Jean Inman - Domain II

  1. Serum Albumin normal lab values
    3.5-5.0 g/dl
  2. Serum albumin is what type of protein
    Visceral protein (blood and organs)
  3. ______ is associated with edema, surgery.
  4. best reflects protein status
  5. serum albumin levels above normal range is likely due to...
  6. half-life of serum albumin
  7. serum albumin does or does not reflect current protein intake
    does not
  8. Serum transferrin level is controlled by _____ storage pool
  9. TTHY
  10. PAB
  11. half-life of transthyretin/prealbumin
  12. RBP
    retinol-binding protein
  13. What does RBP do
    • circulates with prealbumin
    • binds and transports retinol
  14. Hct (hematocrit) levels for men
  15. Hct (hematocrit) levels for women
  16. Hct (hematocrit) levels for pregnant women
  17. What is Hgb (hemoglobin)
    iron-containing pigment of red blood cells
  18. Hgb (hemoglobin) levels for men
    14-17 gm/dl
  19. Hgb (hemoglobin) levels for women
    12-15 gm/dl
  20. Hgb (hemoglobin) levels for pregnant women
  21. What does serum ferritin measure
    size of iron storage pool
  22. Serum creatinine lab values
    0.6-1.4 mg/dl
  23. Serum creatinine is related to _____ and measures _____ protein
    • muscle mass
    • somatic protein
  24. Serum creatinine may indicate...
    renal disease or muscle wasting
  25. CHI
    creatinine height index
  26. What is CHI
    ratio of creatinine excreted/24 hours to height
  27. CHI estimates
    lean body mass - somatic protein
  28. BUN (blood urea nitrogen) lab values
    10-20 mg/dl
  29. BUN is related to _____ and an indicator of ______
    • protein intake
    • renal disease
  30. BUN: creatinine ratio lab values
  31. Urinary creatinine clearance measures
    GFR - glomerular filtration, renal function
  32. TLC
    total lymphocyte count
  33. TLC lab value
    >2700 cells/ cu mm
  34. TLC is decreased in
    protein-energy malnutrition
  35. Severe depletion of TLC lab value
  36. CRP
    C-reactive protein
  37. What does CRP (C-reactive protein) measure
    marker of acute inflammatory stress
  38. FEP
    Free erythrocyte protoporphyrin
  39. FEP (free erythrocyte protoporphyrin is increased in _____
    lead poisoning
  40. Too much lead in the body depletes...
    • iron leading to anemia
    • calcium in the bone leading to zinc deficiency
  41. PT
    Prothrombim time
  42. PT (prothrombim time) lab values
    11.0-12.5 seconds; 85-100% of normal
  43. PT (prothrombim time) evaluates ____ and ____ will alter rate
    • clotting adequacy
    • vitamin K
  44. SGA
    • Subjective Global Assessment
    • (history, intake, GI symptoms, functional capacity, physical appearance, edema, weight change)
    • NO lab values
  45. MNA
    • Mini Nutritional Assessment
    • (evaluates independence, medications, number of full meals consumed each day, protein intake, fruts and veg, fluid, mode of feeding
    • 65 years of age and older
  46. NSI
    • Nutrition Screening Initiative
    • (elderly)
  47. GNRI
    • Geriatric Nutritional Risk Index
    • (serum albumin, weight changes)
  48. Dietary intake assessment:
    Present patterns of eating. Do not ask leading questions
    diet history
  49. Dietary intake assessment:
    Exact record of everything eaten in a specific period of time
    food record
  50. Dietary intake assessment:
    mental recall of everything eaten in previous 24 hours. Quick tool to estimate a sample daily intake. Clinical setting
    24 hour recall
  51. Dietary intake assessment:
    how often an item is consumed. Community setting. Quick way to determine intakes on large numbers of people
    food frequency lists
  52. IBW for women
    • 100 lbs for first 5'
    • add 5 lbs for each additional inch
    • +/- 10% for frame size
  53. IBW for men
    • 106 lbs for first 5'
    • add 6 lbs for each additional inch
    • +/- 10% for frame size
  54. Amputations: 
    Entire leg
  55. Amputations: 
    Lower leg (below knee)
  56. Amputations:
    Entire arm
