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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.
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. Increased nutrient needs

2. Inadequate enteral nutrition infusion
High BGL - Weight gain - High Hgb A1C - diet hx of energy dense food intake - Excess eating away from home
Low cholesterol - Low Ca - High PTT - Low Cu/Zn/Fe - Weight loss - Dehydration
Anthropometric data -Clinical data -Dietary intake assessment
High chol - PO4 - GFR <90 - High BUN - Edema - Dx: kidney/liver

3. Excessive intake
Underweight-bmi<18.5 normal- 18.5-24.9 overweight-25.0-29.9 obese- bmi>30
High/low BGL - Meds (steroids) - Diet hx
High liver enzymes - Constipation - Diarrhea - CV changes - High intake of supplements/plant foods
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

4. Inadequate fluid intake
High BUN - High serum osmolality - High Na - Weight loss - Thirst
Dry skin - Weight loss - diet hx of low intake - dx: AIDS - TB - AN - sepsis - infection - xs ETOH
Ketone breath - Diet hx low CHO - Dx: liver - pancreas - celiac's disease
Low alb - Low BMI - Weight loss - Poor growth rate - Diet hx low PRO

5. Inadequate parenteral nutrition infusion
Biochemical parameters indicating excessive nutrient intake - Knowledge deficit - Meds affecting appetite - Nutrition in Patient Care
Ketone breath - Diet hx low CHO - Dx: liver - pancreas - celiac's disease
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

6. How do you manage TPN?

7. What is Primary Nutrition Risk?
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
Inadequate Intake
GI problems - Diarrhea - Nausea and vomiting - Cramping - Distention - Constipation - Mechanical complications - Tube displacement - Tube obstruction - Pulmonary aspiration - Mucosal damage
Indirect calorimetry measurement - Vitamin/mineral abnormalities in lab values - Inadequate weight gain - or unintentional weight loss Clinical evidence of vitamin/mineral deficiency

8. What is the other biochemical analysis and values?
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
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
Weight status and trends - BUN - creatinine - serum chemistries - proteins - Fluid status - intake and output
Ketone breath - Diet hx low CHO - Dx: liver - pancreas - celiac's disease

9. What is Regular/General Diet?
Ketone breath - Diet hx low CHO - Dx: liver - pancreas - celiac's disease
Underweight-bmi<18.5 normal- 18.5-24.9 overweight-25.0-29.9 obese- bmi>30
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
High AST/GGT - Blood ETOH - diet hx of > 2 drinks/day - liver dx

10. Excessive fluid intake
Low serum osmolality - Weight gain - Edema - Excess salt intake
Pureed - Mechanically altered - Advanced
Indirect calorimetry measurement - Vitamin/mineral abnormalities in lab values - Inadequate weight gain - or unintentional weight loss Clinical evidence of vitamin/mineral deficiency
Low cholesterol - Low Ca - High PTT - Low Cu/Zn/Fe - Weight loss - Dehydration

11. What is the clinical assessments?
Allows body to heal -To prepare diagnostic test -To prepare Surgical Procedure
Socioeconomic status -comorbid disease states -Age adults: =< 75 children<5 PHYSICAL -stress and trauma- metabolic demands -mechanical ventilation-unable to eat -therapeutic bowel rest
Diet hx of low intake
High/low BGL - Meds - Insulin use -

12. What is the short-term nutritional biochemical analysis? What are the values?
Prealbumin- (visceral protein status) Normal Value: 16-40 g/dl Compromised Protein status: 10-15 g/dl Possible protein malnutrition: <10 g/dl
High chol - PO4 - GFR <90 - High BUN - Edema - Dx: kidney/liver
Pureed - Mechanically altered - Advanced
Ketone breath - Diet hx low CHO - Dx: liver - pancreas - celiac's disease

13. What is the long-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
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
High chol - PO4 - GFR <90 - High BUN - Edema - Dx: kidney/liver

14. What is Fat-Controlled Diet?
Assessment - Residuals - Weight - Lung sounds - Edema - I & O - Blood glucose monitoring - Blood chemistry
A- Anthropometric approach B- Biochemical Tests C- Clinical Observations D- Diet Evaluations (Kcal - 24 hr recall etc)
Dry skin - Weight loss - diet hx of low intake - dx: AIDS - TB - AN - sepsis - infection - xs ETOH
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. What is Carb-controlled Diet?
Caused by disease
CHO 55-60% - protein 10-20% - lipid <30% - fiber 20-35 grams - Evaluate glucose levels - serum lipids - kcalories - diet - insulin/medication
High/low BGL - Meds (steroids) - Diet hx
Before Putting anything in - Radiography - pH of aspirated fluids - Air injection and ausculation - Visual assessment of aspiration

16. Decreased nutrient needs
High BUN - High serum osmolality - High Na - Weight loss - Thirst
High chol - PO4 - GFR <90 - High BUN - Edema - Dx: kidney/liver
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
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

