Nutrition Diagnosis

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• 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

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2. Predicted suboptimal energy intake
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
Low serum mineral levels - Physical signs of deficiency - Diet hx of low intake - Celiac disease - SBS - IBD
Ketone breath - Diet hx low CHO - Dx: liver - pancreas - celiac's disease
Before Putting anything in - Radiography - pH of aspirated fluids - Air injection and ausculation - Visual assessment of aspiration


3. What are the Carb and Protein Parenteral Nutrition Solutions?
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
A- Anthropometric approach B- Biochemical Tests C- Clinical Observations D- Diet Evaluations (Kcal - 24 hr recall etc)


4. Excessive intake
Caused by disease
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 -
High liver enzymes - Constipation - Diarrhea - CV changes - High intake of supplements/plant foods


5. What is Low-Residue Diet?
Allows body to heal -To prepare diagnostic test -To prepare Surgical Procedure
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 serum vitamin levels - Physical signs of deficiency - Diet hx of low intake
Biochemical parameters indicating suboptimal nutrient intake - Estimated intake less than needs - Cultural or religious practices - Knowledge deficit - Meds affecting appetite


6. Inadequate fluid intake
High BUN - High serum osmolality - High Na - Weight loss - Thirst
Provides essential nutrients in blenderized form - Clients who are unable to chew or swallow - Can be used long-term
Caused by disease
Low chol - alb - prealb - elytes/minerals - vitamins - Weight loss - Low BMI - Diet hx of low intake - fever - dx: Crohn's - AIDS - burns


7. Excessive carbohydrate intake
High serum vit. A -D -K - B6 - niacin - Physical signs of excess - Diet hx
Kcal count -24 hr recall -Food records
Biochemical parameters indicating suboptimal nutrient intake - Estimated intake less than needs - Cultural or religious practices - Knowledge deficit - Meds affecting appetite
Diet hx of aberrant CHO intake - Steroids - DM - Inborn errors


8. Excessive fiber intake
High BUN - Low GFR - Poor growth - Deranged AA ratios - diet hx high PRO or AA supplement
Weight status and trends - BUN - creatinine - serum chemistries - proteins - Fluid status - intake and output
Diet hx of xs fiber intake - GI distress
Underweight-bmi<18.5 normal- 18.5-24.9 overweight-25.0-29.9 obese- bmi>30


9. How do you feed patients with Dysphagia?
Low cholesterol - Weight loss - Poor dentition - Self-feeding problems - Inadequate nutrition support
Pureed - Mechanically altered - Advanced
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
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


10. How long should Nutritional screenings be done to residents being admitted?
Diet hx of aberrant CHO intake - Steroids - DM - Inborn errors
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
14 days of admission
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


11. What are the confirmations of tube placement?
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
Before Putting anything in - Radiography - pH of aspirated fluids - Air injection and ausculation - Visual assessment of aspiration
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


12. What is Mechanically Altered Diet?

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13. What is the Parenteral Nutrition?
High chol - PO4 - GFR <90 - High BUN - Edema - Dx: kidney/liver
Low cholesterol - Low Ca - High PTT - Low Cu/Zn/Fe - Weight loss - Dehydration
Weight Loss - dx: AIDS - TB - AN
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


14. What are the 3 levels of Dysphagia?
High liver enzymes - Constipation - Diarrhea - CV changes - High intake of supplements/plant foods
Pureed - Mechanically altered - Advanced
Diet hx of high intake - Diarrhea - Constipation - GI distress
Low HDL - High TSH - High Mg - High PO4 - Diet hx of xs intake - Liver damage - GI distress


15. What are some other Restricted Diets?

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16. What are the complications of Parenteral Nutrition?
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
Socioeconomic status -comorbid disease states -Age adults: =< 75 children<5 PHYSICAL -stress and trauma- metabolic demands -mechanical ventilation-unable to eat -therapeutic bowel rest
Technical complications - Pneumothorax - Septic complications - Local or systemic - Metabolic complications - Most common complication - Most common is hyperglycemia
Low serum vitamin levels - Physical signs of deficiency - Diet hx of low intake


17. What are some tube-feeding complications?
Socioeconomic status -comorbid disease states -Age adults: =< 75 children<5 PHYSICAL -stress and trauma- metabolic demands -mechanical ventilation-unable to eat -therapeutic bowel rest
Low serum vitamin levels - Physical signs of deficiency - Diet hx of low intake
GI problems - Diarrhea - Nausea and vomiting - Cramping - Distention - Constipation - Mechanical complications - Tube displacement - Tube obstruction - Pulmonary aspiration - Mucosal damage
Diet hx of aberrant CHO intake - Steroids - DM - Inborn errors


