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is the dietary intake for the last 24 includes proportions, asking about activities can help jog memories, inexpensive, quick 20 min or less, only short-term memory, limitations is a person has a poor memory, withhold info, or false info |
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does not depend on memory, provides detail info on eating, multiply day record up to 7 days, limits, lots of cooperation, low response rates, more time to get data recording may alter diet (eat better) work estimated portions |
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self-administrated, machine readable, inexpensive, more representative of usual intake (UI), limits not represent portions, abilitie to describe dieat and read |
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ask how many times a week, month, year or day eats a certain food |
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quantitative food frequency |
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describes the size of serving as small, medium, large |
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M-meats, E-eggs, D-dairy, F-fried foods, I-in baked goods, C-convenience foods major contributor to total fat |
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good validity, let time thatn 24-recall, less of a burden, accepticable to people, limits expensive, how meals are prepared, techinal problems |
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are used to measure dietary intake within households and institution where congregate feeding such as nursing homes homes boarding schools, prisons, good for large sample sizes, long periods, less likely to alter diets, limits, does not account for loss or food, able to read, does not measure comsumption |
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is a method of indirectly eastimating the amounts of food consumed by a country's population at a certain time. can give a view of a coutnries total food supply, indicate food habits, plan interanational nutrition policies, may be the only data availabe |
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Difference Between Significant and Severe Wt Loss |
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wt loss<5% is small, 5% to 10% significant, wt loss > 10% is definitly significant severe wt change over 1 pound a day is fl changes |
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calculation of the energy and nutrient value of food eaten by a subject, such as a hospital patient |
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Food Label & nutrient claims |
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all processed foods must have nutrient labels if the food is fortified it must be listed and health claims, serving size, list of ingredients, nutrients, vitamins, and minerals, nutrient claims like cholesterol fee, low fat, there are guidelines for these claims ex: low-sodium must contain less than 25% per serving than appropriate food used in comparison |
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is the measurement of body size, wt, and proportions |
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head circumference, good indicator of health in infants brain abnormalities up to 36 months during 1 year routine, lenth, wt, ht recumbent lenght lying down, stature (ht) for 2 to 20 years of age start a 2-3, wt most important in measurements,non-amulatory bed or sclae chair 100g (1/4 lb) |
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develope by CDC, compares growth to other children birth to 36 months, wht lenght and hc for age based on the National health and nutrition examination survey I-III |
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BMI-for-age <5th percentile - underweight >/=5th percentile - < 85th percentile – healthy weight >/= 85th percentile =95% - overweight >/=95th percentile OR >/= 30 kg/m2 BMI - obese |
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For men: 106# first 5 feet 6# for every inch over 5 feet If < 5 feet tall, subtract 6# for each inch under 5 feet +/- 10% for frame For women: 100# for first 5 feet 5# for every inch over five feet If < 5 feet tall, subtract 5# for each inch under 5 feet +/- 10% for frame |
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Percent ideal body weight or relative body weight Actual weight / ideal body weight X 100 Example: a woman who is 5’6” tall weighs 155# 155#/130# (ideal body weight) x 100 = 119% Woman is 119% of her ideal body weight |
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> 200% Morbid Obesity > 120% Obesity 110-120% Overweight 101-109% Normal 80-90% Mild Malnutrition 70-79% Moderate Malnutrition < 69% Severe Malnutrition |
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< 18.5 – Underweight 18.5-24.9 – Normal 25.0-29.9 – Overweight 30-34.9 – Obesity Grade I 35-39.9 – Obesity Grade II High correlation with estimates of body fat >/= 40 – Extreme Obesity (Grade III) |
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Wt(lb)/ht (inches)/ht (inches) x 703 140# 5'5" 140/65/5x703=23.3 |
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Difference between gynoid (women) and android (men) body types and risks |
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ANDRIOD obesity Upper body Male-type GYNOID obesity Lower body Female-type weight close to heart associate to heart disease visceral fat-surrounds the organs retroperitoneal- outside the of the peritoneal cavity |
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Waist-to-hip ratio (WHR) Divide waist circumference by hip circumference Recommendation to have WHR <1 Waist Circumference < 40 males < 35 females great the waist increase chance for heart attack, hypertension |
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Estimating body fat and protein reserves common in assessing nutritional status Skinfold measurements Inexpensive Easy and quick Fairly accurate Best assesses when measuring at least 3 sites Skinfold measurement sites: Chest Triceps single fold Subscapular Midaxillary Spurailiac Abdomen Thigh Medial Calf two site skin folds 6-20 triceps and subscapular (sum) |
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Females =8% - Unhealthy/Too Low 9-23% - Acceptable (lower end) 24-31% - Acceptable (higher end) >/= 32% - Unhealthy/Too High males =5% - Unhealthy/Too Low 6-15% - Acceptable (lower end) 16-24% - Acceptable (higher end) >/= 25% - Unhealthy/Too High |
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Example: A woman – 185# and 22% body fat wishes to have 15% body fat Weight of fat = 185 lbs x .22 = 41 lbs body fat Fat-free weight = 185 lbs – 41 lbs = 144 lbs Target weight = 144 lbs / (100 - 15) 144 / .85 = 169 lbs |
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Anthropometric-phycical ht/lenght,wt,circumfernce, skinfold Biochemical-labs, tissue, fluids,excrections blood, urine Clinical-finding from physical hair&skin Dietarty-food intake 24-hour recall, food frequancy, food diary, food record |
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Elbow breadth Wrist circumference r=H/C R = ratio of body height to wrist circumference H – height in centimeters C = circumference of right wrist in centimeters |
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EAR-estimated average requirement intake value estimated to meet the requirements for 50% of life stage and gender group, you need EAR for RDA |
