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Nutrition Diagnosis

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

Instructions:

Answer 50 questions in 15 minutes.
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Match each statement with the correct term.
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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 Nutritional risk?
Potential to become malnourished
High AST/GGT - Blood ETOH - diet hx of > 2 drinks/day - liver dx
Prealbumin- (visceral protein status) Normal Value: 16-40 g/dl Compromised Protein status: 10-15 g/dl Possible protein malnutrition: <10 g/dl
Low serum vitamin levels - Physical signs of deficiency - Diet hx of low intake

2. 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
Abnormal liver function tests - Abnormal levels of nutrient - Weight gain or weight loss - Edema - Nausea - Intolerance
Low serum vitamin levels - Physical signs of deficiency - Diet hx of low intake
Diet hx of aberrant CHO intake - Steroids - DM - Inborn errors

3. Inadequate oral food/ beverage intake
Anthropometric data -Clinical data -Dietary intake assessment
High/low BGL - Meds (steroids) - Diet hx
Weight Loss - dx: AIDS - TB - AN
Dry skin - Weight loss - diet hx of low intake - dx: AIDS - TB - AN - sepsis - infection - xs ETOH

4. What is Pureed Diet?
Kcal count -24 hr recall -Food records
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 chol - alb - prealb - elytes/minerals - vitamins - Weight loss - Low BMI - Diet hx of low intake - fever - dx: Crohn's - AIDS - burns
Provides essential nutrients in blenderized form - Clients who are unable to chew or swallow - Can be used long-term

5. What are the thickened liquids?
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
High serum vit. A -D -K - B6 - niacin - Physical signs of excess - Diet hx
Low HDL - High TSH - High Mg - High PO4 - Diet hx of xs intake - Liver damage - GI distress
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

6. Inadequate fat intake
Indirect calorimetry measurement - Vitamin/mineral abnormalities in lab values - Inadequate weight gain - or unintentional weight loss Clinical evidence of vitamin/mineral deficiency
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
Weight Loss - dx: AIDS - TB - AN
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

7. Excessive parenteral nutrition infusion
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
Elevated BUN:creatinine ratio - Hyperglycemia - Hypercapnia - Elevated liver enzymes - Weight gain - Edema - Meds that reduce energy requirements or impair metabolism
Low serum osmolality - Weight gain - Edema - Excess salt 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

8. What is the classifications of BMI and numbers?
Height/length -Weight -BMI -Body Measures (skin fold thickness)
Elevated BUN:creatinine ratio - Hyperglycemia - Hypercapnia - Elevated liver enzymes - Weight gain - Edema - Meds that reduce energy requirements or impair metabolism
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
Underweight-bmi<18.5 normal- 18.5-24.9 overweight-25.0-29.9 obese- bmi>30

9. Excessive oral food/beverage intake
Height/length -Weight -BMI -Body Measures (skin fold thickness)
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 BGL - Weight gain - High Hgb A1C - diet hx of energy dense food intake - Excess eating away from home
CHO 55-60% - protein 10-20% - lipid <30% - fiber 20-35 grams - Evaluate glucose levels - serum lipids - kcalories - diet - insulin/medication

10. Why is it important to know primary/secondary nutritional risk?
High/low BGL - Meds - Insulin use -
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
Serum Albumin- (visceral protein status) Normal Value: 3.5-5 g/dl 2.8-3.5- compromised protein status <2.4- possible protein malnutrition
Poor nutrition prevents or delays recovery from injury.

11. What is Secondary Nutrition Risk?
Socioeconomic status -comorbid disease states -Age adults: =< 75 children<5 PHYSICAL -stress and trauma- metabolic demands -mechanical ventilation-unable to eat -therapeutic bowel rest
Caused by disease
Assessment - Residuals - Weight - Lung sounds - Edema - I & O - Blood glucose monitoring - Blood chemistry
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

12. Why are dietary adjustments sometimes necessary?
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
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
Allows body to heal -To prepare diagnostic test -To prepare Surgical Procedure
Potential to become malnourished

13. What are the IV lipid emulsions for Parenteral Nutriton Solution?
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
Elevated BUN:creatinine ratio - Hyperglycemia - Hypercapnia - Elevated liver enzymes - Weight gain - Edema - Meds that reduce energy requirements or impair metabolism
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

14. Excessive energy intake
Weight Loss - dx: AIDS - TB - AN
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 gain - Diet hx of energy dense food intake
Anthropometric data -Clinical data -Dietary intake assessment

15. How long does TJC require resident screenings to be done during admission?
Low alb - Low BMI - Weight loss - Poor growth rate - Diet hx low PRO
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
TJC requires screenings within 48hrs
GI problems - Diarrhea - Nausea and vomiting - Cramping - Distention - Constipation - Mechanical complications - Tube displacement - Tube obstruction - Pulmonary aspiration - Mucosal damage