  57. Amputations:
  58. IBW equation with amputations:
    (IBW - % amputation)/100 x IBW for original height
  59. TSF measures
    • Triceps skinfold thickness
    • body fat reserves
    • calorie reserves
  60. AMA measures
    • arm muscle area
    • skeletal muscle mass (somatic protein)
    • *important to measure in growing children
  61. Healthy BMI for elderly
  62. Healthy BMI for adults
  63. Waist circumference for men and women
    • >40 M
    • >35 W
  64. Waist/hip ratio (WHR) of ____ or greater in men, _____ or greater in women is indicative of android obesity and increased risk for obesity-related diseases (diabetes, hypertension)
    • 1 M
    • 0.8 W
  65. Nutrition focused physical exam:
    thin, sparse, dull dry brittle hair
    vitamin C, protein deficiency
  66. Nutrition focused physical exam:
    easily pluckable hair
    protein deficiency
  67. Nutrition focused physical exam:
    pale or dry eyes, poor vision
    vitamin A, zinc or riboflavin deficiencies
  68. Nutrition focused physical exam:
    swollen, red, dry, cracked lips
    riboflavin, pyridoxine, niacin deficiencies
  69. Nutrition focused physical exam:
    smooth, slick, purple, white coating on tongue
    vitamin or iron deficiencies
  70. Nutrition focused physical exam:
    sore, red, swollen, bleeding gums
    vitamin C deficiency
  71. Nutrition focused physical exam:
    missing or loose teeth, loss of enamel
    calcium deficiency, poor intake
  72. Nutrition focused physical exam:
    pale, dry, scaly skin
    iron, folic acid, zinc deficiency
  73. Nutrition focused physical exam:
    brittle, thin, spoon-shaped nails
    iron or protein deficiency
  74. Drug or nutrient effects:
    Megestrol acetate
    appetite stimulat
  75. Drug or nutrient effects:
    • appetite suppressant
    • anorexia
    • nausea
    • weight loss
  76. Drug or nutrient effects:
    • decrease fat absorption by binding lipase
    • vitamin/mineral supp.
  77. Drug or nutrient effects:
    appetite stimulant
  78. Drug or nutrient effects:
    methylphenidate (Ritalin)
    • anorexia
    • weight loss
    • nausea
  79. Drug or nutrient effects:
    lithium carbonate (antidepressant)
    • maintain consistent sodium and caffeine intake
    • if restricted, lithium excretion decreases, leading to toxicity
    • 2 gm Na diet too low
  80. Drug or nutrient effects:
    1.1 cals/cc
  81. Drug or nutrient effects:
    vitamin B6 and protein
    • decrease effectiveness of levodopa (Parkinson's disease)
    • Take drug in morning with limited protein - no more than 10 g
  82. Drug or nutrient effects:
    hypertension if taken with MAOI (monoamine oxidase inhibitor)
  83. Foods with high tyramine content
    • hard, aged cheese (cheddar, swiss)
    • sauerkraut
    • some sausgaes
    • lunch meats
    • tofu
    • miso
    • sour cream, yogurt, buttermilk

    Best to buy, cook, eat fresh foods
  84. Nutrition assessment of population and community needs:
    • Health Risk Appraisal
    • Survey categorizing a populations' general health status 
    • used in work sites, government agencies as a health education or screening tool
  85. Define incidence
    number of NEW cases of a disease over a period of time
  86. Define prevalence
    TOTAL number of people with a disease during a period of time
  87. Infant mortality rate:
    • infant deaths under 1 year of age
    • expressed as the number of deaths per 1000 live births
  88. 3 strategies that strengthen local food systems:
    • farmer's markets
    • food recovery and gleaning programs
    • PPFPs - Prepared and Perishable Food Programs
  89. what are PPFPs
    • Prepared and Perishable Food Programs
    • nonprofit programs that link sources of unused, cooked and fresh foods with social service agencies that serve the hungry
  90. Examination of a population group at a particular point of time
    nutrition survey
  91. Continuous collection of data
    nutritional surveillance
  92. nutritional surveillance detects ____ by using...
