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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 are the assessments for Enteral Feedings?
Serum Albumin- (visceral protein status) Normal Value: 3.5-5 g/dl 2.8-3.5- compromised protein status <2.4- possible protein malnutrition
Assessment - Residuals - Weight - Lung sounds - Edema - I & O - Blood glucose monitoring - Blood chemistry
High/low BGL - Meds - Insulin use -
Allows body to heal -To prepare diagnostic test -To prepare Surgical Procedure

2. 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
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
Low chol - alb - prealb - elytes/minerals - vitamins - Weight loss - Low BMI - Diet hx of low intake - fever - dx: Crohn's - AIDS - burns
Anthropometric data -Clinical data -Dietary intake assessment

3. What is Clear Liquid Diet?
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
Diet hx of xs fiber intake - GI distress
High BUN - High serum osmolality - High Na - Weight loss - Thirst
Low serum mineral levels - Physical signs of deficiency - Diet hx of low intake - Celiac disease - SBS - IBD

4. What are the complications of Parenteral Nutrition?
Low serum vitamin levels - Physical signs of deficiency - Diet hx of low intake
Diet hx of aberrant CHO intake - Steroids - DM - Inborn errors
High BUN - High BGL - High liver enzymes - Weight gain - Edema
Technical complications - Pneumothorax - Septic complications - Local or systemic - Metabolic complications - Most common complication - Most common is hyperglycemia

5. What is Low-Residue Diet?
Before Putting anything in - Radiography - pH of aspirated fluids - Air injection and ausculation - Visual assessment of aspiration
High AST/GGT - Blood ETOH - diet hx of > 2 drinks/day - liver dx
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 more than needs - Lower physical activity - Planned change in mobility/physical activity - Meds increasing appetite - Knowledge deficit

6. What are the 3 levels of Dysphagia?
Anthropometric data -Clinical data -Dietary intake assessment
Diet hx of low fiber intake - Constipation/low stool volume
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
Pureed - Mechanically altered - Advanced

7. Inadequate fiber intake
Ketone breath - Diet hx low CHO - Dx: liver - pancreas - celiac's disease
Diet hx of low fiber intake - Constipation/low stool volume
High/low BGL - Meds - Insulin use -
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

8. Inadequate intake
Inadequate 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
Abnormal liver function tests - Abnormal levels of nutrient - Weight gain or weight loss - Edema - Nausea - Intolerance
Diet hx of low plant food intake

9. What else do you check with biochemical tests?
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
Socioeconomic status -comorbid disease states -Age adults: =< 75 children<5 PHYSICAL -stress and trauma- metabolic demands -mechanical ventilation-unable to eat -therapeutic bowel rest
Anthropometric data -Clinical data -Dietary intake assessment
A- Anthropometric approach B- Biochemical Tests C- Clinical Observations D- Diet Evaluations (Kcal - 24 hr recall etc)

10. What is the other biochemical analysis and values?
Low HDL - High TSH - High Mg - High PO4 - Diet hx of xs intake - Liver damage - GI distress
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
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
TJC requires screenings within 48hrs

11. Imbalance of nutrients
Diet hx of high intake - Diarrhea - Constipation - GI distress
TJC requires screenings within 48hrs
High chol - amylase/lipase - liver function tests - Diet hx high fat
Diet hx of low plant food intake

12. What is Fat-Controlled Diet?
Diet hx of xs fiber intake - GI distress
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
Abnormal liver function tests - Abnormal levels of nutrient - Weight gain or weight loss - Edema - Nausea - Intolerance
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

13. What is Full-Liquid Diet?
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
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 alb - Low BMI - Weight loss - Poor growth rate - Diet hx low PRO
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

14. Excessive mineral intake
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
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
Low HDL - High TSH - High Mg - High PO4 - Diet hx of xs intake - Liver damage - GI distress

15. Less than optimal enteral nutrition
14 days of admission
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 high intake - Diarrhea - Constipation - GI distress
Abnormal liver enzymes - Fatty liver - Weight gain/loss - Edema

16. What is 'Diet as Tolerated'?

17. What are some other Restricted Diets?

18. What are the IV lipid emulsions for Parenteral Nutriton Solution?
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 chol - PO4 - GFR <90 - High BUN - Edema - Dx: kidney/liver
Ketone breath - Diet hx low CHO - Dx: liver - pancreas - celiac's disease
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

19. What are some tube-feeding complications?
Pureed - Mechanically altered - Advanced
Weight gain - Diet hx of energy dense food intake
GI problems - Diarrhea - Nausea and vomiting - Cramping - Distention - Constipation - Mechanical complications - Tube displacement - Tube obstruction - Pulmonary aspiration - Mucosal damage
Low serum vitamin levels - Physical signs of deficiency - Diet hx of low intake