16. Inconsistent carbohydrate intake
Caused by disease
High AST/GGT - Blood ETOH - diet hx of > 2 drinks/day - liver dx
High/low BGL - Meds - Insulin use -
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

17. Inadequate enteral nutrition infusion
Technical complications - Pneumothorax - Septic complications - Local or systemic - Metabolic complications - Most common complication - Most common is hyperglycemia
Elevated BUN:creatinine ratio - Hyperglycemia - Hypercapnia - Elevated liver enzymes - Weight gain - Edema - Meds that reduce energy requirements or impair metabolism
Low cholesterol - Low Ca - High PTT - Low Cu/Zn/Fe - Weight loss - Dehydration
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

18. What are some swallowing aids?
Caused by disease
Poor nutrition prevents or delays recovery from injury.
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
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

19. Inadequate fiber intake
Diet hx of low fiber intake - Constipation/low stool volume
Low alb - Low BMI - Weight loss - Poor growth rate - Diet hx low PRO
Kcal count -24 hr recall -Food records
Weight status and trends - BUN - creatinine - serum chemistries - proteins - Fluid status - intake and output

20. Inadequate vitamin 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
Low serum vitamin levels - Physical signs of deficiency - Diet hx of low intake
Reports or observations of energy intake more than needs - Lower physical activity - Planned change in mobility/physical activity - Meds increasing appetite - Knowledge deficit
CHO 55-60% - protein 10-20% - lipid <30% - fiber 20-35 grams - Evaluate glucose levels - serum lipids - kcalories - diet - insulin/medication

21. 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
CHO 55-60% - protein 10-20% - lipid <30% - fiber 20-35 grams - Evaluate glucose levels - serum lipids - kcalories - diet - insulin/medication
Socioeconomic status -comorbid disease states -Age adults: =< 75 children<5 PHYSICAL -stress and trauma- metabolic demands -mechanical ventilation-unable to eat -therapeutic bowel rest

22. What are Dysphagia 'warning signs'?
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
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
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
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

23. Inadequate parenteral nutrition infusion
Biochemical parameters indicating excessive nutrient intake - Knowledge deficit - Meds affecting appetite - Nutrition in Patient Care
Diet hx of low fiber intake - Constipation/low stool volume
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

24. What are the assessments for Enteral Feedings?
Weight status and trends - BUN - creatinine - serum chemistries - proteins - Fluid status - intake and output
Assessment - Residuals - Weight - Lung sounds - Edema - I & O - Blood glucose monitoring - Blood chemistry
Provides essential nutrients in blenderized form - Clients who are unable to chew or swallow - Can be used long-term
Low cholesterol - Low Ca - High PTT - Low Cu/Zn/Fe - Weight loss - Dehydration

25. Inadequate protein-energy intake
Dry skin - Weight loss - diet hx of low intake - dx: AIDS - TB - AN - sepsis - infection - xs ETOH
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
Poor nutrition prevents or delays recovery from injury.
Low alb - Low BMI - Weight loss - Poor growth rate - Diet hx low PRO

26. Inadequate energy intake
Serum Albumin- (visceral protein status) Normal Value: 3.5-5 g/dl 2.8-3.5- compromised protein status <2.4- possible protein malnutrition
Diet hx of high intake - Diarrhea - Constipation - GI distress
Low cholesterol - Weight loss - Poor dentition - Self-feeding problems - Inadequate nutrition support
Dry skin - Weight loss - diet hx of low intake - dx: AIDS - TB - AN - sepsis - infection - xs ETOH

27. What are the Dietary Evaluations?
GI problems - Diarrhea - Nausea and vomiting - Cramping - Distention - Constipation - Mechanical complications - Tube displacement - Tube obstruction - Pulmonary aspiration - Mucosal damage
Weight status and trends - BUN - creatinine - serum chemistries - proteins - Fluid status - intake and output
Kcal count -24 hr recall -Food records
Underweight-bmi<18.5 normal- 18.5-24.9 overweight-25.0-29.9 obese- bmi>30

28. How long should Nutritional screenings be done to residents being admitted?
14 days of admission
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
Provides essential nutrients in blenderized form - Clients who are unable to chew or swallow - Can be used long-term
Biochemical parameters indicating suboptimal nutrient intake - Estimated intake less than needs - Cultural or religious practices - Knowledge deficit - Meds affecting appetite

29. What are some other Restricted Diets?

30. What is 'Diet as Tolerated'?

31. Excessive vitamin intake
Abnormal liver function tests - Abnormal levels of nutrient - Weight gain or weight loss - Edema - Nausea - Intolerance
High serum vit. A -D -K - B6 - niacin - Physical signs of excess - Diet hx
High chol - amylase/lipase - liver function tests - Diet hx high fat
Low chol - alb - prealb - elytes/minerals - vitamins - Weight loss - Low BMI - Diet hx of low intake - fever - dx: Crohn's - AIDS - burns