    • changes in trends
    • by using height, weight, hematocrit, hemoglobin, serum cholesterol
  93. Promote nutrition and improve nutritional care for the ELDERLY
    NSI - Nutrition Screening Initiative
  94. Level II screen for Nutrition Screening Initiative provides
    • more specific diagnostic info on nutritional status
    • RD most involved with level II
  95. PNSS
    Pregnancy Nutrition Surveillance System
  96. NSLP acronym
    National School Lunch Program
  97. National School Lunch Program and School Breakfast Program are regulated by....
  98. With the National School Lunch Program, lunch must provide on average
    • 1/3 of the recommended intake for
    • -protein
    • -vitamins A and C
    • -iron
    • -calcium
  99. With the School Breakfast Program, breakfast must provide on average
    • 1/4 daily recommended levels for: 
    • -protein
    • -vitamin A and C
    • -iron
    • -calcium
  100. Together the National School Lunch Program and the School Breakfast Program provide ___ of the recommended intake.
  101. 2 surveys that are based on what America is eating
    WWEIA and NFCS
  102. WWEIA:
    acronym and what it is
    • What We Eat in America
    • survey - dietary intake component of NHANES
  103. WWEIA is regulated by...
  104. WWEIA is alson known as
    National Food and Nutrition Survey (NFNS)
  105. NFCS:
    acronym and what it evaluates
    • Nationwide Food Consumption Surveys
    • Evaluates 7 nutrients: protein, calcium, iron, thiamin, riboflavin, vitamins C and A
  106. NFCS is regulated by...
  107. BRFSS
    acronym and what it is
    • Behavioral Risk Factor Surveillance System
    • Telephone interviews: info on height, weight, smoking, alcohol use, food frequency for fat, fruits and vegetables, preventable health problems, diabetes
  108. YRBS acronym
    Youth Risk Behavior Survey
  109. What does the Commodity Food Donation/Distribution Program do?
    • Provides foods to help meet nutritional needs of children and adults
    • Strengthens agricultural market for products produced by American farmers.
  110. Who regulates the Commodity Food Donation/Distribution Program
  111. CSFP
    acronym and who administers
    • Commodity Supplemental Food Program
    • administered by state health agencies

    Part of the Commodity Food Donation/Distribution Program ran by USDA
  112. SMP
    acronym and what it is
    • Special Milk Program
    • encourage consumption of milk by children
  113. SMP regulated by...
  114. SFSP
    acronym and what it is
    • Summer Food Service Program
    • Initiate, maintain or expand foodservice programs to children when school is not in session
  115. SFSP is regulated by...
  116. CACFP
    acronym and what it is
    • Child and Adult Care Food Program
    • Reimburses operators for meal costs
    • Provides commodity foods and nutrition education materials

    Eligibility standards same as NSLP
  117. CACFP is regulated by...
  118. FFVP
    acronym and what it is
    • Fresh Fruit and Vegetable Program
    • Introduce children to fresh fruits and vegetables
    • Free to children nationwide in selected schools
  119. WIC
    acronym and what it does
    • The Special Supplemental Nutrition Program for Women, Infants, and Children
    • Provides food, nutrition education, and referrals to other agencies for low income mothers at nutritional risk
  120. is WIC an entitlement program?
