1. Copyright 2002, Delmar, A division of Thomson Learning Chapter 7 Nutritional Assessment

2. 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.

3. 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)

4. 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

5. 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)

6. Copyright 2002, Delmar, A division of Thomson Learning Nutritional Guidelines for Young and Middle- Aged Adults  Type 2 Diabetes Mellitus  Atheroschlerosis

7. 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?

8. 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)

9. 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

10. 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?

11. 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

12. Copyright 2002, Delmar, A division of Thomson Learning Components of a Nutritional Assessment Nutritional history Physical assessment Anthropometric measurements Laboratory data Diagnostic data

13. 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)

14. 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

15. 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

16. 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)

17. 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

18. 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

19. 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

20. Copyright 2002, Delmar, A division of Thomson Learning Diagnostic Data Radiographic studies