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 are the Anthropometric measures?
Height/length -Weight -BMI -Body Measures (skin fold thickness)
Diet hx of low intake
Diet hx of high intake - Diarrhea - Constipation - GI distress
Elevated BUN:creatinine ratio - Hyperglycemia - Hypercapnia - Elevated liver enzymes - Weight gain - Edema - Meds that reduce energy requirements or impair metabolism


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

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3. What is Carb-controlled Diet?
CHO 55-60% - protein 10-20% - lipid <30% - fiber 20-35 grams - Evaluate glucose levels - serum lipids - kcalories - diet - insulin/medication
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 high intake - Diarrhea - Constipation - GI distress
High BGL - Weight gain - High Hgb A1C - diet hx of energy dense food intake - Excess eating away from home


4. Inadequate energy 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
Low cholesterol - Weight loss - Poor dentition - Self-feeding problems - Inadequate nutrition support
High BUN - High serum osmolality - High Na - Weight loss - Thirst
Ketone breath - Diet hx low CHO - Dx: liver - pancreas - celiac's disease


5. Excessive or inappropriate protein intake
Elevated BUN:creatinine ratio - Hyperglycemia - Hypercapnia - Elevated liver enzymes - Weight gain - Edema - Meds that reduce energy requirements or impair metabolism
Weight status and trends - BUN - creatinine - serum chemistries - proteins - Fluid status - intake and output
High BUN - Low GFR - Poor growth - Deranged AA ratios - diet hx high PRO or AA supplement
Kcal count -24 hr recall -Food records


6. Excessive alcohol intake
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
High AST/GGT - Blood ETOH - diet hx of > 2 drinks/day - liver dx
Low serum mineral levels - Physical signs of deficiency - Diet hx of low intake - Celiac disease - SBS - IBD
High BUN - Low GFR - Poor growth - Deranged AA ratios - diet hx high PRO or AA supplement


7. Excessive energy intake
Provides essential nutrients in blenderized form - Clients who are unable to chew or swallow - Can be used long-term
Weight gain - Diet hx of energy dense food intake
Caused by disease
Potential to become malnourished


8. Symptoms of Intakes - Increased energy expenditure
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
High chol - amylase/lipase - liver function tests - Diet hx high fat
Low cholesterol - Weight loss - Poor dentition - Self-feeding problems - Inadequate nutrition support
Weight loss (5% in 1 month; 10% in 6 months) - Increased activity - dx: Parkinsons - cerebral palsy - dementia


9. Excessive enteral nutrition infusion
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 alb - Low BMI - Weight loss - Poor growth rate - Diet hx low PRO
High BUN - High BGL - High liver enzymes - Weight gain - Edema
Biochemical parameters indicating suboptimal nutrient intake - Estimated intake less than needs - Cultural or religious practices - Knowledge deficit - Meds affecting appetite


10. Inadequate protein-energy intake
High/low BGL - Meds (steroids) - Diet hx
Pureed - Mechanically altered - Advanced
High BUN - High BGL - High liver enzymes - Weight gain - Edema
Low alb - Low BMI - Weight loss - Poor growth rate - Diet hx low PRO


11. Predicted suboptimal energy intake
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
Food items that minimize elimination patterns by reducing fecal volume - Restricted - High fiber foods - Milk and milk products - Fried foods - Pepper - Alcohol - Heavy seasonings
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


12. Excessive fiber intake
Diet hx of xs fiber intake - GI distress
Allows body to heal -To prepare diagnostic test -To prepare Surgical Procedure
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


13. Inadequate fluid intake
High BUN - High serum osmolality - High Na - Weight loss - Thirst
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
Caused by disease
Prealbumin- (visceral protein status) Normal Value: 16-40 g/dl Compromised Protein status: 10-15 g/dl Possible protein malnutrition: <10 g/dl


14. 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
Patients who have difficulty chewing or swallowing food - Goal is to provide a diet that meets nutritional needs and prevents aspiration - Causes of dysphagia - Acute: CVA - seizure - trauma - surgery - anoxia - Progressive: dementia - Parkinson's -
Ketone breath - Diet hx low CHO - Dx: liver - pancreas - celiac's disease
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


15. Inadequate fiber intake
Diet hx of low fiber intake - Constipation/low stool volume
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
Prealbumin- (visceral protein status) Normal Value: 16-40 g/dl Compromised Protein status: 10-15 g/dl Possible protein malnutrition: <10 g/dl
Ketone breath - Diet hx low CHO - Dx: liver - pancreas - celiac's disease


16. Less than optimal parenteral infusion
Anthropometric data -Clinical data -Dietary intake assessment
Potential to become malnourished
Abnormal liver function tests - Abnormal levels of nutrient - Weight gain or weight loss - Edema - Nausea - Intolerance
Reports or observations of energy intake more than needs - Lower physical activity - Planned change in mobility/physical activity - Meds increasing appetite - Knowledge deficit


17. What is Primary Nutrition Risk?
Poor nutrition prevents or delays recovery from injury.
High/low BGL - Meds (steroids) - Diet hx
Weight Loss - dx: AIDS - TB - AN
Inadequate Intake


