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Health Assessment
Chapter 11- Nutritional Assessment
147
Health Care
Undergraduate 1
03/26/2012

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Term
Android obesity
Definition
excess body fat that is placed predominantly within the abdomen and upper body, as opposed to the hips and thighs
Term
Anthropometry
Definition
measurement of the body (height, weight, circumferences, skinfold, thickness)
Term
Body mass index
Definition
weight in kilograms divided by height in meters squared (W/H2); value of 30 or more is indicative of obesity; value of less than 18.5 is indicative of undernutrition
Term
Diet history
Definition
a detailed record of dietary intake obtainable from 24 hour recalls, food frequency questionnaire, food diaries, and similar methods
Term
Gynoid obesity
Definition
excess fat that is placed premoinantly within the hips and thighs
Term
Kwashiorkor
Definition
primarily a protein defieciency characterized by edemea, growth failure, and muscle wasting
Term
Malnutrition
Definition
may mean any nutrition disorder but usually refers to long-term nutritional inadequacies or excess
Term
Marasmic Kwashiorkor
Definition
combination of chronic energy deficit  and chronic or acute protein deficiency
Term
Marasmus
Definition
results from energy and protein deficiency, presenting with significant loss of body weight, skeletal muscle, and adipose tissue mass, but with serum protein concentrations relatively intact
Term
Mid-arm muscle area (MAMA)
Definition
a more sensitive indicator of lean body mass than MAC or MAMC
Term
Mid-upper arm circumference
Definition
indicator of lead body mass and fat stores
Term
Mid-upper arm muscle cirfumference
Definition
indicator of lean body mass calculated from tricepts skinfold thickness and the miss upper arm circumference
Term
Nutritional Monitoring
Definition
assessment of dietary or nutritional status at intermittent times with the aim of detecting changes in the dietary or nutrional status of a population
Term
Nutritional screening
Definition
process used to identify  individuals  at nutrition risk or with nutritional problems
Term
obesity
Definition
excess accumulation of body fat; usually defined as 20% above a desirable weight or body mass index is 30.0-39.9
Term
Protein-calorie malnutrition (PCM)
Definition
inadequate consumption of protein and energy, resulting in a gradual body wasting and increased susceptibility to infection
Term
Recommended dietary allowance (RDA)
Definition
levels of intake of essential nutrients considered to be adequate to meet the nutritional needs of practically all healthy persons
Term
Serum proteins
Definition
proteins present in serum that are indicators of the body's visceral protein status (albumin, prealbumin, transferrin)
Term
skinfold thickness
Definition
double fold of skin and underlying subcutaneous tissue that is measured with skinfold calipers at various body sites
Term
waist-to-hip ratio (WHR)
Definition
waist or abdominal circumference divided by the hip or gluteal cirfumference; method for assessing fat distribution
Term
Nutritional Status
Definition
Refers to the degree of balances between nutrient intake and nutrient requirements that can be affected by many factors including physiologic, psychsocial, developmental, cultural, and economic
Term
optimal nutritional status
Definition
sufficient nutrients consumed; people with this status are more active , have fewer physical illnesses and live longer than those who are malnourished
Term
Undernutrition
Definition
nutrient intake is inadequate; vulnerable groups are at risk for impaired growth and developement, have lower resistance to infection and disease, delayed wound healing, longer health care stays, and health care costs
Term
Overnutrition
Definition
consumption of more than body requirements , especailly in fats, soium, and calories. This can lead to obesity, heart disease, diabetes, hyptension, stroke, cancers, etc
Term

Role cultural heritage and values

 

Definition
cultural hertiage play a role because there are people of different races that have different nutrient needs like how black women have lower hemoglobin levels than white women, so white women dont need as much iron as black women. Culture values vary within culture that it can be conflicting to the optimal nutition status: someone countries may see obesity as beautiful
Term

-identify individuals who are malnourished or at risk for developing malnutrition

-provide data for designing a nutritoina plan of care that will prevent or minimize the development of malnutrition

-establsh inadequate food intake or recent illness

Definition
3 purposes of a nutritional assessment
Term
comprehensive nutrtional assessment
Definition
individuals who are identified at the nutritonal risk during screening should undergo____________that includes dietary history and clinical info, physical exam for clincal signs, anthropometric measures, and lab tests
Term
24 hour recall, food frequency, questionnaire, and food diary
Definition
various methods for collecting current dietary intake
Term
24 hour recall
Definition
the easiest and most popular method of obtaining info about dietary intake is the
Term