18. Excessive energy intake
Weight gain - Diet hx of energy dense food intake
Reports or observations of energy intake more than needs - Lower physical activity - Planned change in mobility/physical activity - Meds increasing appetite - Knowledge deficit
Low serum mineral levels - Physical signs of deficiency - Diet hx of low intake - Celiac disease - SBS - IBD
Anthropometric data -Clinical data -Dietary intake assessment


19. What is Secondary Nutrition Risk?
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
Caused by disease
Kcal count -24 hr recall -Food records


20. Why are dietary adjustments sometimes necessary?
Low serum osmolality - Weight gain - Edema - Excess salt intake
Allows body to heal -To prepare diagnostic test -To prepare Surgical Procedure
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
Before Putting anything in - Radiography - pH of aspirated fluids - Air injection and ausculation - Visual assessment of aspiration


21. What else do you check with biochemical tests?
Anthropometric data -Clinical data -Dietary intake assessment
Pureed - Mechanically altered - Advanced
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
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


22. Inadequate fat intake
High BGL - Weight gain - High Hgb A1C - diet hx of energy dense food intake - Excess eating away from home
Weight Loss - dx: AIDS - TB - AN
Diet hx of low fiber intake - Constipation/low stool volume
Low serum osmolality - Weight gain - Edema - Excess salt intake


23. What is the long-term nutritional biochemical analysis? What are the values?
Serum Albumin- (visceral protein status) Normal Value: 3.5-5 g/dl 2.8-3.5- compromised protein status <2.4- possible protein malnutrition
Provides essential nutrients in blenderized form - Clients who are unable to chew or swallow - Can be used long-term
Caused by disease
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


24. Predicted excessive 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
Reports or observations of energy intake more than needs - Lower physical activity - Planned change in mobility/physical activity - Meds increasing appetite - Knowledge deficit
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 cholesterol - Low Ca - High PTT - Low Cu/Zn/Fe - Weight loss - Dehydration


25. Imbalance of nutrients
Before Putting anything in - Radiography - pH of aspirated fluids - Air injection and ausculation - Visual assessment of aspiration
Diet hx of high intake - Diarrhea - Constipation - GI distress
Technical complications - Pneumothorax - Septic complications - Local or systemic - Metabolic complications - Most common complication - Most common is hyperglycemia
High/low BGL - Meds (steroids) - Diet hx


26. What is Fat-Controlled Diet?
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 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 enzymes - Fatty liver - Weight gain/loss - Edema
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


27. Inadequate carbohydrate intake

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28. Excessive parenteral nutrition infusion
Elevated BUN:creatinine ratio - Hyperglycemia - Hypercapnia - Elevated liver enzymes - Weight gain - Edema - Meds that reduce energy requirements or impair metabolism
Socioeconomic status -comorbid disease states -Age adults: =< 75 children<5 PHYSICAL -stress and trauma- metabolic demands -mechanical ventilation-unable to eat -therapeutic bowel rest
Poor nutrition prevents or delays recovery from injury.
Low serum osmolality - Weight gain - Edema - Excess salt intake


29. What is the clinical assessments?
Socioeconomic status -comorbid disease states -Age adults: =< 75 children<5 PHYSICAL -stress and trauma- metabolic demands -mechanical ventilation-unable to eat -therapeutic bowel rest
Weight gain - Diet hx of energy dense food intake
Before Putting anything in - Radiography - pH of aspirated fluids - Air injection and ausculation - Visual assessment of aspiration
Low cholesterol - Low Ca - High PTT - Low Cu/Zn/Fe - Weight loss - Dehydration


30. What is 'Diet as Tolerated'?

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31. What are the Dietary Evaluations?
14 days of admission
Kcal count -24 hr recall -Food records
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 loss (5% in 1 month; 10% in 6 months) - Increased activity - dx: Parkinsons - cerebral palsy - dementia


32. What is the classifications of BMI and numbers?
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
Underweight-bmi<18.5 normal- 18.5-24.9 overweight-25.0-29.9 obese- bmi>30
Diet hx of xs fiber intake - GI distress
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. Inadequate enteral nutrition infusion
Low cholesterol - Low Ca - High PTT - Low Cu/Zn/Fe - Weight loss - Dehydration
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
Low alb - Low BMI - Weight loss - Poor growth rate - Diet hx low PRO


34. Why is it important to know primary/secondary nutritional risk?
Low serum osmolality - Weight gain - Edema - Excess salt intake
High chol - PO4 - GFR <90 - High BUN - Edema - Dx: kidney/liver
Poor nutrition prevents or delays recovery from injury.
TJC requires screenings within 48hrs


35. Inappropriate intake of types of carbohydrates
High/low BGL - Meds (steroids) - Diet hx
Diet hx of aberrant CHO intake - Steroids - DM - Inborn errors
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


36. Excessive alcohol intake
High AST/GGT - Blood ETOH - diet hx of > 2 drinks/day - liver dx
Caused by disease
Before Putting anything in - Radiography - pH of aspirated fluids - Air injection and ausculation - Visual assessment of aspiration
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


