Questions and CORRECT Answers
causes of malnutrition - CORRECT ANSWER - 1. inadequate intake
2. increased requirements
3. inadequate absorption of nutrients
4. inadequate nutrient utilization
5. increased nutrient losses
consequences of malnutrition (under or over) - CORRECT ANSWER - 1. increase
morbidity & mortality
2. increased length of stay (LOS)
3. increased hospital readmission
4. increased health-related costs
5. decreased functional status (decreased activities of daily living, ADL)
6. decreased quality of life
7. impaired immunity & wound healing
Basic features of marasmus - CORRECT ANSWER - no inflammation
starvation-related malnutrition
simple, unstressed or uncomplicated starvation
chronic starvation
depressed anthropometrics
<80% DBW &/or wt loss 10% UBW w/in 6 months w/visible muscle wasting
Usually ketones in urine in prolonged starvation
NORMAL visceral proteins (eg. serum albumin) until late in the process due to compensatory
shift of albumin from extravascular to plasma space
,basic features of acute disease/injury related malnutrition in clinical setting - CORRECT
ANSWER - - inflammation occurs
- metabolic stress associated with disease & trauma increases risk for malnutrition - due to
increased demands for nutrients
- Kwashiorkor-like symptoms can result
- low serum albumin (protein malnutrition - enough energy, not enough protein)
- edema
- poor wound healing
- chronic disease-related malnutrition
- hypermetabolism in response to inflammation, injury, or major surgery
- essentially no major change in NORMAL anthropometrics from before injury
- may exhibit edema
- typically no ketones in urine - but possible in small amounts
- DEPRESSED visceral proteins (eg. albumin) due to inflammation & stress-induced shift of
albumin from plasma to extravascular space & other changes
risk factors for malnutrition - CORRECT ANSWER - 1. involuntary weight loss or gain of
10% or more of usual body weight within 6 mo. or 5% w/in 1 month
2. body weight of 20% over/under desirable weight
3. presence of chronic disease or increased metabolic requirements
4. altered diets, or enteral or parenteral nutrition
5. recent surgery, illness or trauma
6. inadequate nutrient intake, ie impaired ability to ingest, digest or absorb nutrients for longer
than 7 days
7. See table 4-2 on page 133 in Krause
key data routinely available as part of a standard nutrition screen - CORRECT ANSWER -
1. serum albumin
2. admitting diagnosis
3. current diet order (CL or NPP> 5 days, EN or PN, other)
,4. height, weight, BMI, weight change
5. problems w/chewing, swallowing, appetite
6. nausea, vomiting, diarrhea, constipation
7. number & % of meals consumed per day
8. supplements & medications
9. cultural, economic, religious factors
4 steps of the Nutrition Care Process - CORRECT ANSWER - 1. Assessment - gather
data, critical thinking
2. Nutrion diagnosis - identify and label a nutrition problem
3. Intervention - how to address the problem
4. Monitoring & evaluation - measure outcomes, progress towards goals, follow-up, adjustments
to plan
Step 1 - Assessment - CORRECT ANSWER - gather data, critical thinking
- diet history
- medical history, PMH, current nx, medications, etc
- anthropometric data
- biochemical data
- psychosocial history
- exercise history, other health habits
- identify medical problems & issues that may impact nutritional status
- prioritize the problems
- assess educational needs of patient
- analyze data to identify nutritional needs
Step 2 - Nutrition Diagnosis - CORRECT ANSWER - Identify & label a nutrition problem
- organize & evaluate data using professional judgement
, - identify & label an actual occurrence, risk of/potential for developing a nutritional problem that
dietetics professionals are responsible for treating independently
Step 3 - Intervention - CORRECT ANSWER - How to address the problem
- collect additional info
- establish goals, make plan
- modify diet/nutrition support as needed
- counsel/educate as appropriate
- provide referrals
- schedule follow-up
Step 4 - monitoring & evaluation - CORRECT ANSWER - Measure outcomes, progress
towards goals, follow-up, adjustments to plan
- monitor intake, tolerance & adequacy of NS or dietary regimen
- assess knowledge after education by evaluating behavioral changes
- monitor biochemical/anthropometric data
- monitor progress toward goals
- adjust goals as needed
- documentation is integral part of each step
Characteristics of a nutrition screen - that would make it effective - CORRECT
ANSWER - 1. simple & can be completed quickly
2. relies on data that are routinely gathered in a particular setting
3. includes collection & interpretation or relevant data on risk factors
4. is cost-effective
5. determines the need for a nutrition assessment
how might MNT reduce the cost of healthcare costs in the hospital setting - CORRECT
ANSWER - - reduce secondary complications from hospital stay (bed sores, muscle
wasting, etc) ***