Term
| when do you refer a pt to a RD (11) |
|
Definition
NPO/clears x3d
prealbumin less than 18
tube feeding
TPN: total parental nutrition (vein in neck or arm)
ICU
stroke patient
nausea/vomiting/diarrhea
weight loss less than 85% IBW
newly diagnosed diabetic
uncontrolled DM
bariatrics |
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Term
| what are the 4 parts of care a RD provides |
|
Definition
nutrition assessment
nutrition diagnosis
nutrition intervention
nutrition monitoring and evaluation |
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Term
| what are the parts to a nutritional assessment (5) |
|
Definition
anthropometry
labs
nutritional physical
patient history
dietary goals |
|
|
Term
|
Definition
height
weight
BMI
IBW
weight change |
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|
Term
|
Definition
| demi span or standing scale |
|
|
Term
|
Definition
|
|
Term
|
Definition
females 100 lbs for 5 ft and 5 lbs for each inch over
males 106 lbs for 5 ft and 6 lbs for each inch over
+/-10% |
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|
Term
| how do you adjust for an amputation in IBW |
|
Definition
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Term
| what is the percent amputation of a hand, forearm and hand, entire arm, foot, lower leg and foot, entire leg |
|
Definition
hand 0.7
forearm and hand 2.3
entire arm 5
foot 1.5
lower leg and foot 5.9
entire leg 16 |
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|
Term
| what is weight change calculated, what is it dependent on, what is severe loss |
|
Definition
in elderly it is associated with morbidity and mortality
% change is based on usual and current weight
greater than 2% loss in a week or 5% in a month is severe |
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|
Term
| what are the parts to a nutrition physical |
|
Definition
| apperarance, information from doctors chart |
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Term
| what is part of a nutrition patient history (9) |
|
Definition
medication
supplements
medical history
diet history
nutrition awareness history
food availability
religious beliefs about food
activity
exercise |
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|
Term
| what are diet history goals (7) |
|
Definition
identify nutrient intake and imbalances
reasons for potential problems
food intolerances and allergies
appetite
physical handicap affecting food intake or perparation
meal patterns
readiness to change |
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|
Term
| what are the parts to a nutrition diagnosis |
|
Definition
etiology signs/symptoms statement (PES)
problem
etiology
signs and symptoms |
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|
Term
| what is done in the nutrition intervention phase |
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Definition
| priortize nutrition diagnosis by severity and importance |
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|
Term
| what is done in the nutrition monitoring phase, how often |
|
Definition
reexamination and data comparison
flexiable depends on patient progress
in hopsital every day or e/o day |
|
|
Term
| what is the BMI number scale |
|
Definition
<18 underweight
18.5 - 25 healthy
25 - 30 overweight
30 - 40 obease
40+ severe obesity |
|
|
Term
| what is caloric needs calculated based on |
|
Definition
| weight, height, age, activity, stress |
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|
Term
| what is the normal proteiin value |
|
Definition
|
|
Term
| what is the normal fluid value |
|
Definition
30-35 mL/ kg/ d
decrease in elderly
increase in young |
|
|
Term
| what is a normal albumin value what does it indicate |
|
Definition
<3.5 g/dl
hepatic protein that shows in response to injury, stress,infection, surgery, trauma. decrease in response to acute phase of stress
half life 19-21d (hard to tell excatly when it dropped or raised |
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|
Term
| what is a normal prealbumin level what does it indicate |
|
Definition
<18 g/dl
hepatic protein that shows in response to injury, stress,infection, surgery, trauma. decrease in response to acute phase of stress
half life 3-5 days better indicator |
|
|
Term
| what is a normal cholesterol level |
|
Definition
|
|
Term
| what is a normal LDL level |
|
Definition
|
|
Term
| what is a normal HDL level |
|
Definition
|
|
Term
| what is a normal TG level |
|
Definition
|
|
Term
| what is a normal WBC level |
|
Definition
|
|
Term
| what is a normal glucose level |
|
Definition
|
|
Term
| what is a normal HbA1C level |
|
Definition
