Test your basic knowledge |

Nutrition Diagnosis

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

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. Less than optimal enteral nutrition
Caused by disease
Abnormal liver enzymes - Fatty liver - Weight gain/loss - Edema
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
Weight status and trends - BUN - creatinine - serum chemistries - proteins - Fluid status - intake and output

2. What are the Anthropometric measures?
Reports or observations of energy intake more than needs - Lower physical activity - Planned change in mobility/physical activity - Meds increasing appetite - Knowledge deficit
Height/length -Weight -BMI -Body Measures (skin fold thickness)
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 -
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

3. Inadequate fluid intake
Diet hx of low 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 chol - amylase/lipase - liver function tests - Diet hx high fat
High BUN - High serum osmolality - High Na - Weight loss - Thirst

4. Inadequate mineral intake
Low serum mineral levels - Physical signs of deficiency - Diet hx of low intake - Celiac disease - SBS - IBD
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
Low alb - Low BMI - Weight loss - Poor growth rate - Diet hx low PRO
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

5. What are some swallowing aids?
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
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
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

6. What is Fat-Controlled Diet?
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 -
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
Height/length -Weight -BMI -Body Measures (skin fold thickness)
Serum Albumin- (visceral protein status) Normal Value: 3.5-5 g/dl 2.8-3.5- compromised protein status <2.4- possible protein malnutrition

7. Inadequate protein-energy intake
Indirect calorimetry measurement - Vitamin/mineral abnormalities in lab values - Inadequate weight gain - or unintentional weight loss Clinical evidence of vitamin/mineral deficiency
CHO 55-60% - protein 10-20% - lipid <30% - fiber 20-35 grams - Evaluate glucose levels - serum lipids - kcalories - diet - insulin/medication
Weight gain - Diet hx of energy dense food intake
Low alb - Low BMI - Weight loss - Poor growth rate - Diet hx low PRO

8. What is Enteral Nutrition? Why preferred over 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
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 cholesterol - Weight loss - Poor dentition - Self-feeding problems - Inadequate nutrition support
Reports or observations of energy intake more than needs - Lower physical activity - Planned change in mobility/physical activity - Meds increasing appetite - Knowledge deficit

9. Excessive enteral nutrition infusion
High/low BGL - Meds - Insulin use -
TJC requires screenings within 48hrs
High BUN - High BGL - High liver enzymes - Weight gain - Edema
High chol - amylase/lipase - liver function tests - Diet hx high fat

10. 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
High BUN - High BGL - High liver enzymes - Weight gain - Edema
Diet hx of xs fiber intake - GI distress
Low HDL - High TSH - High Mg - High PO4 - Diet hx of xs intake - Liver damage - GI distress

11. What are the thickened liquids?
High chol - amylase/lipase - liver function tests - Diet hx high fat
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
Low alb - Low BMI - Weight loss - Poor growth rate - Diet hx low PRO
High BGL - Weight gain - High Hgb A1C - diet hx of energy dense food intake - Excess eating away from home

12. Inadequate intake
Diet hx of low plant food intake
Diet hx of xs fiber intake - GI distress
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
14 days of admission

13. Inadequate energy intake
Low cholesterol - Weight loss - Poor dentition - Self-feeding problems - Inadequate nutrition support
Carbohydrate - Dextrose solutions - Available in initial concentrations of 5% to 70% - Mixed with amino acids and other nutrients to form the final solution - Protein - Mixture of essential and nonessential crystalline amino acids - Available wi
High serum vit. A -D -K - B6 - niacin - Physical signs of excess - Diet hx
Abnormal liver function tests - Abnormal levels of nutrient - Weight gain or weight loss - Edema - Nausea - Intolerance

14. Excessive alcohol intake
Weight Loss - dx: AIDS - TB - AN
High AST/GGT - Blood ETOH - diet hx of > 2 drinks/day - liver dx
A- Anthropometric approach B- Biochemical Tests C- Clinical Observations D- Diet Evaluations (Kcal - 24 hr recall etc)
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

15. How long does TJC require resident screenings to be done during admission?
TJC requires screenings within 48hrs
Before Putting anything in - Radiography - pH of aspirated fluids - Air injection and ausculation - Visual assessment of aspiration
Height/length -Weight -BMI -Body Measures (skin fold thickness)
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

16. How do you manage TPN?

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

18. Excessive energy intake
High BUN - Low GFR - Poor growth - Deranged AA ratios - diet hx high PRO or AA supplement
Low serum osmolality - Weight gain - Edema - Excess salt intake
Weight gain - Diet hx of energy dense food intake
Potential to become malnourished

19. Excessive mineral intake
Diet hx of aberrant CHO intake - Steroids - DM - Inborn errors
Low HDL - High TSH - High Mg - High PO4 - Diet hx of xs intake - Liver damage - GI distress
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
Socioeconomic status -comorbid disease states -Age adults: =< 75 children<5 PHYSICAL -stress and trauma- metabolic demands -mechanical ventilation-unable to eat -therapeutic bowel rest