32. What are the Carb and Protein Parenteral Nutrition Solutions?
High chol - amylase/lipase - liver function tests - Diet hx high fat
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 serum vit. A -D -K - B6 - niacin - Physical signs of excess - Diet hx
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

33. What is Fat-Controlled Diet?
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
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
TJC requires screenings within 48hrs
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

34. How do you manage TPN?

35. What is Enteral Nutrition based on?

36. Inadequate carbohydrate intake

37. Less than optimal enteral nutrition
Low cholesterol - Low Ca - High PTT - Low Cu/Zn/Fe - Weight loss - Dehydration
Inadequate Intake
Abnormal liver enzymes - Fatty liver - Weight gain/loss - Edema
Elevated BUN:creatinine ratio - Hyperglycemia - Hypercapnia - Elevated liver enzymes - Weight gain - Edema - Meds that reduce energy requirements or impair metabolism

38. How do you monitor response for enteral treatment?
Weight gain - Diet hx of energy dense food intake
Low cholesterol - Low Ca - High PTT - Low Cu/Zn/Fe - Weight loss - Dehydration
Weight status and trends - BUN - creatinine - serum chemistries - proteins - Fluid status - intake and output
Diet hx of low plant food intake

39. What is Primary Nutrition Risk?
Low alb - Low BMI - Weight loss - Poor growth rate - Diet hx low PRO
Inadequate Intake
Elevated BUN:creatinine ratio - Hyperglycemia - Hypercapnia - Elevated liver enzymes - Weight gain - Edema - Meds that reduce energy requirements or impair metabolism
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

40. What is Mechanically Altered Diet?

41. Excessive intake
Diet hx of low fiber intake - Constipation/low stool volume
Reports or observations of energy intake more than needs - Lower physical activity - Planned change in mobility/physical activity - Meds increasing appetite - Knowledge deficit
High liver enzymes - Constipation - Diarrhea - CV changes - High intake of supplements/plant foods
Allows body to heal -To prepare diagnostic test -To prepare Surgical Procedure

42. What is Enteral Nutrition? Why preferred over Parenteral Nutrition?
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
Dry skin - Weight loss - diet hx of low intake - dx: AIDS - TB - AN - sepsis - infection - xs ETOH
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 aberrant CHO intake - Steroids - DM - Inborn errors

43. Decreased nutrient needs
Abnormal liver enzymes - Fatty liver - Weight gain/loss - Edema
High chol - PO4 - GFR <90 - High BUN - Edema - Dx: kidney/liver
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
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

44. Inadequate intake
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
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
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

45. Less than optimal parenteral infusion
Low HDL - High TSH - High Mg - High PO4 - Diet hx of xs intake - Liver damage - GI distress
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 serum vit. A -D -K - B6 - niacin - Physical signs of excess - Diet hx
Abnormal liver function tests - Abnormal levels of nutrient - Weight gain or weight loss - Edema - Nausea - Intolerance

46. What are some tube-feeding complications?
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
14 days of admission
GI problems - Diarrhea - Nausea and vomiting - Cramping - Distention - Constipation - Mechanical complications - Tube displacement - Tube obstruction - Pulmonary aspiration - Mucosal damage
Elevated BUN:creatinine ratio - Hyperglycemia - Hypercapnia - Elevated liver enzymes - Weight gain - Edema - Meds that reduce energy requirements or impair metabolism

47. What are the Anthropometric measures?
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
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
Height/length -Weight -BMI -Body Measures (skin fold thickness)
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

48. Imbalance of nutrients
High BUN - Low GFR - Poor growth - Deranged AA ratios - diet hx high PRO or AA supplement
Pureed - Mechanically altered - Advanced
Diet hx of high intake - Diarrhea - Constipation - GI distress
Underweight-bmi<18.5 normal- 18.5-24.9 overweight-25.0-29.9 obese- bmi>30

49. What is the Parenteral Nutrition?
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
Low serum mineral levels - Physical signs of deficiency - Diet hx of low intake - Celiac disease - SBS - IBD
Potential to become malnourished
Prealbumin- (visceral protein status) Normal Value: 16-40 g/dl Compromised Protein status: 10-15 g/dl Possible protein malnutrition: <10 g/dl

50. What are the complications of Parenteral Nutrition?
>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
Before Putting anything in - Radiography - pH of aspirated fluids - Air injection and ausculation - Visual assessment of aspiration
Diet hx of low intake
Technical complications - Pneumothorax - Septic complications - Local or systemic - Metabolic complications - Most common complication - Most common is hyperglycemia