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 is Clear Liquid Diet?
High BUN - High BGL - High liver enzymes - Weight gain - Edema
Before Putting anything in - Radiography - pH of aspirated fluids - Air injection and ausculation - Visual assessment of aspiration
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 - amylase/lipase - liver function tests - Diet hx high fat


2. Inconsistent carbohydrate intake
Low alb - Low BMI - Weight loss - Poor growth rate - Diet hx low PRO
High/low BGL - Meds - Insulin use -
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


3. Inadequate fiber intake
Diet hx of low fiber intake - Constipation/low stool volume
Low chol - alb - prealb - elytes/minerals - vitamins - Weight loss - Low BMI - Diet hx of low intake - fever - dx: Crohn's - AIDS - burns
Biochemical parameters indicating suboptimal nutrient intake - Estimated intake less than needs - Cultural or religious practices - Knowledge deficit - Meds affecting appetite
Underweight-bmi<18.5 normal- 18.5-24.9 overweight-25.0-29.9 obese- bmi>30


4. Symptoms of Intakes - Increased energy expenditure
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
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
Weight status and trends - BUN - creatinine - serum chemistries - proteins - Fluid status - intake and output


5. Inadequate protein-energy intake
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
Before Putting anything in - Radiography - pH of aspirated fluids - Air injection and ausculation - Visual assessment of aspiration
Elevated BUN:creatinine ratio - Hyperglycemia - Hypercapnia - Elevated liver enzymes - Weight gain - Edema - Meds that reduce energy requirements or impair metabolism
Low alb - Low BMI - Weight loss - Poor growth rate - Diet hx low PRO


6. Excessive fluid 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
Anthropometric data -Clinical data -Dietary intake assessment
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


7. What is 'Diet as Tolerated'?

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8. What is the assessment of nutritional risk approach? (abcd)
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 BUN - High serum osmolality - High Na - Weight loss - Thirst
A- Anthropometric approach B- Biochemical Tests C- Clinical Observations D- Diet Evaluations (Kcal - 24 hr recall etc)
Before Putting anything in - Radiography - pH of aspirated fluids - Air injection and ausculation - Visual assessment of aspiration


9. 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
14 days of admission
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
High BUN - Low GFR - Poor growth - Deranged AA ratios - diet hx high PRO or AA supplement


10. What is Dysphagia Nutritional Therapy?
GI problems - Diarrhea - Nausea and vomiting - Cramping - Distention - Constipation - Mechanical complications - Tube displacement - Tube obstruction - Pulmonary aspiration - Mucosal damage
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
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


11. What is Pureed Diet?
High AST/GGT - Blood ETOH - diet hx of > 2 drinks/day - liver dx
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
Provides essential nutrients in blenderized form - Clients who are unable to chew or swallow - Can be used long-term
Low HDL - High TSH - High Mg - High PO4 - Diet hx of xs intake - Liver damage - GI distress


12. What is the classifications of BMI and numbers?
Underweight-bmi<18.5 normal- 18.5-24.9 overweight-25.0-29.9 obese- bmi>30
Low cholesterol - Low Ca - High PTT - Low Cu/Zn/Fe - Weight loss - Dehydration
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
High BUN - High serum osmolality - High Na - Weight loss - Thirst


13. Excessive fiber intake
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
Diet hx of aberrant CHO intake - Steroids - DM - Inborn errors
Diet hx of xs fiber intake - GI distress
Kcal count -24 hr recall -Food records


14. What are the confirmations of tube placement?
Abnormal liver enzymes - Fatty liver - Weight gain/loss - Edema
Before Putting anything in - Radiography - pH of aspirated fluids - Air injection and ausculation - Visual assessment of aspiration
High BUN - Low GFR - Poor growth - Deranged AA ratios - diet hx high PRO or AA supplement
Food items that minimize elimination patterns by reducing fecal volume - Restricted - High fiber foods - Milk and milk products - Fried foods - Pepper - Alcohol - Heavy seasonings


15. Increased nutrient needs

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16. Excessive mineral 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
A- Anthropometric approach B- Biochemical Tests C- Clinical Observations D- Diet Evaluations (Kcal - 24 hr recall etc)
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 HDL - High TSH - High Mg - High PO4 - Diet hx of xs intake - Liver damage - GI distress


17. What else do you check with biochemical tests?
Weight status and trends - BUN - creatinine - serum chemistries - proteins - Fluid status - intake and output
Prealbumin- (visceral protein status) Normal Value: 16-40 g/dl Compromised Protein status: 10-15 g/dl Possible protein malnutrition: <10 g/dl
Caused by disease
Anthropometric data -Clinical data -Dietary intake assessment