37. Less than optimal parenteral infusion
Abnormal liver function tests - Abnormal levels of nutrient - Weight gain or weight loss - Edema - Nausea - Intolerance
Dry skin - Weight loss - diet hx of low intake - dx: AIDS - TB - AN - sepsis - infection - xs ETOH
Height/length -Weight -BMI -Body Measures (skin fold thickness)
Low cholesterol - Weight loss - Poor dentition - Self-feeding problems - Inadequate nutrition support


38. What is Dysphagia Nutritional Therapy?
Biochemical parameters indicating excessive nutrient intake - Knowledge deficit - Meds affecting appetite - Nutrition in Patient Care
Prealbumin- (visceral protein status) Normal Value: 16-40 g/dl Compromised Protein status: 10-15 g/dl Possible protein malnutrition: <10 g/dl
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
Assessment - Residuals - Weight - Lung sounds - Edema - I & O - Blood glucose monitoring - Blood chemistry


39. Inadequate vitamin intake
Diet hx of aberrant CHO intake - Steroids - DM - Inborn errors
Before Putting anything in - Radiography - pH of aspirated fluids - Air injection and ausculation - Visual assessment of aspiration
Low serum vitamin levels - Physical signs of deficiency - Diet hx of low intake
A- Anthropometric approach B- Biochemical Tests C- Clinical Observations D- Diet Evaluations (Kcal - 24 hr recall etc)


40. Decreased nutrient needs
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
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 chol - PO4 - GFR <90 - High BUN - Edema - Dx: kidney/liver
Low cholesterol - Weight loss - Poor dentition - Self-feeding problems - Inadequate nutrition support


41. Inadequate parenteral nutrition infusion
Low alb - Low BMI - Weight loss - Poor growth rate - Diet hx low PRO
High chol - PO4 - GFR <90 - High BUN - Edema - Dx: kidney/liver
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


42. What is Pureed Diet?
Poor nutrition prevents or delays recovery from injury.
Provides essential nutrients in blenderized form - Clients who are unable to chew or swallow - Can be used long-term
Elevated BUN:creatinine ratio - Hyperglycemia - Hypercapnia - Elevated liver enzymes - Weight gain - Edema - Meds that reduce energy requirements or impair metabolism
High/low BGL - Meds - Insulin use -


43. What is the other biochemical analysis and values?
Weight gain - Diet hx of energy dense food intake
Underweight-bmi<18.5 normal- 18.5-24.9 overweight-25.0-29.9 obese- bmi>30
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
Pureed - Mechanically altered - Advanced


44. What is Nutritional risk?
A- Anthropometric approach B- Biochemical Tests C- Clinical Observations D- Diet Evaluations (Kcal - 24 hr recall etc)
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
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
Potential to become malnourished


45. What are the thickened liquids?
High BUN - High serum osmolality - High Na - Weight loss - Thirst
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
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
GI problems - Diarrhea - Nausea and vomiting - Cramping - Distention - Constipation - Mechanical complications - Tube displacement - Tube obstruction - Pulmonary aspiration - Mucosal damage


46. Excessive or inappropriate fat intake
High chol - amylase/lipase - liver function tests - Diet hx high fat
Socioeconomic status -comorbid disease states -Age adults: =< 75 children<5 PHYSICAL -stress and trauma- metabolic demands -mechanical ventilation-unable to eat -therapeutic bowel rest
High BUN - Low GFR - Poor growth - Deranged AA ratios - diet hx high PRO or AA supplement
Pureed - Mechanically altered - Advanced


47. Inadequate oral food/ beverage intake
Allows body to heal -To prepare diagnostic test -To prepare Surgical Procedure
Low alb - Low BMI - Weight loss - Poor growth rate - Diet hx low PRO
Dry skin - Weight loss - diet hx of low intake - dx: AIDS - TB - AN - sepsis - infection - xs ETOH
Low cholesterol - Weight loss - Poor dentition - Self-feeding problems - Inadequate nutrition support


48. Excessive enteral nutrition infusion
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
Biochemical parameters indicating suboptimal nutrient intake - Estimated intake less than needs - Cultural or religious practices - Knowledge deficit - Meds affecting appetite
High/low BGL - Meds - Insulin use -
High BUN - High BGL - High liver enzymes - Weight gain - Edema


49. Inadequate intake
Low cholesterol - Low Ca - High PTT - Low Cu/Zn/Fe - Weight loss - Dehydration
Low alb - Low BMI - Weight loss - Poor growth rate - Diet hx low PRO
Diet hx of low plant food intake
Pureed - Mechanically altered - Advanced


50. What is Carb-controlled Diet?
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
Diet hx of aberrant CHO intake - Steroids - DM - Inborn errors
CHO 55-60% - protein 10-20% - lipid <30% - fiber 20-35 grams - Evaluate glucose levels - serum lipids - kcalories - diet - insulin/medication