front 1 Nurses key role in assessment | back 1 - assessing the nutritional needs of clients
- monitor and
intervene with clients requiring acute and chronic
nutritional
care. - consider and incorporate the family’s
nutritional habits into a client’s individual plan of care.
- take an active role in assessing and teaching community groups
regarding nutrition.
Cultural, social, and physical norms must be part of a client’s assessment |
| back 2 - is an assessment of usual foods, fluids, and supplements
- Components include the following:
- ● Time, type, and
amount of food eaten for breakfast, lunch, dinner, and
snacks
● Time, type, and amount of fluids consumed
throughout the day, including water, health drinks, coffee/tea,
carbonated beverages, and beverages with caffeine
● Type,
amount, and frequency of “special foods” (celebration foods,
movie foods)
● Typical preparation of foods and fluids
(coffee with sugar, fried foods)
● Number of meals eaten
away from home (at work or school)
● Type of preferred or
prescribed diet (ovo-lacto vegetarian, 2 g sodium/low-fat
diet)
● Foods avoided due to allergy or preference
●
Frequency and dose/amount of medications or nutritional
supplements taken daily
● Satisfaction with diet over a
specified time frame (last 3 months, 1 year) |
| back 3 - is performed by the provider or nurse to identify indicators of
inadequate nutrition.
- However, other diseases, or
conditions can cause these
clinical findings. |
front 4 Manifestations - Inadequate Nutrition | back 4 ● Hair that is dry or brittle, or skin that has dry patches
●
Poor wound healing or sores
● Lack of subcutaneous fat or muscle
wasting
● Irregular cardiovascular measurements (heart rate and
rhythm, blood pressure)
● Enlarged spleen or liver
● General
weakness or impaired coordination |
| back 5 - Weigh at the same time of day wearing similar clothingto ensure
accurate weight readings.
- Daily fluctuations generally are
indicative of water weight changes.
- Percentage weight
change calculation (weight change over a specified time):
-
%
weight change = (Usual weight - present weight / usual
weight) x 100
- Greater than 2% in 1
week indicates a significant weight loss.
- Greater than
7.5% in 3 months indicates a significant weight loss
|
front 6 “Ideal” body weight based on height (plus or minus 10% depending on
frame size). | back 6 ◯ MALES: 48 kg (106 lb) for the first 152 cm (5 ft)
of height, and 2.7 kg (6 lb) for each additional 2.5 cm (1 in).
◯ FEMALES: 45 kg (100 lb) for the first 152 cm (5
ft) of height, and 2.3 kg (5 lb) for each additional 2.5 cm (1 in) |
| back 7 ● Measure on a vertical, flat surface. Ask the client to remove shoes
and head coverings and stand straight with heels together looking
straight ahead.
● Obtain a recumbent measurement (lying on a
firm, flat surface) for infants and young children. |
| back 8 - Healthy weight is indicated by a BMI of 18.5 to 24.9.
- Overweight is defined as an increased body weight in relation to
height. It is indicated by a BMI of 25 to 29.9.
- Obesity is
an excess amount of body fat. It indicated by a BMI greater than or
equal to 30.
-
BMI =
weight (kg) ÷ height (m2)
|
front 9 Fluid intake and output (I&O) | back 9 ● Adults: 2,000 to 3,000 mL (2 to 3 L) per day
● Total average
output: 1,750 to 3,000 mL/day |
| back 10 are measured by serum albumin levels. Many non-nutritional factors
(injury or kidney disease), interfere with this measure for protein malnutrition. |
front 11 Prealbumin (thyroxine-binding protein) | back 11 is a sensitive measure used to assess critically ill clients who are
at risk
for malnutrition. This test reflects acute changes rather
than gradual changes. However, it is more expensive
and often unavailable. This is not part of routine
assessment.
● Prealbumin levels can decrease with an
inflammatory process resulting in an inaccurate measurement.
●
Prealbumin levels are used to measure effectiveness of total
parenteral nutrition. |
| back 12 refers to the relationship between protein breakdown (catabolism) and
protein
synthesis (anabolism). |
front 13 How to measure Nitrogen Balance | back 13 - Record protein intake (g) over 24 hr and divide by 6.25.
- Record nitrogen excretion in urine over 24 hr and add 4 g.
- Subtract nitrogen output from nitrogen intake.
- 24 hr
protein intake ÷ 6.25 = nitrogen intake (g)
- 24 hr urinary
urea nitrogen + 4 g = total nitrogen output
- Nitrogen intake
‑ total nitrogen
output = nitrogen balance - A neutral
nitrogen balance indicates adequate
nutritional intake
- A positive nitrogen balance indicates
protein synthesis is greater than protein breakdown as during
growth, pregnancy, or during recovery.
- A
negative nitrogen balance indicates protein is
used at a greater rate than it is synthesized as in starvation
or a catabolic state following injury or disease.
|
front 14 BIOPHYSICAL FACTORS FOR INADEQUATE NUTRITION | back 14 ● Medical disease/conditions/treatment (hypertension, HIV/AIDS,
surgery)
● Genetic predisposition (lactose intolerance,
osteoporosis)
● Age |
front 15 PSYCHOLOGICAL FACTORS FOR INADEQUATE NUTRITION | back 15 ● Mental illness (clinical depression)
● Excessive stress
●
Negative self-concept
● Use of comfort foods |
front 16 SOCIOECONOMIC FACTORS FOR INADEQUATE NUTRITION | back 16 ● Poverty
● Alcohol and other substance use disorders
● Fad
or “special” diets
● Food preferences: cultural, ethnic, or religious |