18. Excessive carbohydrate intake
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
Potential to become malnourished
Diet hx of aberrant CHO intake - Steroids - DM - Inborn errors
Caused by disease


19. What is Primary Nutrition Risk?
Weight gain - Diet hx of energy dense food intake
Assessment - Residuals - Weight - Lung sounds - Edema - I & O - Blood glucose monitoring - Blood chemistry
Inadequate Intake
Technical complications - Pneumothorax - Septic complications - Local or systemic - Metabolic complications - Most common complication - Most common is hyperglycemia


20. What are some swallowing aids?
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
High chol - amylase/lipase - liver function tests - Diet hx high fat
Low cholesterol - Weight loss - Poor dentition - Self-feeding problems - Inadequate nutrition support
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 -


21. What is Full-Liquid Diet?
Poor nutrition prevents or delays recovery from injury.
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
Abnormal liver enzymes - Fatty liver - Weight gain/loss - Edema


22. Why are dietary adjustments sometimes necessary?
Inadequate Intake
Allows body to heal -To prepare diagnostic test -To prepare Surgical Procedure
Pureed - Mechanically altered - Advanced
High BUN - High BGL - High liver enzymes - Weight gain - Edema


23. What are the 3 levels of Dysphagia?
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
Pureed - Mechanically altered - Advanced
Based on - Patient's digestive and absorptive capabilities - Metabolic requirements - Need for fluid restriction - Done in conjunction with dietician who will calculate patients individual nutritional need and develop plan to initiate feedings
High serum vit. A -D -K - B6 - niacin - Physical signs of excess - Diet hx


24. Inadequate parenteral nutrition infusion
Low cholesterol - Low Ca - High PTT - Low Cu/Zn/Fe - Weight loss - Dehydration
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
Indirect calorimetry measurement - Vitamin/mineral abnormalities in lab values - Inadequate weight gain - or unintentional weight loss Clinical evidence of vitamin/mineral deficiency
Diet hx of high intake - Diarrhea - Constipation - GI distress


25. Inadequate protein intake
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
Low serum vitamin levels - Physical signs of deficiency - Diet hx of low intake
Diet hx of low intake
High/low BGL - Meds (steroids) - Diet hx


26. What is the short-term nutritional biochemical analysis? What are the values?
Weight Loss - dx: AIDS - TB - AN
Ketone breath - Diet hx low CHO - Dx: liver - pancreas - celiac's disease
Low alb - Low BMI - Weight loss - Poor growth rate - Diet hx low PRO
Prealbumin- (visceral protein status) Normal Value: 16-40 g/dl Compromised Protein status: 10-15 g/dl Possible protein malnutrition: <10 g/dl


27. Excessive enteral nutrition infusion
Dry skin - Weight loss - diet hx of low intake - dx: AIDS - TB - AN - sepsis - infection - xs ETOH
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
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 BUN - High BGL - High liver enzymes - Weight gain - Edema


28. Excessive energy intake
High chol - amylase/lipase - liver function tests - Diet hx high fat
Weight gain - Diet hx of energy dense food intake
Diet hx of low plant food 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


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
Diet hx of aberrant CHO intake - Steroids - DM - Inborn errors
A- Anthropometric approach B- Biochemical Tests C- Clinical Observations D- Diet Evaluations (Kcal - 24 hr recall etc)
Ketone breath - Diet hx low CHO - Dx: liver - pancreas - celiac's disease


30. Inadequate energy intake
High BGL - Weight gain - High Hgb A1C - diet hx of energy dense food intake - Excess eating away from home
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
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. What are the assessments for Enteral Feedings?
Assessment - Residuals - Weight - Lung sounds - Edema - I & O - Blood glucose monitoring - Blood chemistry
Weight status and trends - BUN - creatinine - serum chemistries - proteins - Fluid status - intake and output
Diet hx of low fiber intake - Constipation/low stool volume
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


32. What is Protein-Controlled Diet?
Diet hx of aberrant CHO intake - Steroids - DM - Inborn errors
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
14 days of admission
Low alb - Low BMI - Weight loss - Poor growth rate - Diet hx low PRO


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

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34. Excessive parenteral nutrition infusion
Low alb - Low BMI - Weight loss - Poor growth rate - Diet hx low PRO
Provides essential nutrients in blenderized form - Clients who are unable to chew or swallow - Can be used long-term
Food items that minimize elimination patterns by reducing fecal volume - Restricted - High fiber foods - Milk and milk products - Fried foods - Pepper - Alcohol - Heavy seasonings
Elevated BUN:creatinine ratio - Hyperglycemia - Hypercapnia - Elevated liver enzymes - Weight gain - Edema - Meds that reduce energy requirements or impair metabolism