| <5-6% (6-9% in controlled DM) |
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|
Term
| what does regular diet mean |
|
Definition
| no restrictions or modifications to diet |
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|
Term
|
Definition
| no salt added for pt with hypertension diet |
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|
Term
|
Definition
| uncontrolled hypertension, stroke pt, edema diet |
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|
Term
|
Definition
| poor or no dentition, oral surgery diet |
|
|
Term
| what does mechanical soft mean |
|
Definition
| dysphagia after stroke, no dentition ciet |
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|
Term
| who is consistant carb fore |
|
Definition
|
|
Term
| who is high protin high calorie for |
|
Definition
| poor intake, wounds, pressure ulcers, underweight |
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|
Term
|
Definition
|
|
Term
| what does low fiber/residue mean |
|
Definition
|
|
Term
| what does a cardic diet mean |
|
Definition
|
|
Term
| what does diabetic renal mean |
|
Definition
| diet for DM and kidney issue pt |
|
|
Term
| when is a clear liquid diet needed |
|
Definition
|
|
Term
| when is a full liquid diet needed |
|
Definition
|
|
Term
| what does stage 1 bariatric clear mean |
|
Definition
| surger free post bariatric surgery diet |
|
|
Term
| what does stage 2 bariatric full mean |
|
Definition
|
|
Term
| who is a purreed diet for |
|
Definition
|
|
Term
| who is a thickened liquid diet for |
|
Definition
| post SALT eval after stroke |
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|
Term
| hair exam: healthy, abnormal, implications |
|
Definition
healthy: normal distribution, shiny
abnormal: thin, dry, dull brittle
implications: chemo, protein, vit C vit A, zinc deficiency |
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|
Term
| lips exam: healthy, abnormal, implications |
|
Definition
healthy: moist, good color
abnormal: swollen, red, dry, cracked
implications: riboflavin, pyridoxine, niacin deficiency |
|
|
Term
| gums exam: healthy, abnormal, implications |
|
Definition
healthy: pink, firm
abnormal: sore, spongy, read, swollen, bleed easy
implications: vit C deficiency |
|
|
Term
| tongue exam: healthy, abnormal, implications |
|
Definition
healthy: pink
abnormal: purple, white, gray, smooth
implications: riboflavin, pyridoxine, folic acid, niacin, vit B12, fe deficient |
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|
Term
| teeth exam: healthy, abnormal, implications |
|
Definition
healthy: clean, intact, present
abnormal: dentures, loss of enamel, missing teeth
implications: vit C deficient |
|
|
Term
| skin exam: healthy, abnormal, implications |
|
Definition
healthy: smooth, slightly moist, good turgot
abnormal: pale, dry, poor turgor
implications: Fe, vit A, vit C, zinc, EFA deficient, dehydration |
|
|
Term
| nails exam: healthy, abnormal, implications |
|
Definition
healthy: smooth
abnormal:brittle, spoon shaped
implications: protein or Fe deficient |
|
|
Term
| define food intolerance and give an example |
|
Definition
adverse reaction to food that results in symptoms but is not caused by a reaction of the immune system
lactose intolerance |
|
|
Term
| define food allergy and give some examples |
|
Definition
adverse reaction to food that results in symptoms and is an immune mediated response
fish, wheat, peanuts, egg, milk, soy, tree nuts, shell fish |
|
|
Term
| how are allergies diagnosed |
|
Definition
skin prick
RAST test: measures presence of antibody IgE to special foods
elimination and re-challange |
|
|
Term
| how does a food allergin cause problems and 8 symptoms |
|
Definition
immune system identifies food as eaten as allergin and makes IgE
IgE attach to mast cell
mast cell releases histamine and other chemicals causing symptoms
hives, swelling in tongue and throat, difficult breathing, abdominal cramping, vomiting, diarrhea, low BP, anaphylaxis |
|
|
Term
| if someone is allergic to fish what nutrients are they missing, what are the alternativies |
|
Definition
missing: niacin, vitamin B, B12, E phosphorus, omega 3, selenium
instead: lean meat, poltury, whole grain, flax seed, legumes, walnuts, brazil nuts, vegetable oil |
|
|
Term
| what should people allergic to egg not ear |
|
Definition
| egg nog, dairy prepared with egg, egg substitute, poltury and fish seasoned with egg, egg bread, egg roll, mayo, salad dressing |
|
|
Term
| what nutrients is someone allergic to egg missing, what are alternativies |
|
Definition
B12, riboflavin, pantothenic acid, biotin, selenium
alternatives lean meat, poultry, legumes, whole or enriched grains |