20. What is Enteral Nutrition based on?

21. What are the confirmations of tube placement?
Before Putting anything in - Radiography - pH of aspirated fluids - Air injection and ausculation - Visual assessment of aspiration
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
Carbohydrate - Dextrose solutions - Available in initial concentrations of 5% to 70% - Mixed with amino acids and other nutrients to form the final solution - Protein - Mixture of essential and nonessential crystalline amino acids - Available wi
High liver enzymes - Constipation - Diarrhea - CV changes - High intake of supplements/plant foods

22. What are some tube-feeding complications?
Weight loss (5% in 1 month; 10% in 6 months) - Increased activity - dx: Parkinsons - cerebral palsy - dementia
GI problems - Diarrhea - Nausea and vomiting - Cramping - Distention - Constipation - Mechanical complications - Tube displacement - Tube obstruction - Pulmonary aspiration - Mucosal damage
High liver enzymes - Constipation - Diarrhea - CV changes - High intake of supplements/plant foods
Regular diet with attention to texture - Consistency of food can be varied according to the patient's ability to chew and swallow - Foods chopped - ground - mashed - or pureed - Patient's needs should be evaluated - Modifying consistency according to

23. Inadequate oral food/ beverage 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
Dry skin - Weight loss - diet hx of low intake - dx: AIDS - TB - AN - sepsis - infection - xs ETOH
Low HDL - High TSH - High Mg - High PO4 - Diet hx of xs intake - Liver damage - GI distress
High serum vit. A -D -K - B6 - niacin - Physical signs of excess - Diet hx

24. Why are dietary adjustments sometimes necessary?
Allows body to heal -To prepare diagnostic test -To prepare Surgical Procedure
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 -
Indirect calorimetry measurement - Vitamin/mineral abnormalities in lab values - Inadequate weight gain - or unintentional weight loss Clinical evidence of vitamin/mineral deficiency
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

25. Excessive 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
Indirect calorimetry measurement - Vitamin/mineral abnormalities in lab values - Inadequate weight gain - or unintentional weight loss Clinical evidence of vitamin/mineral deficiency
High liver enzymes - Constipation - Diarrhea - CV changes - High intake of supplements/plant foods
Low alb - Low BMI - Weight loss - Poor growth rate - Diet hx low PRO

26. What are the complications of Parenteral Nutrition?
Technical complications - Pneumothorax - Septic complications - Local or systemic - Metabolic complications - Most common complication - Most common is hyperglycemia
High serum vit. A -D -K - B6 - niacin - Physical signs of excess - Diet hx
Caused by disease
Weight gain - Diet hx of energy dense food intake

27. Predicted Suboptimal Nutrient Intake
Weight status and trends - BUN - creatinine - serum chemistries - proteins - Fluid status - intake and output
Weight loss (5% in 1 month; 10% in 6 months) - Increased activity - dx: Parkinsons - cerebral palsy - dementia
Low cholesterol - Low Ca - High PTT - Low Cu/Zn/Fe - Weight loss - Dehydration
Biochemical parameters indicating suboptimal nutrient intake - Estimated intake less than needs - Cultural or religious practices - Knowledge deficit - Meds affecting appetite

28. Predicted excessive energy intake
Reports or observations of energy intake more than needs - Lower physical activity - Planned change in mobility/physical activity - Meds increasing appetite - Knowledge deficit
Weight gain - Diet hx of energy dense food intake
Diet hx of aberrant CHO intake - Steroids - DM - Inborn errors
Low HDL - High TSH - High Mg - High PO4 - Diet hx of xs intake - Liver damage - GI distress

29. 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
High chol - PO4 - GFR <90 - High BUN - Edema - Dx: kidney/liver
Provides essential nutrients in blenderized form - Clients who are unable to chew or swallow - Can be used long-term
Allows body to heal -To prepare diagnostic test -To prepare Surgical Procedure

30. What is the clinical assessments?
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
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 HDL - High TSH - High Mg - High PO4 - Diet hx of xs intake - Liver damage - GI distress
Food items that minimize elimination patterns by reducing fecal volume - Restricted - High fiber foods - Milk and milk products - Fried foods - Pepper - Alcohol - Heavy seasonings

31. Decreased nutrient needs
>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
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
Carbohydrate - Dextrose solutions - Available in initial concentrations of 5% to 70% - Mixed with amino acids and other nutrients to form the final solution - Protein - Mixture of essential and nonessential crystalline amino acids - Available wi
High chol - PO4 - GFR <90 - High BUN - Edema - Dx: kidney/liver

32. What is Primary Nutrition Risk?
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
Inadequate 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 chol - PO4 - GFR <90 - High BUN - Edema - Dx: kidney/liver

33. What is Nutritional risk?
Potential to become malnourished
Weight loss (5% in 1 month; 10% in 6 months) - Increased activity - dx: Parkinsons - cerebral palsy - dementia
Weight gain - Diet hx of energy dense food 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