1) the individual or family member may not be able to recall the type of amount that was eaten

2) intake within the last 24 hours may be atypical of usual intake

3) the individual or family member may alter the truth for a variety of reasons

4) snack items, gracies, sauces, and condiments (salt or pepper) may be unreported

Definition
4 sources of error that may occur when using the 24 hour recall
Term
breastfeeding
Definition
recommendations for full-term infacnts for the 1st year of life to promote normal infant growth and development and natural immunity is
Term
cow's milk
Definition
this milk is not recommended for untils until 1 year of age because it can cause gastrointestinal and kidney problems and is a poor source of iron and vitamins c and e
Term
those who have HIV because HIV can be transmitted through breast milk
Definition
who shouldn't ever breastfeed their baby
Term
skim; low fat; low fat
Definition
infant and children should not drink _________ or________milk or even be placed in ________ diets
Term
fat
Definition
what do infant and toddlers need for proper growth and central nervous sytem development
Term
calories, protein, iron, and calcium
Definition
with adolescence the requirements increase
Term
nutritional snacks
Definition
not only should adolescents eat three times per day but they should also have
Term
skipping meals, excessive fast food and sweetened beverage consumed, limited fruits and vegetables,eating disorders,hectic schedules,drugs and alcholo
Definition
adolesence tend to have unhealthy habits such as
Term
stabilized
Definition
during adulthood growth and nutrient must be
Term
educations, to preserve health and to prevent or delay onset of chronic disease
Definition
because of lfiestyle factors such as smoking or lack of excercise in the adults, it is the time for
Term
undernutrtion or overnutrition
Definition
older adults have increased risk for
Term
nutrient-dense food choices (milk, eggs, cheese, and peanut butter) are important o offset low energy/calorie needs
Definition
in aging adults they need
Term
poor physical or mental health, limited function, poor dentiiton, decreased visual acuity, decreased gastrointestinal absorption and diminshed olfactory and taste of sensitivty
Definition
the aging adult declines in these areas
Term
medications
Definition
taking multiple ______can be considered to increasing the risk of a older adult to become undernutrition or over nutrition
Term
sufficient calories, protein, vitamins, minerals, iron, folate, and zinc
Definition
pregnant women need to take this
Term
25-35 lbs
Definition
The recommended weight gain for a normal weight woman
Term
28-40 lbs
Definition
the normal weight gain for pregnant underweight women
Term
15-25 lbs
Definition
the recommended weight gain for women who are overweight is
Term
11-20 lbs
Definition
the recommended weight gain for obese pregnant women is
Term
digestion, absorption, metabolism, and utilization
Definition
many medications can interact with nutrients and impair their
Term
less than 70% of ideal body weight
Definition
severe malnutrition is
Term
nutritional deficiency
Definition
when menarche hasn't occcured there may be
Term
interview or questionnaire
Definition
the 24 hour recall can be an
Term
60% of total calorie intake
Definition
complex carbohydrates make up
Term
Metabolic syndrome
Definition

