nausea - Intolerance


37. Increased nutrient needs


38. Excessive fluid intake
CHO 55-60% - protein 10-20% - lipid <30% - fiber 20-35 grams - Evaluate glucose levels - serum lipids - kcalories - diet - insulin/medication
Abnormal liver enzymes - Fatty liver - Weight gain/loss - Edema
Low serum osmolality - Weight gain - Edema - Excess salt intake
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


39. What is the other biochemical analysis and values?
14 days of admission
Diet hx of aberrant CHO intake - Steroids - DM - Inborn errors
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
Technical complications - Pneumothorax - Septic complications - Local or systemic - Metabolic complications - Most common complication - Most common is hyperglycemia


40. Excessive carbohydrate intake
Diet hx of low plant food intake
Diet hx of aberrant CHO intake - Steroids - DM - Inborn errors
Abnormal liver function tests - Abnormal levels of nutrient - Weight gain or weight loss - Edema - Nausea - Intolerance
Diet hx of xs fiber intake - GI distress


41. What is Pureed Diet?
Poor nutrition prevents or delays recovery from injury.
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
Indirect calorimetry measurement - Vitamin/mineral abnormalities in lab values - Inadequate weight gain - or unintentional weight loss Clinical evidence of vitamin/mineral deficiency
Provides essential nutrients in blenderized form - Clients who are unable to chew or swallow - Can be used long-term


42. What else do you check with biochemical tests?
Anthropometric data -Clinical data -Dietary intake assessment
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
Food items that minimize elimination patterns by reducing fecal volume - Restricted - High fiber foods - Milk and milk products - Fried foods - Pepper - Alcohol - Heavy seasonings
Method of feeding clients who do not have a functioning GI tract - Clinical disease (malabsorption) - surgical intervention - trauma/stress - malignancies - Energy and nutrients provided intravenously - Total parenteral nutrition (TPN) - Infused into


43. What are the Anthropometric measures?
Height/length -Weight -BMI -Body Measures (skin fold thickness)
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
Underweight-bmi<18.5 normal- 18.5-24.9 overweight-25.0-29.9 obese- bmi>30
Potential to become malnourished


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


45. Less than optimal enteral nutrition
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/low BGL - Meds (steroids) - Diet hx
Diet hx of low intake
Abnormal liver enzymes - Fatty liver - Weight gain/loss - Edema


46. How long should Nutritional screenings be done to residents being admitted?
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
Indirect calorimetry measurement - Vitamin/mineral abnormalities in lab values - Inadequate weight gain - or unintentional weight loss Clinical evidence of vitamin/mineral deficiency
14 days of admission
High BUN - Low GFR - Poor growth - Deranged AA ratios - diet hx high PRO or AA supplement


47. Excessive alcohol intake
High AST/GGT - Blood ETOH - diet hx of > 2 drinks/day - liver dx
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
Indirect calorimetry measurement - Vitamin/mineral abnormalities in lab values - Inadequate weight gain - or unintentional weight loss Clinical evidence of vitamin/mineral deficiency
Weight gain - Diet hx of energy dense food intake


48. Why is it important to know primary/secondary nutritional risk?
High BUN - High serum osmolality - High Na - Weight loss - Thirst
Poor nutrition prevents or delays recovery from injury.
Abnormal liver enzymes - Fatty liver - Weight gain/loss - Edema
GI problems - Diarrhea - Nausea and vomiting - Cramping - Distention - Constipation - Mechanical complications - Tube displacement - Tube obstruction - Pulmonary aspiration - Mucosal damage


49. What is Clear Liquid Diet?
Elevated BUN:creatinine ratio - Hyperglycemia - Hypercapnia - Elevated liver enzymes - Weight gain - Edema - Meds that reduce energy requirements or impair metabolism
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
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
Diet hx of low intake


50. What is the short-term nutritional biochemical analysis? What are the values?
Technical complications - Pneumothorax - Septic complications - Local or systemic - Metabolic complications - Most common complication - Most common is hyperglycemia
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
Prealbumin- (visceral protein status) Normal Value: 16-40 g/dl Compromised Protein status: 10-15 g/dl Possible protein malnutrition: <10 g/dl
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