17. What is Clear Liquid Diet?
Ketone breath - Diet hx low CHO - Dx: liver - pancreas - celiac's disease
Low cholesterol - Low Ca - High PTT - Low Cu/Zn/Fe - Weight loss - Dehydration
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
Abnormal liver function tests - Abnormal levels of nutrient - Weight gain or weight loss - Edema - Nausea - Intolerance

18. What are the confirmations of tube placement?
Dry skin - Weight loss - diet hx of low intake - dx: AIDS - TB - AN - sepsis - infection - xs ETOH
Before Putting anything in - Radiography - pH of aspirated fluids - Air injection and ausculation - Visual assessment of aspiration
A- Anthropometric approach B- Biochemical Tests C- Clinical Observations D- Diet Evaluations (Kcal - 24 hr recall etc)
Weight gain - Diet hx of energy dense food intake

19. Excessive parenteral nutrition infusion
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
Elevated BUN:creatinine ratio - Hyperglycemia - Hypercapnia - Elevated liver enzymes - Weight gain - Edema - Meds that reduce energy requirements or impair metabolism
Allows body to heal -To prepare diagnostic test -To prepare Surgical Procedure

20. What else do you check with biochemical tests?
Anthropometric data -Clinical data -Dietary intake assessment
High BGL - Weight gain - High Hgb A1C - diet hx of energy dense food intake - Excess eating away from home
High BUN - High serum osmolality - High Na - Weight loss - Thirst
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

21. Inadequate oral food/ beverage 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
Dry skin - Weight loss - diet hx of low intake - dx: AIDS - TB - AN - sepsis - infection - xs ETOH
Assessment - Residuals - Weight - Lung sounds - Edema - I & O - Blood glucose monitoring - Blood chemistry
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

22. What are the assessments for Enteral Feedings?
Low alb - Low BMI - Weight loss - Poor growth rate - Diet hx low PRO
CHO 55-60% - protein 10-20% - lipid <30% - fiber 20-35 grams - Evaluate glucose levels - serum lipids - kcalories - diet - insulin/medication
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
Assessment - Residuals - Weight - Lung sounds - Edema - I & O - Blood glucose monitoring - Blood chemistry

23. What are the Dietary Evaluations?
Diet hx of xs fiber intake - GI distress
Kcal count -24 hr recall -Food records
Low cholesterol - Low Ca - High PTT - Low Cu/Zn/Fe - Weight loss - Dehydration
High AST/GGT - Blood ETOH - diet hx of > 2 drinks/day - liver dx

24. Excessive or inappropriate fat intake
High AST/GGT - Blood ETOH - diet hx of > 2 drinks/day - liver dx
High BGL - Weight gain - High Hgb A1C - diet hx of energy dense food intake - Excess eating away from home
High chol - amylase/lipase - liver function tests - Diet hx high fat
Low serum vitamin levels - Physical signs of deficiency - Diet hx of low intake

25. 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
Diet hx of low plant food intake
High/low BGL - Meds - Insulin use -
Weight gain - Diet hx of energy dense food intake

26. Inadequate fiber 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
High BGL - Weight gain - High Hgb A1C - diet hx of energy dense food intake - Excess eating away from home
Diet hx of low fiber intake - Constipation/low stool volume
Height/length -Weight -BMI -Body Measures (skin fold thickness)

27. What are some other Restricted Diets?

28. How do you feed patients with Dysphagia?
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
Indirect calorimetry measurement - Vitamin/mineral abnormalities in lab values - Inadequate weight gain - or unintentional weight loss Clinical evidence of vitamin/mineral deficiency
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
TJC requires screenings within 48hrs

29. Excessive enteral nutrition infusion
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
High BUN - High BGL - High liver enzymes - Weight gain - Edema
High/low BGL - Meds - Insulin use -

30. Why are dietary adjustments sometimes necessary?
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
High/low BGL - Meds - Insulin use -
Diet hx of high intake - Diarrhea - Constipation - GI distress
Allows body to heal -To prepare diagnostic test -To prepare Surgical Procedure

31. How do you monitor response for enteral treatment?
Underweight-bmi<18.5 normal- 18.5-24.9 overweight-25.0-29.9 obese- bmi>30
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
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

32. How long should Nutritional screenings be done to residents being admitted?
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
Low serum osmolality - Weight gain - Edema - Excess salt intake
Underweight-bmi<18.5 normal- 18.5-24.9 overweight-25.0-29.9 obese- bmi>30
14 days of admission

33. What are the complications of Parenteral Nutrition?
Technical complications - Pneumothorax - Septic complications - Local or systemic - Metabolic complications - Most common complication - Most common is hyperglycemia
A- Anthropometric approach B- Biochemical Tests C- Clinical Observations D- Diet Evaluations (Kcal - 24 hr recall etc)
Food items that minimize elimination patterns by reducing fecal volume - Restricted - High fiber foods - Milk and milk products - Fried foods - Pepper - Alcohol - Heavy seasonings
High chol - PO4 - GFR <90 - High BUN - Edema - Dx: kidney/liver