20. What are the Dietary Evaluations?
Caused by disease
Abnormal liver function tests - Abnormal levels of nutrient - Weight gain or weight loss - Edema - Nausea - Intolerance
Kcal count -24 hr recall -Food records
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

21. Inadequate protein intake
Weight Loss - dx: AIDS - TB - AN
Kcal count -24 hr recall -Food records
Diet hx of low intake
Elevated BUN:creatinine ratio - Hyperglycemia - Hypercapnia - Elevated liver enzymes - Weight gain - Edema - Meds that reduce energy requirements or impair metabolism

22. What is Primary Nutrition Risk?
High BUN - High BGL - High liver enzymes - Weight gain - Edema
Pureed - Mechanically altered - Advanced
Ketone breath - Diet hx low CHO - Dx: liver - pancreas - celiac's disease
Inadequate Intake

23. Inappropriate intake of types of carbohydrates
Low chol - alb - prealb - elytes/minerals - vitamins - Weight loss - Low BMI - Diet hx of low intake - fever - dx: Crohn's - AIDS - burns
High/low BGL - Meds (steroids) - Diet hx
CHO 55-60% - protein 10-20% - lipid <30% - fiber 20-35 grams - Evaluate glucose levels - serum lipids - kcalories - diet - insulin/medication
Abnormal liver enzymes - Fatty liver - Weight gain/loss - Edema

24. What are the confirmations of tube placement?
Low cholesterol - Low Ca - High PTT - Low Cu/Zn/Fe - Weight loss - Dehydration
Weight loss (5% in 1 month; 10% in 6 months) - Increased activity - dx: Parkinsons - cerebral palsy - dementia
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

25. What are some swallowing aids?
High BUN - High serum osmolality - High Na - Weight loss - Thirst
Poor nutrition prevents or delays recovery from injury.
Low serum osmolality - Weight gain - Edema - Excess salt 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

26. Predicted Excessive Nutrient Intake
Collecting food in the mouth - Spitting out food - Inability to control tongue - Coughing before or after swallowing - Choking - Excessive drooling - Regurgitation of food or liquid through nose - mouth or trach tube - Increased time required to eat
Biochemical parameters indicating suboptimal nutrient intake - Estimated intake less than needs - Cultural or religious practices - Knowledge deficit - Meds affecting appetite
Biochemical parameters indicating excessive nutrient intake - Knowledge deficit - Meds affecting appetite - Nutrition in Patient Care
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

27. Predicted Suboptimal Nutrient Intake
High BGL - Weight gain - High Hgb A1C - diet hx of energy dense food intake - Excess eating away from home
Height/length -Weight -BMI -Body Measures (skin fold thickness)
Dry skin - Weight loss - diet hx of low intake - dx: AIDS - TB - AN - sepsis - infection - xs ETOH
Biochemical parameters indicating suboptimal nutrient intake - Estimated intake less than needs - Cultural or religious practices - Knowledge deficit - Meds affecting appetite

28. What is Regular/General Diet?
Inadequate Intake
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
Biochemical parameters indicating excessive nutrient intake - Knowledge deficit - Meds affecting appetite - Nutrition in Patient Care
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

29. How long should Nutritional screenings be done to residents being admitted?
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
14 days of admission
Diet hx of high intake - Diarrhea - Constipation - GI distress

30. Increased nutrient needs

31. 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
Low cholesterol - Weight loss - Poor dentition - Self-feeding problems - Inadequate nutrition support
Food items that minimize elimination patterns by reducing fecal volume - Restricted - High fiber foods - Milk and milk products - Fried foods - Pepper - Alcohol - Heavy seasonings
Biochemical parameters indicating excessive nutrient intake - Knowledge deficit - Meds affecting appetite - Nutrition in Patient Care

32. What is Carb-controlled Diet?
Common for this diet to be ordered postoperatively - Permits patient's preferences and situations to be taken into consideration - Also allows for postoperative diet progression at the patient's tolerance
Low serum osmolality - Weight gain - Edema - Excess salt intake
CHO 55-60% - protein 10-20% - lipid <30% - fiber 20-35 grams - Evaluate glucose levels - serum lipids - kcalories - diet - insulin/medication
Low HDL - High TSH - High Mg - High PO4 - Diet hx of xs intake - Liver damage - GI distress

33. Excessive intake
Ketone breath - Diet hx low CHO - Dx: liver - pancreas - celiac's disease
Diet hx of low intake
High liver enzymes - Constipation - Diarrhea - CV changes - High intake of supplements/plant foods
CHO 55-60% - protein 10-20% - lipid <30% - fiber 20-35 grams - Evaluate glucose levels - serum lipids - kcalories - diet - insulin/medication