Waist circumference: in men > or = to 40

in women > or = to 35

glucose: -> or = to 100 mg/dL

Triglycerides > or = 150 mg/ dL

HDL: in men < 40mg/dL

in women < 50 mg/dl

Blood pressure: > or = systolically/ > or =85 systolically

Term
Bitot's spots
Definition
foamy plaques of the cornea that are sign of vitamin A deficiency. Severe deoketuib nay result in conjunctival xerosis (drying) and progess to corneal ulceration and destruction of the eye (keratomalacia)
Term
HIV infection malnutriton
Definition
one that can been sickly since shortly after birth can suffer from this malnutrition
Term
Rickets
Definition
Sign of vitammin D and calium defeciencies in children (disorder of cartilage cell growth, enlargement of epiphyseal growth plates) and in adult (osteromalacia)
Term
Magenta tongue
Definition
sign of riboflavin deficiency.
Term
iron deficiency
Definition
pale tongue indiciateds
Term
vitamin B-complex deficincy
Definition
a beefy-red-colored tongue i caused by
Term
Scorbutic gums
Definition
deficinecy of vitaminc C. Gums are swollen, ulcerated,a nd bleeding due to vitamin c induced defects in oral epithelial basement membrane and periodontal collagen giber synthesis
Term
Follicular Hyperkeratosis
Definition
dry, bumpy skin associated wutg vutanub A and or linoleic acid deficncy may also result in eczematous skin, especially in infants
Term
Pellagra
Definition
pigmented kerattic scaling lesions from deficiency of niacin these lesions are esp.prominent in areas exposed to the sun, such as hands, forearms, neck, and elegs
Term
Kwashirkor
Definition
occurs in childresn and adult who diets contain mostly carbs and little or nor protein and under stress. Generalized edema, scaling areas of decreased hair pigmentation
Term
food frequency questionairre to collect how many time per day, week, or month they eat
Definition
if you encounter any difficulties with the 24 hour recall use the
Term
food diaries
Definition
individual or family member writes fown everyrthing consumed for certain period of time
Term
direct observation
Definition
eatine and feeding process can detect problems not readily identified through nutrition interviews
Term
malnutrition screening tool
Definition
this method is used for adult care patients
Term
Mini Nutritional Assessment
Definition
this method is used in older adults in long term care and community setting
Term
subjective data
Definition

-eating patterns

-usual weight

changes in appetite, taste, smells, chewing, and swallowing

-recent surgery, trauma, burns, infection

-chronic illnesses

-vomitin,diarrhea, constipation

-food allergies or intolerances

-medication and or nutritional supplements

-self-care behaviors

-alcohol or illegal drug use

excercise and activity patterns

-family history

Term
depleted
Definition
underweight individuals are at risk because their fuels may be
Term
increase
Definition
when one can had any recent surgery, trauma, burns, or infection an _______calories and nutrient intake is greater than normal
Term
vitamins/minerals
Definition
these supplements have harmful side effects if taken in large amounts
Term
< 2500 g
Definition
low birth weight that is a major factor in infant morbidity and mortality
Term
small portions, finger foods, simple meals, and nutritious snacks
Definition
preschoolers should eat
Term
grapes, round candies, nuts, and hotdogs
Definition
avoid these foods for preschoolers
Term
anabolic steroids
Definition
these give adverse effects including personality disorders of agreesives, liver, and organ damage
Term
dehydrates, high blood pressure and heart rate, and sleeping problems
Definition
large amounts of caffeine, stimulants, herbal products can make adolescents
Term
binge-eating
Definition
the most common eat disorder of all age groups
Term
nutritional deficiency
Definition
 scan mentstrual flow and amenorrhea occurs from
Term
latent diabetes
Definition
an infant that was 10 lbs or more may indicate that the mother has
Term
mercury toxicity
Definition
large amount of fish consumption may be associated with maternal,fetal, and neborn
Term
cachectic
Definition
fat and muscle wasting
Term
mild malnutrition
Definition
weight of 80% to 90% of ideal weight
Term
moderate malnutrition
Definition
weight of 70% to 80% of ideal weight
Term
severe malnutrition
Definition
weight of < 70% of ideal body weight
Term

underweight

 

Definition
BMI of < 18.5
Term
normal weight
Definition
BMI of 18.5-24.9
Term
overweight
Definition
BMI of 25-29.9
Term
obesity
Definition
BMI of 30-39.9
Term
extreme obesity
Definition
BMI of > 40
Term
underweight
Definition
BMI for children > 5th percentile
Term
normal weight
Definition
BMI for children 5th - 85th percentile
Term
oberweight
Definition
BMI for children 85th to 95th percentile
Term
obese
Definition
BMI children > to equal to 95th percental
Term
android obesity
Definition

A waist-ti-hip ratio of 1.0  or greater in men or 0.8 or greater in women is indicative of 

 

Term
> 35
Definition

women with this waist circumference are at risk

 