34. What else do you check with biochemical tests?
Anthropometric data -Clinical data -Dietary intake assessment
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
Weight status and trends - BUN - creatinine - serum chemistries - proteins - Fluid status - intake and output
High liver enzymes - Constipation - Diarrhea - CV changes - High intake of supplements/plant foods

35. How long should Nutritional screenings be done to residents being admitted?
Low cholesterol - Low Ca - High PTT - Low Cu/Zn/Fe - Weight loss - Dehydration
14 days of admission
Serum Albumin- (visceral protein status) Normal Value: 3.5-5 g/dl 2.8-3.5- compromised protein status <2.4- possible protein malnutrition
Dry skin - Weight loss - diet hx of low intake - dx: AIDS - TB - AN - sepsis - infection - xs ETOH

36. What is the long-term nutritional biochemical analysis? What are the values?
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
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 low fiber intake - Constipation/low stool volume
Abnormal liver function tests - Abnormal levels of nutrient - Weight gain or weight loss - Edema - Nausea - Intolerance

37. What is Regular/General Diet?
High BUN - High serum osmolality - High Na - Weight loss - Thirst
Diet hx of low fiber intake - Constipation/low stool volume
Designed to attain or maintain optimal nutritional status in those who do not require modified or therapeutic diets - Used to promote health and reduce risks for developing chronic diet-related diseases
Allows body to heal -To prepare diagnostic test -To prepare Surgical Procedure

38. What is the other biochemical analysis and values?
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
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 BGL - Weight gain - High Hgb A1C - diet hx of energy dense food intake - Excess eating away from home
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

39. What is Low-Residue Diet?
Pureed - Mechanically altered - Advanced
Food items that minimize elimination patterns by reducing fecal volume - Restricted - High fiber foods - Milk and milk products - Fried foods - Pepper - Alcohol - Heavy seasonings
Diet hx of high intake - Diarrhea - Constipation - GI distress
Diet hx of low fiber intake - Constipation/low stool volume

40. Excessive oral food/beverage intake
High BGL - Weight gain - High Hgb A1C - diet hx of energy dense food intake - Excess eating away from home
High AST/GGT - Blood ETOH - diet hx of > 2 drinks/day - liver dx
High BUN - Low GFR - Poor growth - Deranged AA ratios - diet hx high PRO or AA supplement
Low alb - Low BMI - Weight loss - Poor growth rate - Diet hx low PRO

41. Inadequate carbohydrate intake

42. Inadequate enteral nutrition infusion
Low cholesterol - Low Ca - High PTT - Low Cu/Zn/Fe - Weight loss - Dehydration
Poor nutrition prevents or delays recovery from injury.
High BUN - High serum osmolality - High Na - Weight loss - Thirst
Low serum vitamin levels - Physical signs of deficiency - Diet hx of low intake

43. What are the Dietary Evaluations?
Diet hx of xs fiber intake - GI distress
High chol - PO4 - GFR <90 - High BUN - Edema - Dx: kidney/liver
Kcal count -24 hr recall -Food records
Diet hx of low intake

44. What is Pureed Diet?
Diet hx of aberrant CHO intake - Steroids - DM - Inborn errors
Weight status and trends - BUN - creatinine - serum chemistries - proteins - Fluid status - intake and output
Inadequate Intake
Provides essential nutrients in blenderized form - Clients who are unable to chew or swallow - Can be used long-term

45. What is Full-Liquid Diet?
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 BUN - Low GFR - Poor growth - Deranged AA ratios - diet hx high PRO or AA supplement
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
Potential to become malnourished

46. What is 'Diet as Tolerated'?

47. How do you monitor response for enteral treatment?
Before Putting anything in - Radiography - pH of aspirated fluids - Air injection and ausculation - Visual assessment of aspiration
Weight status and trends - BUN - creatinine - serum chemistries - proteins - Fluid status - intake and output
High/low BGL - Meds (steroids) - Diet hx
High chol - PO4 - GFR <90 - High BUN - Edema - Dx: kidney/liver

48. Excessive parenteral nutrition infusion
High chol - PO4 - GFR <90 - High BUN - Edema - Dx: kidney/liver
High serum vit. A -D -K - B6 - niacin - Physical signs of excess - Diet hx
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

49. What is Dysphagia Nutritional Therapy?
Diet hx of aberrant CHO intake - Steroids - DM - Inborn errors
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/low BGL - Meds - Insulin use -
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

50. What are the feeding modalities?
>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
CHO 55-60% - protein 10-20% - lipid <30% - fiber 20-35 grams - Evaluate glucose levels - serum lipids - kcalories - diet - insulin/medication
Poor nutrition prevents or delays recovery from injury.
Prealbumin- (visceral protein status) Normal Value: 16-40 g/dl Compromised Protein status: 10-15 g/dl Possible protein malnutrition: <10 g/dl