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RDA- recommended dietary allowence intake value sufficient to meet the requirements of 97% to 98% of individuals in a life stage, if EAR can't be determine than RDA can |
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AI- aduquate intake, recommend intake for infants, intakes of vit k, pantothenic acid, sodium and chloride for all life-stages are expressed a AI used when RDA can't be set |
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Upper tolerable upper level intake |
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or hyperalimentation is a form of malnutrition in which the intake of nutrients is oversupplied. The amount of nutrients exceeds the amount required for normal growth, development, and metabolism. The term can also refer to: ... Oversupplying a specific nutrient, such as dietary minerals or vitamin poisoning. |
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time frame for nurtional screening |
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doctors, nurses and DTR can complete nutrtional screenings done with in 24-48 hours of hospital stay best done by a diet tech |
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NCP-nutrtion care process nutrition assessment and reassessment nutrition diagnosis nutrition intervention nutrition monitoring and evaluation |
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Nutritional assessment and reassessment |
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Definition
obtain/collect date timely and appropriatly, analyze and interpret data, document |
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identify and label problem, determine cause, cluster signs and symptoms, document |
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plan nutrition intervention, formulate goals, implement nutrition intervention, care delivered and actions are carried out, document |
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nutriton monitoring and evaluation |
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Definition
monitor progress, measure out come, evaluate out come, document |
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format used to write nutritional diagnosis NCP P-problem E-etiology s-signs and symptoms |
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p- what e-why s-how do i, how severe is the problem |
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Ex:Inadequate energy intake r/t poor appetite AEB weight loss of 1 pound in the past month. o Food- and nutrition-related knowledge deficit r/t lack of prior nutrition related education regarding infant/toddler feeding practices AEB MOI reports not knowing when to introduce complementary foods. o Inadequate energy intake r/t routinely providing pureed fruit and milk as primary part of diet AEB inadequate gain 7 oz in 2 months, w/l <2nd %ile. |
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related to and as evident by 61 yr old male who has a poor appetite and unitemtional wt loss of 15% during the past 3 months has colon cancer anf gets chemo, inadequate oral intake related to chemo-associated to dysgeusia as evidenced by oral intake of 60% estimated needs |
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the identification and descriptive labeling of a nutrition problem that the dietetics practitioneris responsible for independently addressing, it is different than medical diagnosis, it is written in terms of a client problem for which nutrition related activities provide the primary intervention |
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PES statements are a written diagnosis of a patient’s nutritional problem. A PES is a simple statement that identifies the Problem, gives the Etiology of the diagnosis and states the Signs/Symptoms that support the diagnosis. Always use the words “related to” and “as evidenced by.” |
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“Inadequate energy intake related to calorie intake not meeting calculated needs as evidenced by 15lb weight loss in 3 months.” |
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Females: 100# for first 5 ft plus 5# for each additional inch above 5 ft
Males: 106# for first 5 ft plus 6# for each additional inch above 5 ft
+ 10% for large frame - 10% for small frame |
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(Actual Wt / IBW) x 100 > 200% Morbid Obesity > 120% Obesity 110-120% Overweight 101-109% Normal 80-90% Mild Malnutrition 70-79% Moderate Malnutrition < 69% Severe Malnutrition |
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(Actual Wt / UBW) x 100 85-90% Mild Malnutrition 75-84% Moderate Malnutrition <74% Severe Malnutrition |
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[(UBW – Actual BW) / UBW] x 100
Significant Weight Loss Severe Weight Loss 5% over 1 month > 5% over 1 month 7.5% over 3 months > 7.5% over 3 months 10% over 6 months > 10% over 6 months |
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[(Actual BW – IBW) x 25%] + IBW |
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Ideal amputee weight = preamputation ideal body weight (IBW) – IBW x % amputation)
Segmental Body Weights: Hand 0.7% Lower arm and hand 2.3% Entire arm 5.0% Foot 1.5% Lower leg and foot 5.9% Entire leg 16% |
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Optimal <120/80 Normal <130/85 High Normal 130-139/85-89 Hypertension: Stage 1 140-149/90-99 Stage 2 160-179/100-109 State 3 >180/>110 |
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Females: REE = 655.1 + 9.6W + 1.9S – 4.7A Males: REE = 66.5 + 13.8W + 5.0S – 6.8A * W = weight in kg, S = height in cm, A = age in years |
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Definition
Mifflin-St. Jeor Equation Females: 10(W) + 6.25(Ht) – 5(Age) – 161
Males: 10(W) + 6.25(Ht) – 5(Age) + 5 |
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Healthy, non pregnant, nonlactating adults need 0.8 grams/kg Lose protein in trauma, burns, and other instances/injury Measured through urinary nitrogen losses Protein needs are estimated Based on body weight Based on calorie intake Based on nitrogen balance |
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Estimating proteins based on calories |
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Calorie to Nitrogen Ratio 1 gram of nitrogen = 6.25 grams of protein 1 gram of nitrogen for every 150 NPC (nonprotein calories) usually adequate for critically ill adults and adults with = 10% burns 1 gram of nitrogen for every 100 NPC when severely injured or burns >10% NPC / kcal:N x 6.25 Ex: 1500 calorie diet (NPC) with 150:1 calorie:N would need 63 grams protein 1500 / 150 x 6.25 |
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Estimated proteins based on bw |
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normal- 0.8 healthy mild-0.8-1.2 minor surgery mild indefction moderate-1.2-1.8 mjor sugery, moderate skeletal trama, infection severe 1.6-2.2 major burns severe trama multiple injuries |
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100 mL/kg for the first 10 kg of body weight 50 mL/kg for the second 10 kg of body weight Age adjustment If = 50 yrs old: 20 mL/kg for each of the remaining kg body weight If > 50 yrs old: 15 mL/kg for each of the remaining kg body weight |
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