CDR Exam Domain II - Nutrition Care for
Individuals and Groups
True or False: Data reviewed during assessment is reviewed during ALL steps of the
NCP - ANSWER-TRUE
What is the purpose of nutrition screening? - ANSWER-to identify people who are
malnourished or at risk for malnutrition
How long is nutrition screening? - ANSWER-brief (5-10 minutes)
What is reviewed during nutrition screening? - ANSWER-hx, labs, wt, physical signs
For screening to be accurate what must it be based on? - ANSWER-specificity (ID
patients without a condition) and sensitivity (ID patients with a condition)
What does TJC mandate in regards to nutrition screening? - ANSWER-- TIME FRAME
WITHIN 24 HOURS OF ADMISSION
- does not mandate the method of screening
What is the SGA screening tool and what does it measure? - ANSWER-- Subjective
Global Assessment
- history, intake, GI symptoms, functional capacity, physical appearance, edema, weight
change
What is the MST screening tool and what does it measure? - ANSWER-- Malnutrition
Screening Tool
- acute hospitalized population, recent weight loss, poor dietary intake
What is the MUST screening tool and what does it measure? - ANSWER-- Malnutrition
Universal Screening Tool
- BMI, unintentional wt loss, effect of acute disease on intake for more than 5 days
What are the components of nutritional assessment? - ANSWER-- REVIEW data for
factors that affect nutritional and health status
- Use CLUSTERED assessment data (food and nutrition related hx, anthropometrics,
lab/medical tests, NFPE)
- Comparison of data to IDENTIFIED STANDARDS
What is a food record? - ANSWER-food diary, record of everything eaten in a specific
period of time
,What are concerns with 24 hour recall? - ANSWER-underreporting and over-reporting
What are food frequency lists and when should they be used? - ANSWER-- how often
an item is consumed
- community setting, intakes on large numbers of people
What is the Hamwi formula? - ANSWER-- used to calculate IBW
- Men = 106 lb + 6 lb for every inch over 5ft
- Women = 105 lb + 5 lb for every inch over 5ft
What is the formula for % wt change? - ANSWER-(USUAL WEIGHT) - (CURRENT
WEIGHT)/(USUAL WEIGHT) x 100
What constitutes significant wt change? - ANSWER-- 5% in one month
- 7.5% in 3 months
- 10% in 6 months
What waist circumference is identified as a risk factor for disease in men and women? -
ANSWER-- M = >40
- W = >35
- WC is BEST FOR RISK, predicts adiposity
How does a bod pod measure body composition? - ANSWER-- determines body
density by measuring the amount of air displaced
- as accurate as underwater weighing
What are the 4 physical examination techniques? - ANSWER-- Inspection (gathering
info via observation)
- Palpation (gathering data via touch)
- Auscultation (listening to heart, bowel)
- Percussion (not done by RD)
What is the normal range for serum albumin and what does it measure? - ANSWER--
3.5-5.0mg/dL
- visceral protein (blood and organs) that maintains osmotic pressure
- levels above normal range suggest dehydration
- DOES NOT reflect current protein intake
What is the normal range for serum transferrin and what does it measure? - ANSWER--
> 200mg/dL
- visceral protein that transports iron to bone marrow
- rises with iron deficiency
- can be determined from TIBC
,What is the normal range for serum prealbumin and what does it measure? -
ANSWER-- 16-40mg/dL
- during inflammation liver synthesizes CRP at expense of PAB
- LIMITED USEFULNESS
What is the normal range for serum hematocrit and what does it measure? - ANSWER--
M = 42-52%, W = 36-48%
- volume of packed cells in whole blood
What is the normal range for serum Hgb and what does it measure? - ANSWER-- M =
14-18mg/dL, W = 12-16mg/dL
- iron containing pigment of RBC
What is the normal range for serum ferritin and what does it measure? - ANSWER-- F =
10-150ng/mL, M = 12-300ng/mL
- indicates size of iron storage pool
What is the normal range for serum creatinine and what does it measure? - ANSWER--
M = 0.6-1.2mg/dL, W = 0.5-1.1mg/dL
- r/t muscle mass (somatic protein)
What is the normal range for serum BUN and what does it measure? - ANSWER-- 10-
20mg/dL
- related to protein intake, indicator of renal disease
- BUN to creatinine ratio 10-15:1 is normal
What is the normal range for urinary creatinine clearance and what does it measure? -
ANSWER-- 115±20ml/min
- measures GFR
What is the normal range for total lymphocyte count and what does it measure? -
