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Exam (elaborations)

Exam (elaborations) Essentials for Nursing practice

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ENTAILS QUESTIONS AND ANSWERS

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,What role do nurses play in nutritional care? - CORRECT ANSWERS-- screen
hospitalized patients to identify those at nutritional risk
- serve as a liaison between dietitian and physician
- available as a nutrition resource when dietitians are not
- reinforce nutrition counseling provided by the dietitian
- basic nutrition education

Nutrition screening - CORRECT ANSWERS-- a quick look at a few variables to identify
individuals who are malnourished or who are at risk for malnutrition so that an in-depth
analysis can follow
- can be custom designed for a particular population or a specific disorder
- no universally agreed upon tool that is valid and reliable at identifying risk of
malnutrition in all populations at all times

Role of the Joint Commission (JCAHO) - CORRECT ANSWERS-- sets health-care
standards and accredits health-care facilities that meet those standards
- specifies that nutrition screening be conducted within 24 hours after admission
- allows facilities to determine screening criteria, how risk is defined, and who performs
the screening

Malnutrition - CORRECT ANSWERS-- "bad nutrition"
or any nutritional imbalance including overnutrition
- in practice, usually means undernutrition or inadequate intake of protein and/or
calories that causes loss of fat stores and/or muscle wasting

Nutrition Screen - Acute Care - CORRECT ANSWERS-Common parameters in hospital
setting:
- dementia?
- difficulty swallowing?
- advanced age? (80+ years)
- abnormal BMI?
- nausea/vomiting?
- decreased appetite?

Nutritional Assessment - CORRECT ANSWERS-- an in-depth analysis of a person's
nutritional status (by dietitian)
- in the clinical setting, nutritional assessments focus on *moderate- to high-risk*
patients with suspected or confirmed protein-energy malnutrition
- patients who are identified to be a low or no nutritional risk are re-screened within a
specified period of time to determine if status has changed

, - referred to as the nutrition care process
=> 4 steps (ADIME): Assessment Diagnosis
Intervention Monitoring/
Evaluating

ABCD of an Assessment - CORRECT ANSWERS-*A*nthropometric data
*B*iochemical data
*C*linical data
*D*ietary data

Anthropemetric data - CORRECT ANSWERS-- physical measurements
- BMI (body mass index)
=> formula:
wt.(kg) / ht.(m)^2
***1 kg = 2.2 lb. and 1 in. = 2.54 cm***
=> healthy: 18.5 -24.9
=> underweight: < 18.5
=> overweight: 25 - 29.9
=> obese: > 30
- IBW (ideal body weight)
=> Females: 100 lb. + 5 lb.(x), for every inch over 5 ft.
=> Males: 106 lb. + 6 lb.(x), for every inch over 5 ft
- % change in wt.
=> unintentional
=> formula:
((usual body wt. - current body wt.) / (usual)) x 100
- Estimating calorie and protein needs

Anthropometric Data: What skews weight measurements? - CORRECT ANSWERS--
hydration status
=> dehydration (lose fluid weight)
- edema
- anasarca
- fluid resuscitation
- chronic liver or renal disease
- congestive heart failure (excess weight)

Anthropometric Data: Pros & Cons - CORRECT ANSWERS-Pros:
- easy measurements
Cons:
- not always properly measured
- BMI does not take muscle mass into account
- Can still be malnourished

Body Mass Index (BMI) - CORRECT ANSWERS-- an index of a person's weight in
relation to height used to estimate relative risk of health problems related to weight

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