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Nutritional Assessment

Nutritional Assessment. Chapter 11. Defining Nutritional Status. Optimal nutritional status Undernutrition Overnutrition Nutritional requirements at different ages Infants and children Adolescence Pregnancy and lactation Adulthood The aging adult.

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Nutritional Assessment

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  1. Nutritional Assessment Chapter 11

  2. Defining Nutritional Status • Optimal nutritional status • Undernutrition • Overnutrition • Nutritional requirements at different ages • Infants and children • Adolescence • Pregnancy and lactation • Adulthood • The aging adult

  3. Purposes and Components of Nutritional Assessment • Purposes of nutritional assessment • Nutrition screening • Admission nutrition screening tool • 24-Hour diet recall • Food frequency questionnaire • Food diaries • Direct observation • Food guide pyramid

  4. Subjective Data—Health History Questions • Eating patterns • Usual weight • Changes in appetite, taste, smell, chewing, swallowing • Recent surgery, trauma, burns, infection • Chronic illnesses • Vomiting, diarrhea, constipation • Food allergies or intolerances • Medications and/or nutritional supplements • Self-care behaviors • Alcohol or illegal drug use • Exercise and activity patterns • Family history

  5. Objective Data—Physical Exam • Equipment needed • Skinfold calipers—Lange or Harpenden • Measurement tape • Anthropometer • Pen or pencil • Nutrition assessment data form

  6. Objective Data—Physical Exam (cont.) • Anthropometric measures • Derived weight measures • Body weight as percent of ideal body weight • Percent usual body weight • Recent weight change

  7. Objective Data—Physical Exam (cont.) Weight (kg) or Weight (lbs) Waist circumference • Body mass index = Height (m)2 Height (in)2 x 705 • Waist-to-hip ratio = Hip circumference

  8. Objective Data—Physical Exam (cont.) • Skinfold thickness • Technique of measurement • Repeat three measurements and then take average • Mid-upper arm circumference (MAC)

  9. Objective Data—Physical Exam (cont.) • Derived anthropometric measures • Mid-upper arm muscle circumference (MAMC) MAMC = MAC – (p × TSF) • Mid-arm muscle area (MAMA) MAMA = (MAC – MAMA)2 4p • Arm span or total arm length • Frame size by elbow breadth

  10. Hemoglobin Hematocrit Cholesterol Triglycerides Total lymphocyte count Skin testing Serum proteins Serum albumin Serum transferrin Prealbumin Nitrogen balance Creatinine-height index Laboratory Studies in Nutritional Assessment

  11. Abnormal FindingsClassification of Malnutrition • Obesity • Marasmus (protein-calorie malnutrition) • Kwashiorkor (protein malnutrition) • Marasmus/kwashiorkor mix

  12. Abnormal FindingsAbnormalities Caused by Nutritional Deficiencies • Pellagra • Scorbutic gums • Follicular hyperkeratosis • Bitot’s spots • Kwashiorkor • Rickets • Magenta tongue • HIV-associated malnutrition

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