ANSWER-- > 2700 cell/cu mm
- measures immunocompetency
- decreased in PCM
What is the normal range for CRP and what does it measure? - ANSWER-- measure of
acute inflammatory stress
- as it declines, indicates when nutritional therapy would be beneficial
- when elevated CRP DECREASES, PAB INCREASES
What is the normal range for prothrombin time and what does it measure? - ANSWER--
11-12.5 seconds
- anticoagulants prolong PT
- evaluates clotting adequacy
- change in vitamin K will alter rate
, What is the TEE for sedentary, active, and stressed pt's? - ANSWER-- sedentary = BEE
x 1.2
- active = BEE x 1.3
- stressed = BEE x 1.5
What is EER? - ANSWER-- Estimated Energy Requirements
- average dietary intake predicted to maintain energy balance in a healthy adult of a
defined age, gender, weight, height, and level of PA consistent with good health
What is the effect of megestrol acetate? - ANSWER-appetite stimulant
What is the effect of dextroamphetamine (adderall)? - ANSWER-appetite suppressant,
anorexia, nausea, wt loss
What is the effect of orlistat? - ANSWER-decreased fat absorption by binding lipase;
vitamin/mineral supplementation
What is the effect of marinol? - ANSWER-appetite stimulant
What is the effect of methylphenidate (Ritalin)? - ANSWER-anorexia, wt loss, nausea
What is the effect of statins? - ANSWER-decreased LDL and TG; increased HDL; avoid
grapefruit juice
What is the effect of chemotherapy? - ANSWER-malabsorption
What is the effect of mineral oil, cholestyramine? - ANSWER-decrease absorption of fat,
fat-soluble vitamins
What is the effect of glucocorticoids, antibiotics? - ANSWER-protein deficits
What is the effect of oral contraceptives? - ANSWER-decreased folate, B6, vitamin C
What is the effect of loop diuretics? - ANSWER-deplete thiamine, K+, Mg++, Ca++, Na+
What is the effect of thiazide diuretics? - ANSWER-decrease K+ and Mg++, absorb Ca+
+
What is the effect of antibiotics? - ANSWER-decrease vitamin K and protein deficits
What is the effect of steroids? - ANSWER-decrease bone growth, CHO intolerance
What is the effect of methotrexate? - ANSWER-decreased folate
What is the effect of lithium carbonate (antidepressant)? - ANSWER-- increased
appetite, wt gain
Individuals and Groups
True or False: Data reviewed during assessment is reviewed during ALL steps of the
NCP - ANSWER-TRUE
What is the purpose of nutrition screening? - ANSWER-to identify people who are
malnourished or at risk for malnutrition
How long is nutrition screening? - ANSWER-brief (5-10 minutes)
What is reviewed during nutrition screening? - ANSWER-hx, labs, wt, physical signs
For screening to be accurate what must it be based on? - ANSWER-specificity (ID
patients without a condition) and sensitivity (ID patients with a condition)
What does TJC mandate in regards to nutrition screening? - ANSWER-- TIME FRAME
WITHIN 24 HOURS OF ADMISSION
- does not mandate the method of screening
What is the SGA screening tool and what does it measure? - ANSWER-- Subjective
Global Assessment
- history, intake, GI symptoms, functional capacity, physical appearance, edema, weight
change
What is the MST screening tool and what does it measure? - ANSWER-- Malnutrition
Screening Tool
- acute hospitalized population, recent weight loss, poor dietary intake
What is the MUST screening tool and what does it measure? - ANSWER-- Malnutrition
Universal Screening Tool
- BMI, unintentional wt loss, effect of acute disease on intake for more than 5 days
What are the components of nutritional assessment? - ANSWER-- REVIEW data for
factors that affect nutritional and health status
- Use CLUSTERED assessment data (food and nutrition related hx, anthropometrics,
lab/medical tests, NFPE)
- Comparison of data to IDENTIFIED STANDARDS
What is a food record? - ANSWER-food diary, record of everything eaten in a specific
period of time
,What are concerns with 24 hour recall? - ANSWER-underreporting and over-reporting
What are food frequency lists and when should they be used? - ANSWER-- how often
an item is consumed
- community setting, intakes on large numbers of people
What is the Hamwi formula? - ANSWER-- used to calculate IBW
- Men = 106 lb + 6 lb for every inch over 5ft
- Women = 105 lb + 5 lb for every inch over 5ft
What is the formula for % wt change? - ANSWER-(USUAL WEIGHT) - (CURRENT
WEIGHT)/(USUAL WEIGHT) x 100
What constitutes significant wt change? - ANSWER-- 5% in one month