34. Why is it important to know primary/secondary nutritional risk?
High liver enzymes - Constipation - Diarrhea - CV changes - High intake of supplements/plant foods
Poor nutrition prevents or delays recovery from injury.
Low serum vitamin levels - Physical signs of deficiency - Diet hx of low intake
Prealbumin- (visceral protein status) Normal Value: 16-40 g/dl Compromised Protein status: 10-15 g/dl Possible protein malnutrition: <10 g/dl

35. Excessive vitamin intake
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
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
TJC requires screenings within 48hrs

36. Excessive enteral nutrition infusion
Technical complications - Pneumothorax - Septic complications - Local or systemic - Metabolic complications - Most common complication - Most common is hyperglycemia
High BUN - High BGL - High liver enzymes - Weight gain - Edema
Low serum vitamin levels - Physical signs of deficiency - Diet hx of low intake
High BGL - Weight gain - High Hgb A1C - diet hx of energy dense food intake - Excess eating away from home

37. What is Secondary Nutrition Risk?
Poor nutrition prevents or delays recovery from injury.
High/low BGL - Meds - Insulin use -
Foods that are easy to chew - digest - and absorb - Used during transition from liquid diets to regular or general diets - Foods low in fiber - Only lightly seasoned - Not appropriate for patients requiring mechanical soft diets
Caused by disease

38. What are Dysphagia 'warning signs'?
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
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/low BGL - Meds - Insulin use -
High AST/GGT - Blood ETOH - diet hx of > 2 drinks/day - liver dx

39. What is Enteral Nutrition? Why preferred over Parenteral Nutrition?
Weight gain - Diet hx of energy dense food intake
Biochemical parameters indicating suboptimal nutrient intake - Estimated intake less than needs - Cultural or religious practices - Knowledge deficit - Meds affecting appetite
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 AST/GGT - Blood ETOH - diet hx of > 2 drinks/day - liver dx

40. Inadequate mineral intake
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)
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
High BGL - Weight gain - High Hgb A1C - diet hx of energy dense food intake - Excess eating away from home

41. Excessive or inappropriate protein intake
High BGL - Weight gain - High Hgb A1C - diet hx of energy dense food intake - Excess eating away from home
High/low BGL - Meds - Insulin use -
Low alb - Low BMI - Weight loss - Poor growth rate - Diet hx low PRO
High BUN - Low GFR - Poor growth - Deranged AA ratios - diet hx high PRO or AA supplement

42. What is Pureed Diet?
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 AST/GGT - Blood ETOH - diet hx of > 2 drinks/day - liver dx
Provides essential nutrients in blenderized form - Clients who are unable to chew or swallow - Can be used long-term
Biochemical parameters indicating excessive nutrient intake - Knowledge deficit - Meds affecting appetite - Nutrition in Patient Care

43. What is Protein-Controlled 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
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
Low serum vitamin levels - Physical signs of deficiency - Diet hx of low intake
Low cholesterol - Low Ca - High PTT - Low Cu/Zn/Fe - Weight loss - Dehydration

44. What is the clinical assessments?
Anthropometric data -Clinical data -Dietary intake assessment
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
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/low BGL - Meds - Insulin use -

45. Inadequate vitamin 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 alb - Low BMI - Weight loss - Poor growth rate - Diet hx low PRO
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

46. What is the classifications of BMI and numbers?
Pureed - Mechanically altered - Advanced
GI problems - Diarrhea - Nausea and vomiting - Cramping - Distention - Constipation - Mechanical complications - Tube displacement - Tube obstruction - Pulmonary aspiration - Mucosal damage
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

47. Inadequate energy 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 cholesterol - Weight loss - Poor dentition - Self-feeding problems - Inadequate nutrition support
Low HDL - High TSH - High Mg - High PO4 - Diet hx of xs intake - Liver damage - GI distress
High BUN - High BGL - High liver enzymes - Weight gain - Edema

48. How do you monitor response for enteral treatment?
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
Diet hx of xs fiber intake - GI distress
High BUN - High BGL - High liver enzymes - Weight gain - Edema
Weight status and trends - BUN - creatinine - serum chemistries - proteins - Fluid status - intake and output

49. What is Mechanically Altered Diet?

50. Inconsistent carbohydrate 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
Caused by disease
High/low BGL - Meds - Insulin use -
GI problems - Diarrhea - Nausea and vomiting - Cramping - Distention - Constipation - Mechanical complications - Tube displacement - Tube obstruction - Pulmonary aspiration - Mucosal damage