18. What is Full-Liquid Diet?
Weight loss (5% in 1 month; 10% in 6 months) - Increased activity - dx: Parkinsons - cerebral palsy - dementia
Serum Albumin- (visceral protein status) Normal Value: 3.5-5 g/dl 2.8-3.5- compromised protein status <2.4- possible protein malnutrition
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
CHO 55-60% - protein 10-20% - lipid <30% - fiber 20-35 grams - Evaluate glucose levels - serum lipids - kcalories - diet - insulin/medication


19. Inadequate vitamin intake
High/low BGL - Meds (steroids) - Diet hx
Provides essential nutrients in blenderized form - Clients who are unable to chew or swallow - Can be used long-term
High liver enzymes - Constipation - Diarrhea - CV changes - High intake of supplements/plant foods
Low serum vitamin levels - Physical signs of deficiency - Diet hx of low intake


20. Excessive fluid intake
Anthropometric data -Clinical data -Dietary intake assessment
Indirect calorimetry measurement - Vitamin/mineral abnormalities in lab values - Inadequate weight gain - or unintentional weight loss Clinical evidence of vitamin/mineral deficiency
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 osmolality - Weight gain - Edema - Excess salt intake


21. What is Nutritional risk?
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
Potential to become malnourished
Food items that minimize elimination patterns by reducing fecal volume - Restricted - High fiber foods - Milk and milk products - Fried foods - Pepper - Alcohol - Heavy seasonings
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


22. Excessive parenteral nutrition infusion
Elevated BUN:creatinine ratio - Hyperglycemia - Hypercapnia - Elevated liver enzymes - Weight gain - Edema - Meds that reduce energy requirements or impair metabolism
Provides essential nutrients in blenderized form - Clients who are unable to chew or swallow - Can be used long-term
Low alb - Low BMI - Weight loss - Poor growth rate - Diet hx low PRO
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


23. What is Secondary Nutrition Risk?
Caused by disease
Low serum vitamin levels - Physical signs of deficiency - Diet hx of low intake
High BUN - High serum osmolality - High Na - Weight loss - Thirst
High liver enzymes - Constipation - Diarrhea - CV changes - High intake of supplements/plant foods


24. Inadequate enteral nutrition infusion
Low cholesterol - Low Ca - High PTT - Low Cu/Zn/Fe - Weight loss - Dehydration
GI problems - Diarrhea - Nausea and vomiting - Cramping - Distention - Constipation - Mechanical complications - Tube displacement - Tube obstruction - Pulmonary aspiration - Mucosal damage
Caused by disease
Before Putting anything in - Radiography - pH of aspirated fluids - Air injection and ausculation - Visual assessment of aspiration


25. What is the long-term nutritional biochemical analysis? What are the values?
Abnormal liver function tests - Abnormal levels of nutrient - Weight gain or weight loss - Edema - Nausea - Intolerance
Low chol - alb - prealb - elytes/minerals - vitamins - Weight loss - Low BMI - Diet hx of low intake - fever - dx: Crohn's - AIDS - burns
High AST/GGT - Blood ETOH - diet hx of > 2 drinks/day - liver dx
Serum Albumin- (visceral protein status) Normal Value: 3.5-5 g/dl 2.8-3.5- compromised protein status <2.4- possible protein malnutrition


26. How do you feed patients with Dysphagia?
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
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
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
High/low BGL - Meds (steroids) - Diet hx


27. What is Enteral Nutrition based on?

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28. Predicted Excessive Nutrient Intake
Elevated BUN:creatinine ratio - Hyperglycemia - Hypercapnia - Elevated liver enzymes - Weight gain - Edema - Meds that reduce energy requirements or impair metabolism
Biochemical parameters indicating excessive nutrient intake - Knowledge deficit - Meds affecting appetite - Nutrition in Patient Care
14 days of admission
Prealbumin- (visceral protein status) Normal Value: 16-40 g/dl Compromised Protein status: 10-15 g/dl Possible protein malnutrition: <10 g/dl


29. Inadequate parenteral nutrition infusion
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
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 serum vit. A -D -K - B6 - niacin - Physical signs of excess - Diet hx
Indirect calorimetry measurement - Vitamin/mineral abnormalities in lab values - Inadequate weight gain - or unintentional weight loss Clinical evidence of vitamin/mineral deficiency


30. What is Regular/General Diet?
Low serum osmolality - Weight gain - Edema - Excess salt intake
Designed to attain or maintain optimal nutritional status in those who do not require modified or therapeutic diets - Used to promote health and reduce risks for developing chronic diet-related diseases
Before Putting anything in - Radiography - pH of aspirated fluids - Air injection and ausculation - Visual assessment of aspiration
14 days of admission


31. Inadequate fat intake
Low serum vitamin levels - Physical signs of deficiency - Diet hx of low intake
Weight Loss - dx: AIDS - TB - AN
High/low BGL - Meds (steroids) - Diet hx
Diet hx of low plant food intake