34. Why is it important to know primary/secondary nutritional risk?
Weight status and trends - BUN - creatinine - serum chemistries - proteins - Fluid status - intake and output
Provides essential nutrients in blenderized form - Clients who are unable to chew or swallow - Can be used long-term
Poor nutrition prevents or delays recovery from injury.
Dry skin - Weight loss - diet hx of low intake - dx: AIDS - TB - AN - sepsis - infection - xs ETOH

35. Less than optimal enteral nutrition
Potential to become malnourished
Weight loss (5% in 1 month; 10% in 6 months) - Increased activity - dx: Parkinsons - cerebral palsy - dementia
Abnormal liver enzymes - Fatty liver - Weight gain/loss - Edema
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

36. Inadequate mineral intake
Low serum vitamin levels - Physical signs of deficiency - Diet hx of low intake
Low serum mineral levels - Physical signs of deficiency - Diet hx of low intake - Celiac disease - SBS - IBD
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
Prealbumin- (visceral protein status) Normal Value: 16-40 g/dl Compromised Protein status: 10-15 g/dl Possible protein malnutrition: <10 g/dl

37. What is Pureed Diet?
Provides essential nutrients in blenderized form - Clients who are unable to chew or swallow - Can be used long-term
Diet hx of low fiber intake - Constipation/low stool volume
Low serum mineral levels - Physical signs of deficiency - Diet hx of low intake - Celiac disease - SBS - IBD
Anthropometric data -Clinical data -Dietary intake assessment

38. Excessive alcohol intake
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
>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
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

39. Excessive vitamin intake
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
Diet hx of xs fiber intake - GI distress
High serum vit. A -D -K - B6 - niacin - Physical signs of excess - Diet hx
14 days of admission

40. Inconsistent carbohydrate intake
High/low BGL - Meds - Insulin use -
14 days of admission
High BUN - Low GFR - Poor growth - Deranged AA ratios - diet hx high PRO or AA supplement
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

41. What are the Anthropometric measures?
Anthropometric data -Clinical data -Dietary intake assessment
Height/length -Weight -BMI -Body Measures (skin fold thickness)
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
GI problems - Diarrhea - Nausea and vomiting - Cramping - Distention - Constipation - Mechanical complications - Tube displacement - Tube obstruction - Pulmonary aspiration - Mucosal damage

42. What is the assessment of nutritional risk approach? (abcd)
Low chol - alb - prealb - elytes/minerals - vitamins - Weight loss - Low BMI - Diet hx of low intake - fever - dx: Crohn's - AIDS - burns
Kcal count -24 hr recall -Food records
Low serum mineral levels - Physical signs of deficiency - Diet hx of low intake - Celiac disease - SBS - IBD
A- Anthropometric approach B- Biochemical Tests C- Clinical Observations D- Diet Evaluations (Kcal - 24 hr recall etc)

43. What is Secondary Nutrition Risk?
Provides essential nutrients in blenderized form - Clients who are unable to chew or swallow - Can be used long-term
Caused by disease
Reports or observations of energy intake more than needs - Lower physical activity - Planned change in mobility/physical activity - Meds increasing appetite - Knowledge deficit
Poor nutrition prevents or delays recovery from injury.

44. What is Protein-Controlled Diet?
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
Weight loss (5% in 1 month; 10% in 6 months) - Increased activity - dx: Parkinsons - cerebral palsy - dementia
Potential to become malnourished
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

45. Inadequate fat intake
Weight Loss - dx: AIDS - TB - AN
Dry skin - Weight loss - diet hx of low intake - dx: AIDS - TB - AN - sepsis - infection - xs ETOH
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
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

46. What are the 3 levels of Dysphagia?
Pureed - Mechanically altered - Advanced
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
GI problems - Diarrhea - Nausea and vomiting - Cramping - Distention - Constipation - Mechanical complications - Tube displacement - Tube obstruction - Pulmonary aspiration - Mucosal damage

47. Excessive or inappropriate protein intake
Dry skin - Weight loss - diet hx of low intake - dx: AIDS - TB - AN - sepsis - infection - xs ETOH
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
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 BUN - Low GFR - Poor growth - Deranged AA ratios - diet hx high PRO or AA supplement

48. Symptoms of Intakes - Increased energy expenditure
Poor nutrition prevents or delays recovery from injury.
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
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 (5% in 1 month; 10% in 6 months) - Increased activity - dx: Parkinsons - cerebral palsy - dementia

49. What are Dysphagia 'warning signs'?
Abnormal liver enzymes - Fatty liver - Weight gain/loss - Edema
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
High BUN - High serum osmolality - High Na - Weight loss - Thirst
Underweight-bmi<18.5 normal- 18.5-24.9 overweight-25.0-29.9 obese- bmi>30

50. What is Nutritional risk?
Potential to become malnourished
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
Prealbumin- (visceral protein status) Normal Value: 16-40 g/dl Compromised Protein status: 10-15 g/dl Possible protein malnutrition: <10 g/dl
Diet hx of low fiber intake - Constipation/low stool volume