|
|
Term
| what is dermatitis herpetiformis a sign of, what does it look like, how to diagnose |
|
Definition
skin manifestation of celiac disease
blisters, itchy
biopsy and stain for IgA |
|
|
Term
| what happens to cause issues in celiac disease |
|
Definition
| SI villi damaged by gluten |
|
|
Term
| what are symptoms of celiac disease in adults |
|
Definition
| weight loss, constipation or diarrhea, abdominal pain, bloating, fatigue, depression, osteopenia, osteoperosis, infertility, migraines |
|
|
Term
| what are symptoms of celiac disease in children |
|
Definition
| poor growth, short stature, diarrhea or constipation, vomiting, muscle wasting, irritability |
|
|
Term
| what is the treatment for celiac disease |
|
Definition
gluten free diet for life: avoid wheat, rye, barley, oats
villi restore in 6 mo in kids and 1-2 years in adults |
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|
Term
| what happens if someone with celiac disease dosent adhere to their diet |
|
Definition
| constpation, weight loss, diabetes, osteoperosis, IBS, infertility, milignancy, anemia, vitamin and mineral deficiencies |
|
|
Term
| what are 5 ways celiac disease is diagnosed briefly describe |
|
Definition
anti-tissue transglutaminase antibody (IgA, IgG): most sensitive
anti-endomysial antibody (IgA): specific marker
anti-deaminated glidian peptide (IgA, IgG): if transglutaminase is negative and pt is IgA deficient use this
anti-gladian antibody (IgA, IgG): used in kids less than 2 because they done have transglutaminase antibody and anti endomysial antibody yet
endoscopic bowel biopsy: best method |
|
|
Term
| after diagnosis of celiac disease, what do you tell your pt to do other than not eat gluten |
|
Definition
find a RD
MDT
bone density scan
discuss compliance issues: eating out, packed lunches, availablity and cost of GF foods, dislikes |
|
|
Term
| what does a RD do with a celiac disease patient |
|
Definition
| food and symptom diary, gluten sources in good and not good food, label reading, eating out, yearly follow up |
|
|
Term
| what deficiencies does someone with celiac disease have in their diet, what does this cause |
|
Definition
low iron
calcium: peak bone mass not achieved in growth if diagnosed late, low absorption
folate: in fortified breads and cereals which they cant eat |
|
|
Term
| can can peoeple with celiac disease eat in the carb, fruit and vegetable, protein, and dairy categories |
|
Definition
carbs: cream of rice cereal, puffed rice or corn cereal, GF products, quinoa, buckwheat, rice cakes, plain popcorn
any protein, fruits and vegetable plain with no sauce
dairy: read cheese sauce and spread labels, salad dressing, mayo, miracle whip |
|
|
Term
| what foods can a celiac disease pt not have |
|
Definition
flour: bromated, enriched, self rising any
beer, ale, port, stout, malt
coullion cubes, soup
candy, cakes, cookies, bread, french fries, chips
gravy, sauces, soy
some medications
oatmeal, cereal bars, oats |
|
|
Term
| what qualifies someone with anorexia nervosa DSM IV |
|
Definition
restriction of foor leading to body weight less than minimally normal for age and heart (<85% expected)
intense fear of gaining weight or being fat |
|
|
Term
| what are warning signs of anorexia |
|
Definition
dressing in layers to hide loss
dramatic weight loss
preoccupation with preparing own meals
refusal to eat certian foods or groups
comments about fat
anxiety about weight
denial of hunger
development of food rituials
avoidance of meal time
excessive excrcise
changes in personality: withdrawl, strange eating patterns, overuse of condiments, boiling hot foods |
|
|
Term
| who is most likley to get anorexia, what other states about morbidity and mortality |
|
Definition
female teenagers
highest death rate in mental illness
treatable and curable |
|
|
Term
| what qualifies someone to have bulimia nervosa DSM IV |
|
Definition
binge eating: amount of food in 2h that is larger than people would eat during a smaller period of time. sense of lack of control
compensatory self-induced vomiting, laxatives, diruetics, enemas, fasting, exercise, or medications
approx 2 times a week
dosent have to be with anorexia |
|
|
Term
|
Definition
focus on weight loss, diet, controlling food
evidence of large quantities of food missing
empty wrappers
frequent trips to bathroom after eating
signs and smells of vomits
food rituials
stealing or hoarding food
baggy clothes
excessive teeth brushing, mouthwashing, or gum
excessive exercise
calluses on fingers
cracks in corners of mouth
social withdrawl |
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