  121. For WIC a health exam is _____
  122. WIC is regulated by...
  123. EFNEP
    acronym and what it is
    • Expanded Food and Nutrition Education Program
    • Provides grants and nutrition education
  124. EFNEP is regulated by...
  125. Maternal and Child Health Block Grant provides...
    training, consultation, and funding for public health nutrition programs
  126. Maternal and Child Health Block Grant is regulated by...
  127. NSIP acronym
    Nutrition Services Incentive Program
  128. OAA
    acronym and what it is
    • Older American Act Nutrition Program
    • One hot meal each day, 5 days/week for all aged 60 and older plus spouse
  129. OAA is regulated by...
  130. ambulatory; transportation essential for rural elderly (OAA nutrition program)
    Congregate Meals
  131. An example of home delivered meals
    • Meals on Wheels -- must be home bound
    • OAA nutrition program
  132. SNAP
    acronym and what it is
    • Supplemental Nutrition Assistance Program
    • Assist low income with monthly benefits
  133. Largest food assistance program
  134. SNAP is regulated by...
  135. CMS
    acronym and its parts
    • Centers for Medicare and Medicaid Services
    • Medicare and Medicaid
  136. CMS is regulated by...
  137. Medicare for what population
    • People over 65
    • Any age with end stage renal disease
  138. Part A for Medicare
    Hospital Insurance
  139. Part B for Medicare
    Optional insurance for supplementary benefits (outside hospital insurance)
  140. Medicaid is for what population
    eligible needy: all ages, blind, disabled, dependent children
  141. CHIP
    acronym and what it is
    • Children's Health Insurance Program
    • expands health coverage to uninsured children whose families earn too much income to qualify for Medicaid but too little to afford private coverage
  142. Headstart is regulated by...
  143. NET
    acronym and what it is
    • Nutrition Education Training Program
    • Provides nutrition education training to teachers and school foodservice personnel

    Amendment to School Lunch Act
  144. NET is regulated by...
  145. SFMNP
    acronym and what it is
    • Senior Farmers' Market Nutrition Program
    • Grants to states to provide low income seniors with coupons to be exchanged for eligible foods at farmers' markets, roadside stands, community supported agriculture programs (CSA)
    • Nutrition education and information is provided (how to select, store, prepare)
  146. SFMNP allows participants to buy..
    fresh, nutritious, unprepared fruits, veg, herbs, and honey
  147. SFMNP is regulated by...
  148. An award of financial or direct assistance
  149. What is an entitlement program
    • requires payment of benefits to all eligible people as established by law
    • for a specific population who meet certain income or other eligibility requirements
  150. The 5 Entitlement Programs
    • SNAP
    • Medicare
    • NSLP
    • SFSP
    • SBP
  151. _____ diagnosis changes as the patient's response changes. (example)
    • Nutrition
    • Undesirable overweight status
  152. ____ diagnosis does not change as long as the condition exists. (example)
    • Medical
    • Type 1 Diabetes
  153. Dietetic professionals are responsible for treating the nutrition diagnosis ____
  154. 3 domains for Nutrition Diagnostic Labels
    • NC: Clinical
    • NI: Intake
    • NB: Behavioral-environmental
  155. 3 parts to Clincial NC
    • Functional balance
    • Biochemical balance
    • Weight balance
  156. Which nutrition diagnostic label is the RD's priority?
    NI - Intake
  157. What enteral nutrition would be given for normal GI function & it must provide how many calories
    • Standard polymeric (whole nutrients, least expensive)
    • Provide 1-1.5 calories/cc
  158. What can be added to enteral nutrition  as an emulsifier
  159. Enteral Nutrition is initiated full strength at a rate of
    10-40 ml/hr
  160. What is modular enteral nutrition
    • mix individual components
    • adds flexibility
  161. What is blenderized enteral nutrition
    whole food, large bore tube, thick intact protein, high residue
  162. Least expensive enteral nutrition formulas
    intact protein (NOT pre-digested), and isotonic (osmolality is close to that of blood)
  163. Pre-digested protein or amino acids, glucose or sucrose, small fat, vitamins, minerals, electrolytes
    • elemental, chemically defined enteral nutrition formula
    • Used with malabsorption (problem with GI tract)
Card Set
Jean Inman - Domain II
Nutrition Care for Individuals and Groups