- 7.5% in 3 months
- 10% in 6 months
What waist circumference is identified as a risk factor for disease in men and women? -
ANSWER-- M = >40
- W = >35
- WC is BEST FOR RISK, predicts adiposity
How does a bod pod measure body composition? - ANSWER-- determines body
density by measuring the amount of air displaced
- as accurate as underwater weighing
What are the 4 physical examination techniques? - ANSWER-- Inspection (gathering
info via observation)
- Palpation (gathering data via touch)
- Auscultation (listening to heart, bowel)
- Percussion (not done by RD)
What is the normal range for serum albumin and what does it measure? - ANSWER--
3.5-5.0mg/dL
- visceral protein (blood and organs) that maintains osmotic pressure
- levels above normal range suggest dehydration
- DOES NOT reflect current protein intake
What is the normal range for serum transferrin and what does it measure? - ANSWER--
> 200mg/dL
- visceral protein that transports iron to bone marrow
- rises with iron deficiency
- can be determined from TIBC
,What is the normal range for serum prealbumin and what does it measure? -
ANSWER-- 16-40mg/dL
- during inflammation liver synthesizes CRP at expense of PAB
- LIMITED USEFULNESS
What is the normal range for serum hematocrit and what does it measure? - ANSWER--
M = 42-52%, W = 36-48%
- volume of packed cells in whole blood
What is the normal range for serum Hgb and what does it measure? - ANSWER-- M =
14-18mg/dL, W = 12-16mg/dL
- iron containing pigment of RBC
What is the normal range for serum ferritin and what does it measure? - ANSWER-- F =
10-150ng/mL, M = 12-300ng/mL
- indicates size of iron storage pool
What is the normal range for serum creatinine and what does it measure? - ANSWER--
M = 0.6-1.2mg/dL, W = 0.5-1.1mg/dL
- r/t muscle mass (somatic protein)
What is the normal range for serum BUN and what does it measure? - ANSWER-- 10-
20mg/dL
- related to protein intake, indicator of renal disease
- BUN to creatinine ratio 10-15:1 is normal
What is the normal range for urinary creatinine clearance and what does it measure? -
ANSWER-- 115±20ml/min
- measures GFR
What is the normal range for total lymphocyte count and what does it measure? -
ANSWER-- > 2700 cell/cu mm
- measures immunocompetency
- decreased in PCM
What is the normal range for CRP and what does it measure? - ANSWER-- measure of
acute inflammatory stress
- as it declines, indicates when nutritional therapy would be beneficial
- when elevated CRP DECREASES, PAB INCREASES
What is the normal range for prothrombin time and what does it measure? - ANSWER--
11-12.5 seconds
- anticoagulants prolong PT
- evaluates clotting adequacy
- change in vitamin K will alter rate
, What is the TEE for sedentary, active, and stressed pt's? - ANSWER-- sedentary = BEE
x 1.2
- active = BEE x 1.3
- stressed = BEE x 1.5
What is EER? - ANSWER-- Estimated Energy Requirements
- average dietary intake predicted to maintain energy balance in a healthy adult of a
defined age, gender, weight, height, and level of PA consistent with good health
What is the effect of megestrol acetate? - ANSWER-appetite stimulant
What is the effect of dextroamphetamine (adderall)? - ANSWER-appetite suppressant,
anorexia, nausea, wt loss
What is the effect of orlistat? - ANSWER-decreased fat absorption by binding lipase;
vitamin/mineral supplementation
What is the effect of marinol? - ANSWER-appetite stimulant
What is the effect of methylphenidate (Ritalin)? - ANSWER-anorexia, wt loss, nausea
What is the effect of statins? - ANSWER-decreased LDL and TG; increased HDL; avoid
grapefruit juice
What is the effect of chemotherapy? - ANSWER-malabsorption
What is the effect of mineral oil, cholestyramine? - ANSWER-decrease absorption of fat,
fat-soluble vitamins
What is the effect of glucocorticoids, antibiotics? - ANSWER-protein deficits
What is the effect of oral contraceptives? - ANSWER-decreased folate, B6, vitamin C
What is the effect of loop diuretics? - ANSWER-deplete thiamine, K+, Mg++, Ca++, Na+
What is the effect of thiazide diuretics? - ANSWER-decrease K+ and Mg++, absorb Ca+
+
What is the effect of antibiotics? - ANSWER-decrease vitamin K and protein deficits
What is the effect of steroids? - ANSWER-decrease bone growth, CHO intolerance
What is the effect of methotrexate? - ANSWER-decreased folate
What is the effect of lithium carbonate (antidepressant)? - ANSWER-- increased
appetite, wt gain