32. Increased nutrient needs

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33. Predicted excessive energy intake
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
Reports or observations of energy intake more than needs - Lower physical activity - Planned change in mobility/physical activity - Meds increasing appetite - Knowledge deficit
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
Potential to become malnourished


34. What is Mechanically Altered Diet?

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35. Imbalance of nutrients
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
Weight loss (5% in 1 month; 10% in 6 months) - Increased activity - dx: Parkinsons - cerebral palsy - dementia
Diet hx of high intake - Diarrhea - Constipation - 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


36. What is Soft Diet?
Low alb - Low BMI - Weight loss - Poor growth rate - Diet hx low PRO
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
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
High BUN - High serum osmolality - High Na - Weight loss - Thirst


37. What are the complications of Parenteral Nutrition?
Indirect calorimetry measurement - Vitamin/mineral abnormalities in lab values - Inadequate weight gain - or unintentional weight loss Clinical evidence of vitamin/mineral deficiency
Food items that minimize elimination patterns by reducing fecal volume - Restricted - High fiber foods - Milk and milk products - Fried foods - Pepper - Alcohol - Heavy seasonings
Technical complications - Pneumothorax - Septic complications - Local or systemic - Metabolic complications - Most common complication - Most common is hyperglycemia
Weight status and trends - BUN - creatinine - serum chemistries - proteins - Fluid status - intake and output


38. Less than optimal enteral nutrition
Abnormal liver enzymes - Fatty liver - Weight gain/loss - Edema
CHO 55-60% - protein 10-20% - lipid <30% - fiber 20-35 grams - Evaluate glucose levels - serum lipids - kcalories - diet - insulin/medication
High serum vit. A -D -K - B6 - niacin - Physical signs of excess - Diet hx
Indirect calorimetry measurement - Vitamin/mineral abnormalities in lab values - Inadequate weight gain - or unintentional weight loss Clinical evidence of vitamin/mineral deficiency


39. 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
Food items that minimize elimination patterns by reducing fecal volume - Restricted - High fiber foods - Milk and milk products - Fried foods - Pepper - Alcohol - Heavy seasonings
Underweight-bmi<18.5 normal- 18.5-24.9 overweight-25.0-29.9 obese- bmi>30
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. Inadequate protein intake
Diet hx of xs fiber intake - GI distress
High serum vit. A -D -K - B6 - niacin - Physical signs of excess - Diet hx
Low cholesterol - Weight loss - Poor dentition - Self-feeding problems - Inadequate nutrition support
Diet hx of low intake


41. Excessive or inappropriate fat intake
Pudding Thick - Consistency of applesauce or smooth mashed potatoes - Most restrictive - Used with severe levels of dysphagia in which oral intake is still allowed - May require IV hydration - Necessary to closely monitor fluid intake to prevent dehy
Foods liquid at room or body temperature - Clear liquid plus milk - pudding - ice cream - soups - yogurt - Used to provide oral nourishment for patients - Difficulty chewing and swallowing solid foods - Commercial nutritional supplements often used
High chol - amylase/lipase - liver function tests - Diet hx high fat
Poor nutrition prevents or delays recovery from injury.


42. What is Pureed Diet?
High BUN - Low GFR - Poor growth - Deranged AA ratios - diet hx high PRO or AA supplement
Allows body to heal -To prepare diagnostic test -To prepare Surgical Procedure
Reports or observations of energy intake more than needs - Lower physical activity - Planned change in mobility/physical activity - Meds increasing appetite - Knowledge deficit
Provides essential nutrients in blenderized form - Clients who are unable to chew or swallow - Can be used long-term


43. Inconsistent carbohydrate intake
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
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


44. What is the classifications of BMI and numbers?
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
High AST/GGT - Blood ETOH - diet hx of > 2 drinks/day - liver dx
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


45. Inadequate mineral 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
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
A- Anthropometric approach B- Biochemical Tests C- Clinical Observations D- Diet Evaluations (Kcal - 24 hr recall etc)
Low serum mineral levels - Physical signs of deficiency - Diet hx of low intake - Celiac disease - SBS - IBD


46. Why are dietary adjustments sometimes necessary?
Diet hx of aberrant CHO intake - Steroids - DM - Inborn errors
Low serum osmolality - Weight gain - Edema - Excess salt intake
Low cholesterol - Low Ca - High PTT - Low Cu/Zn/Fe - Weight loss - Dehydration
Allows body to heal -To prepare diagnostic test -To prepare Surgical Procedure


47. What are some tube-feeding complications?
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
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
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


48. What are the IV lipid emulsions for Parenteral Nutriton Solution?
Food items that minimize elimination patterns by reducing fecal volume - Restricted - High fiber foods - Milk and milk products - Fried foods - Pepper - Alcohol - Heavy seasonings
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
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
Reports or observations of energy intake less than needs - Projected change in ability to procure or consume adequate energy - Knowledge deficit - Projected increase in physical activity


49. Excessive intake
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
High liver enzymes - Constipation - Diarrhea - CV changes - High intake of supplements/plant foods
High BGL - Weight gain - High Hgb A1C - diet hx of energy dense food intake - Excess eating away from home
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


50. Inadequate carbohydrate intake

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