35. Predicted Excessive Nutrient 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
High BUN - High serum osmolality - High Na - Weight loss - Thirst
High/low BGL - Meds (steroids) - Diet hx


36. What is Low-Residue Diet?
Diet hx of low plant food 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
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 low fiber intake - Constipation/low stool volume


37. What is Carb-controlled Diet?
Elevated BUN:creatinine ratio - Hyperglycemia - Hypercapnia - Elevated liver enzymes - Weight gain - Edema - Meds that reduce energy requirements or impair metabolism
High/low BGL - Meds (steroids) - Diet hx
Low serum vitamin levels - Physical signs of deficiency - Diet hx of low intake
CHO 55-60% - protein 10-20% - lipid <30% - fiber 20-35 grams - Evaluate glucose levels - serum lipids - kcalories - diet - insulin/medication


38. What are Dysphagia 'warning signs'?
Low serum osmolality - Weight gain - Edema - Excess salt intake
Low serum mineral levels - Physical signs of deficiency - Diet hx of low intake - Celiac disease - SBS - IBD
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
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


39. Inadequate carbohydrate intake

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40. Inadequate vitamin intake
Low cholesterol - Weight loss - Poor dentition - Self-feeding problems - Inadequate nutrition support
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 serum vit. A -D -K - B6 - niacin - Physical signs of excess - Diet hx
Low serum vitamin levels - Physical signs of deficiency - Diet hx of low intake


41. What are some tube-feeding complications?
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 -
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
Allows body to heal -To prepare diagnostic test -To prepare Surgical Procedure
GI problems - Diarrhea - Nausea and vomiting - Cramping - Distention - Constipation - Mechanical complications - Tube displacement - Tube obstruction - Pulmonary aspiration - Mucosal damage


42. What is the Parenteral Nutrition?
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
Prealbumin- (visceral protein status) Normal Value: 16-40 g/dl Compromised Protein status: 10-15 g/dl Possible protein malnutrition: <10 g/dl
Low serum vitamin levels - Physical signs of deficiency - Diet hx of low intake
Reports or observations of energy intake more than needs - Lower physical activity - Planned change in mobility/physical activity - Meds increasing appetite - Knowledge deficit


43. What is Secondary Nutrition Risk?
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
A- Anthropometric approach B- Biochemical Tests C- Clinical Observations D- Diet Evaluations (Kcal - 24 hr recall etc)
Caused by disease
High serum vit. A -D -K - B6 - niacin - Physical signs of excess - Diet hx


44. What are the Anthropometric measures?
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
Height/length -Weight -BMI -Body Measures (skin fold thickness)
High BUN - High BGL - High liver enzymes - Weight gain - Edema
High BUN - Low GFR - Poor growth - Deranged AA ratios - diet hx high PRO or AA supplement


45. What are some other Restricted Diets?

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46. What is Enteral Nutrition? Why preferred over Parenteral Nutrition?
Kcal count -24 hr recall -Food records
Food items that minimize elimination patterns by reducing fecal volume - Restricted - High fiber foods - Milk and milk products - Fried foods - Pepper - Alcohol - Heavy seasonings
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
Prealbumin- (visceral protein status) Normal Value: 16-40 g/dl Compromised Protein status: 10-15 g/dl Possible protein malnutrition: <10 g/dl


47. Malnutrition - Symptoms
A- Anthropometric approach B- Biochemical Tests C- Clinical Observations D- Diet Evaluations (Kcal - 24 hr recall etc)
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
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 alb - Low BMI - Weight loss - Poor growth rate - Diet hx low PRO


48. Excessive intake
Biochemical parameters indicating excessive nutrient intake - Knowledge deficit - Meds affecting appetite - Nutrition in Patient Care
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
>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
High liver enzymes - Constipation - Diarrhea - CV changes - High intake of supplements/plant foods


49. What are the IV lipid emulsions for Parenteral Nutriton Solution?
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
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
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


50. Excessive or inappropriate fat intake
High chol - amylase/lipase - liver function tests - Diet hx high fat
Weight Loss - dx: AIDS - TB - AN
Food items that minimize elimination patterns by reducing fecal volume - Restricted - High fiber foods - Milk and milk products - Fried foods - Pepper - Alcohol - Heavy seasonings
Elevated BUN:creatinine ratio - Hyperglycemia - Hypercapnia - Elevated liver enzymes - Weight gain - Edema - Meds that reduce energy requirements or impair metabolism