Nutrition Screening and Assessment FCS 5151 Burns
Session Outcomes • Differentiate between nutrition screening and assessment • Analyze the nutritional status of a classmate using a variety of screening and assessment tools. Niedert, 1998
Nutrition Screening • Process of identifying characteristics known to be associated with nutrition problems • Purpose: to quickly identify persons at greatest risk for malnutrition, especially protein energy malnutrition (PEM) • Quick, safe, and cheap Niedert, 1998
Types of Malnutrition • Protein-energy malnutrition • Acute vs. chronic • Kwashiorkor – protein deficiency • Marasmus – energy deficiency Niedert, 1998
Kwashiorkor v marasmus Burns, 2005
Kwashiorkor Edema Less obvious muscle wasting Mental changes Poor appetite Fatty liver Marasmus Severe wasting of muscle and fat Good appetite No mental changes Minimal changes in hair color/texture Identifying characteristics Niedert, 1998
Nutrition Screening • What it is? • Who does it? • When it is done? • Where? • How? Burns, 2005
From the video… • Characteristics of malnutrition • Parts/steps of screening • Outcomes of screening Burns, 2005
Nutrition Screening Process • Includes a quick collection and interpretation of crucial data • Determines the need for nutritional assessment • Identifies level of risk for malnutrition through the examination of many risk factors Niedert, 1998
Nutrition Screening Initiative (NSI) • Focuses on older Americans • Joint effort • Goals • ID potential risk factors • ID indicators of malnutrition • Raise public awareness Boyle, 2004
Nutrition Assessment • Comprehensive approach that defines nutritional status using medical, nutrition, and medication histories; physical examination; anthropometric measurements and laboratory data. • Process of estimatingindividual or group nutritional status as a basis for • identifying needs and goals • planning personal health care • community programs to meet nutritional needs Niedert, 1998
Assessing Nutritional Status • Anthropometrics • Biochemical • Clinical • Dietary • Emotional • Functional • Medication Niedert, 1998
Anthropometric methods • Measurements of physicaldimensions and gross composition of body • Commonly used • Specific measures include height, weight, skinfolds, BMI, waist circumference Burns, 2005
Biochemical methods • Measurements of chemical components • Provide indications of tissue level and/or functioning • Most objective, but expensive and invasive • Examples? • Factoring influencing values Niedert, 1998
Factors Influencing Lab Values • Hydration status • Physiological stress • Sensitivity of the test • Blood being tested • Sensitivity of the equipment • Validity of reference standards Niedert, 1998
Clinical assessment • Observation of physical signs associated with malnutrition • Hair, eyes, lips, gums, mouth, tongue, teeth, face, neck, nails, skin • More subjective • Very useful in screening Niedert, 1998
Dietary assessment • collection of food intake data • analysis and interpretation of food intake data • to make judgments about dietary adequacy • can occur at the national, household, or individual level Niedert, 1998
Dietary Assessment Types • Food records • Estimation by recall • Food frequency • Diet history • Direct observation Niedert, 1998
Emotional Assessment • Why important to include? • What kinds of questions are asked? Niedert, 1998
Functional Assessment • Activities of daily living • Self-care activities • Instrumental activities of daily living • Those that require a higher level of functioning Niedert, 1998
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Medication Assessment • Drug-drug and drug-nutrient interactions • Inhibit absorption of nutrients • Increase the excretion of a nutrient • Cause nausea, vomiting, diarrhea • Inhibit or induce metabolism of a nutrient • Increase or decrease appetite • Alter the taste and smell of the individual Niedert, 1998
What do you think? • What are the top five commonly used medications in men and women aged 65+? Kaufman, Kelly, Rosenburg, etal, 2002
Issues of data collection • Validity • Reliability • Cultural issues Boyle, 2004
Session Assessment • Differentiate between nutrition screening and assessment • Analyze the nutritional status of a classmate using a variety of screening and assessment tools. Niedert, 1998
