Copyright 2002, Delmar, A division of Thomson Learning Chapter 7 Nutritional Assessment
Copyright 2002, Delmar, A division of Thomson Learning Competencies Perform anthropometric measurements. Describe the most common pathophysiologies for abnormal findings. Describe laboratory analyses needed and their clinical significance to the nutritional assessment.
Copyright 2002, Delmar, A division of Thomson Learning Dietary Guidelines Recommended dietary allowances (RDA) Food guide pyramid Six food groups Fats, oils, and sweets: use sparingly Milk, yogurt and cheese: 2–3 servings/day Meat, poultry, fish, eggs: 2–3 servings/day (continues)
Copyright 2002, Delmar, A division of Thomson Learning Dietary Guidelines Vegetables: 3–5 servings per day Fruits: 2–4 servings per day Breads, cereal, rice, pasta: 6–11 servings per day
Copyright 2002, Delmar, A division of Thomson Learning Nutritional Guidelines for Young and Middle- Aged Adults Growth and caloric needs stabilize Eating habits may be influenced by activity levels, life stressors Nutritional risks for development of disease Obesity Osteoporosis (continues)
Copyright 2002, Delmar, A division of Thomson Learning Nutritional Guidelines for Young and Middle- Aged Adults Type 2 Diabetes Mellitus Atheroschlerosis
Copyright 2002, Delmar, A division of Thomson Learning Nutritional Assessment of Young and Middle- Aged Adults Caloric intake? Adherence to specific diet? Satisfaction with current weight? Physical activity? Consumption of snacks? Typical meal patterns?
Copyright 2002, Delmar, A division of Thomson Learning Nutritional Guidelines for the Older Adult Decreased caloric requirements Adhere to food guide pyramid, except consume decreased portion size Encourage to eat in a sitting position Encourage adequate fluid intake and high fiber diet (continues)
Copyright 2002, Delmar, A division of Thomson Learning Nutritional Guidelines for the Older Adult Nutritional risk factors Difficulty chewing or swallowing Decreased appetite Decreased ability to feed self Decreased taste and smell Decreased esophageal emptying time
Copyright 2002, Delmar, A division of Thomson Learning Nutritional Assessment of Older Adults Presence of physical limitations that affect eating? Difficulty chewing or swallowing? Presence of dental problems? Difficulty obtaining or preparing foods? Do you eat alone?
Copyright 2002, Delmar, A division of Thomson Learning Cultural Differences in Nutrition Cultural beliefs related to the consumption of food Religious beliefs related to the consumption of food Food restrictions Periods of fasting
Copyright 2002, Delmar, A division of Thomson Learning Components of a Nutritional Assessment Nutritional history Physical assessment Anthropometric measurements Laboratory data Diagnostic data
Copyright 2002, Delmar, A division of Thomson Learning Nutritional History General diet information Changes in past 12 months Ability to obtain and prepare foods Food preferences Adherence to particular diet Consumption of fast foods (continues)
Copyright 2002, Delmar, A division of Thomson Learning Nutritional History Food intake history 24-hour recall Food diary Calorie count Evaluation of adequacy of diet Food guide pyramid
Copyright 2002, Delmar, A division of Thomson Learning Physical Assessment Head to toe Assess for subjective and objective signs and symptoms of poor nutritional status
Copyright 2002, Delmar, A division of Thomson Learning Signs and Symptoms of Poor Nutritional Status Subjective data Fatigue Weight changes Changes in appetite Weakness Changes in bowel habits (continues)
Copyright 2002, Delmar, A division of Thomson Learning Signs and Symptoms of Poor Nutritional Status Objective data Weight changes Dry, rough, scaly skin Dry, cracked lips Swollen, bleeding gums Edema Decreased muscle tone
Copyright 2002, Delmar, A division of Thomson Learning Anthropometric Measures Height Weight Ideal body weight, percent IBW Percent weight change Triceps skinfold BMI Mid-arm circumference Waist/hip ratio
Copyright 2002, Delmar, A division of Thomson Learning Laboratory Data Hematocrit and hemoglobin Cholesterol and triglyceride levels Transferrin, TIBC, iron Total lymphocyte count Albumin and prealbumin Glucose Creatinine and nitrogen
Copyright 2002, Delmar, A division of Thomson Learning Diagnostic Data Radiographic studies