Jarvis Ch.11: Nutritional Assessment

• Define nutritional status.
1. The balance between nutrient intake and nutrient requirements.
• Describe the unique nutritional needs for various developmental periods throughout the life cycle.
1. Aging Adult: increased risk for undernutrition or over nutrition. Decrease in energy because of loss of lean body mass and an increase in fat mass, protein, vitamins, and minerals need to remain the same or increase.
2. Adulthood: growth and nutrient need to be stabilized.
3. Pregnancy/ lactation: sufficient calories, protein, vitamins, and minerals must be consumed. Iron, folate, and zinc are essential for fetal growth, while the vitamins and minerals are needed
4. Adolescence: Caloric and protein requirements increase for demand of bone and muscle growth, calcium and iron requirements increase.
5. Infant/children: Breast feeding is recommended for the first year of life because it is the ideal formulated to promote normal growth and development and builds natural immunity.
• Describe the role cultural heritage and values may play in an individual’s nutritional intake.
1. Newly arriving immigrants at risk for nutrition intake. (e.g. hypertension, diarrhea, lactose intolerance, osteomalacia (soft bones), scurvy, and dental caries. Other factors: Lots of changes, language barrier, culture diff, no known people, unfamiliar foods, familiar foods are difficult to find, low income may limit ability to access familiar foods.
• State the purposes of a nutritional assessment.
1. They are noninvasive, inexpensive, and easy to perform to asses’ individual nutritional status and if they are at any risks for weight loss, inadequate food intake or recent illness.
• Describe the components of a nutritional assessment. Discuss the strengths and limitations of the methods used for collecting current dietary intake.
1. 24-hour recall: Easiest and most popular. The individual or family member completes a questionnaire or is interviewed and asked about everything eaten w/in the last 24 hours. Has potential errors due to 1. Individual or family member may not be able to recall the type or amount of food eaten. 2. Intake within the last 24 hours may be atypical of usual intake. 3. Individual or family member may alter the truth. 4. Snack items and use of gravies, sauces and condiments may be underreported.
2. Food Frequency: How many times per day, week, or month an individual eats particular food’s, Errors: It doesn't always quantify amount of intake and it relies on the person’s memory .
3. Food Diary: Write down everything consumed for a certain period of time. Typically, three days, or two weekdays. Most complete and most accurate. Potential problems: noncompliance, inaccurate recordings, atypical intake on recording, and conscious alteration of diet during recording period.
4. Direct Observations: Observation of feeding and eating process can detect problems not readily identified through standard nutrition interviews. Observing typical feeding techniques by parent or caregiver and interaction between individual and caregiver can help assess failure to thrive in children or unintentional weight loss in older adults.
• Use anthropometric measures and laboratory data to assess the nutritional status of patients.
1. Derived weight measures, body mass index, waist to hip ratio, skinfold thickness, arm span or total arm length.
• Use nutritional assessment in the provision of health care and for health promotion.
1. To do a nutritional assessment you; 1. Obtain a health history relevant to nutritional status. 2. Elicit dietary history if indicated. 3. Inspect skin, hair, eyes, oral cavity, nails, and musculoskeletal and neurologic system for clinical signs and symptoms suggestive of nutritional deficiencies. 4. Measure height, weight, BMI, WC, and other anthropometric parameters as indicated. 5. Review laboratory test. 6. Offer health promotion teaching.
Key Terms
1. 1. 24-hour recall, p. 184: The individual or family member completes a questionnaire or is interviewed and asked about everything eaten within the last 24 hours.
  1. 2. Comprehensive nutritional assessment, p. 184: individuals that are at risk for nutritional problems go through this screening which includes a dietary history and clinical information, physical examination for clinical signs, anthropometric measures, and laboratory test.
    1. 3. Direct observation, p. 184: Observation of feeding and eating process can detect problems not readily identified through standard nutrition interviews.
      1. 4. Dual-energy x-ray absorptiometry (DEXA), p. 191: a tool that measures body composition; body fat and lean body mass, also bone mineral density.
        5. Food diary, p. 184: Write down everything consumed for a certain period of time.
        6. Food frequency questionnaire, p. 184: How many times per day, week, or month an individual eats particular food’s,
        7. Kwashiorkor, p. 194: Protein malnutrition is caused by diets high in calories but little or no protein.
        8. Marasmus, p. 194: protein-calorie malnutrition is caused by inadequate intake of protein and calories or prolonged starvation.
        9. Metabolic syndrome, p. 182: Increased cardiac risk and is diagnosed when a person has 3 of the following 5 biomarkers; elevated BP, increased fasting plasma glucose, elevated triglycerides, increase waist circumference, and low high-density lipoprotein cholesterol.
        10. Nutrition screening, p. 184: the first step in assessing nutritional status.
        11. Optimal nutrition status, p. 181: Achieved when sufficient nutrients are consumed to support day to day body needs and any increased metabolic demands caused by growth, pregnancy, or illness.
        12. Overnutrition, p. 181: Consumption of nutrients, especially calories, sodium and fat, in excess of body needs.
        13. Percent usual body weight, p. 189: is calculated by taking the current weight devided by the usual weight times by 100.
        14. Sarcopenia, p. 183: Age related loss of muscle mass
        15. Sarcopenic obesity, p. 183: combined with an increase in body fat, decrease in physical activity and decrease in protein intake with aging.
        16. Undernutrition, p. 181: Nutritional reserves are depleted and/or when nutrient intake is inadequate to meet day to day needs or added metabolic demands.

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Jarvis Ch.11: Nutritional Assessment

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