Term
> 40 inches
Definition
a waist circumference in men that are at risk
Term
triceps skinfold (TSF)
Definition
the most easily accesible for skinfold thickness
Term
arms hanging freely at the sides and back to the examiner
Definition
when measuring skinfold thickness of ambulatory person, they should stand with
Term
one sides with upper arm fully extended and hand resting on their thigh
Definition
when measuring an ambulatory person, they should lie on
Term
thumb and forefinger of your left hand; calipers; 3 seconds
Definition
to measure skinfold thickness use your ______ and ____________ to gently grasp fold of skin and fat on the back of the person's left upper arm. While grasping the skinfold, pick up the __________ on the right hand and depress the spring loaded lever, hold ir horizonatlly to fat fold and then release the lever while holding the skin fold. Waist _____Seconds and then read.
Term
repeat three times and average the three skinfold measurements
Definition
when measuring the skinfold thickness
Term
undernutiton or overnutition
Definition
if TCF is over or under 10% it may indiciate
Term
measuring tape; tightly
Definition
when measuring the mid-upper arm circumference the person can stand or sit with their arm hanging fully extended and relaxed on the side of the body loop the _______________-tape around the arm at midpoint of arm and then_________ it firmly but not to tight where it pinches.
Term
23-34.5
Definition
normal mid arm circumference (MAC) onn a male is
Term
37.2-37.2
Definition
normal range of the mid arm cirfumerence for 20 year old female is
Term
sagging skin, changes in fat distribution, and declining muscle mass
Definition
MAC and TCF measurements are difficult to obtain and interpret in older adults because of
Term
bioeletrical impedence analysis and dual energy x-ray absorptiometry
Definition
two new techniques that measures fat and lean body mass are
Term
arm span or total arm length
Definition
measuring this is useful for situations in which height is difficult to measure; measure from the distance of the sternotch to the longest finger of the dominant hand and multiply by 2
Term
elbow breadth (measure of skeletal breadth)
Definition
the most accurate method to determine frame size to find out range of ideal body weight
Term
90 degree angle; condyles
Definition
when measuring frame size, have their arm bend at ________________ and face the person and place the calipers on the____________________of the humerus
Term
60-110 mg/dl
Definition
glucose level for young children (0-2 years)
Term
60-100 md/dl
Definition
glucose level of 2-18 years old
Term
<100 mg/DL
Definition
glucose for adults should be
Term
hemoglobin
Definition
this determins iron deficiency anemia
Term
14.5 to 22.5 g/Dl
Definition
normal hemoglobin values in infant who are 1 to 3 days old is
Term
9.0 to 14.0 g/Dl
Definition
normal hemoglobin values for indants who are 2 months is
Term
11.5 - 15.5 g/Dl
Definition
normal hemoglobin levels for children 6-12 years is
Term
1-18 g/dL
Definition
normal hemoglbin levels of adult males is
Term
12-16
Definition
normal hemoglobin levels ofr adult females is
Term
hematocrit
Definition
measures cell volume
Term
44% to 72%
Definition
hematocrit in infant from 1-3 days is
Term
28% to 42%
Definition
Hematocrit levels for infant at 2 months
Term
35% to 45%
Definition
hematocrit levels of 6-12 years old
Term
37% to 49%
Definition
hematocrit levels of adult males is
Term
36%-46%
Definition
hematocrit levels for adult females is
Term
cholesterol
Definition
this evaluates fat metabolism and risk for cardiovascular disease
Term
120 to 200 mg/dL
Definition
cholesterol varies with age and gender and ranges from
Term
< 100 mg/dL
Definition
LDL-C values in children and adolescent should be
Term
< 130 mg/dL
Definition
LDL  values in adults should be
Term
35- 65 md/dL
Definition
normal values of HDL in men are
Term
35-80 mg/dL
Definition
normal HDL values in women are
Term
triglycerides
Definition
this is used to screen for hyperlipidemia and risk for coronary artery disease
Term
10-100 mg/dL
Definition
normal triglycerides from ages 0-19 is
Term
Definition
normal triglycerides from ages 20-65 is < 150 mg/dL
Term
serum proteins
Definition
mreasurment of visceral protein status
Term
3.5-5.5 g/dL
Definition
normal range for serum albumin concentration is
Term
200 mg/dL; > 250 mg/Dl
Definition
in an obese person serum cholesterol is ___ and serum triglycerides is
Term
well nourished or obese
Definition
individuasl with kwashiorkor may appear
Term
< 3.5 m/dL
Definition
Serum albumin of kkwashirkor is
Term
< 150md/dL
Definition
serum transferrin for Kwashiorkor is
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