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Nutritional assessme
WOCN program
Question | Answer |
---|---|
Describe criteria to be included in a comprehensive nutritional assessment | physical exam, nutritional history (type of diet,) physical exam, (weight change, edema,) risk factors anthropomorphic and lab data |
what is the difference between nutrition screening tool and assessment tool | screening identifies the pt is at risk or not at risk for malnutrition assessment measures the extent of malnutrition |
Identify nursing interventions to manage poor nutrition | offer supplementation, fortify, freq small meals |
Describe the role of carbohydrates in wound healing | provides energy, protein sparing, angiogenesis |
Describe the role of proteins in wound healing | needed for nitrogen balance, provide amino acids and new protein syntheses |
Describe the role of fat in wound healing | cell walls, intracellular structures |
Describe the role of vit C in wound healing | collagen synthesis and iron absorbtion |
Describe the role of iron in wound healing | oxygen transport |
Describe the role of zinc in wound healing | protein metabolism, collagen formation, |
Describe the factors to consider in a nutritional assessment | nutritional hx, physical statues, ability to eat/absorb, lab data, social factors affecting food intake |
What are the criteria for determining the route of nutritional support | ability to consume adequate nutrition PO. GI tract should be used if at all possible, second choice is parenteral.` |
Identify two measures to increase protein and calories for the home care patient with a wound who needs oral nutritional support | nutritional supplements, addition of high protein snacks, small freq. meals |
Identify the risk factors for malnutrition | hypermetabolism, wgt loss, decreased appetite, sociological factors, physical limitations, nausea, vomiting, anorexia, diarrhea, dietary restrictions |
What reverses effects of steroid changes | vit A |
What is required for collagen cross linking | copper |
What provides energy? | carbohydrates |
What is a cofactor for collagen formation and protein synthesis | zinc |
What supports oxygen transport | iron |
Is a cofactor for collagen synthesis and capillary wall integrity | vitamin C |
Calcium metabolism | vitamin D |
Serum albumin is a valid lab measurement to diagnose recent mild to moderate malnutrition true or false? | false |
What is the best lab test to measure nutritional status | there is no ideal lab test for malnutrition serum albumin and prealbumin, transferrin, retinol binding proteins are used |
What does an albumin of 2g/dl indicate? | hypoalbuminemia |
List three anthropometric measurements to perform in the nutritional assessment | height, weight, (BMI) head circumference in children |
The caloric need of an obese person with a chronic non-healing wound is greater than the person of normal weight. True or false? | false |
Arginine increases the rate of healing in a patient with a pressure ulcer. True or false? | false |
what affects serum protein levels | inflammation, hydration, renal status |
what is the fluid requirement for adequate hydration | 30ml/kg unless pt has renal failure or heart disease (min 1500ml/24hr) |
what is malnutrition | insufficient energy intake, wit loss, muscle mass and sub Q fat loss, local or general edema, decreased handgrip strength |
what is the recommended protein intake for healing | 1.25-1.50 g per Kg or enough to maintain a positive nitrogen balance |
what is the the best choice of lab test to measure nutritional status | prealbumin |
role of B complex in healing | cofactors in enzymes, inflammation, synthesis of macronutrients |
role of vit A in healing | angiogenesis, epithelialization,inflammatory response |
role of vit E in healing | antioxidant |
how much fluid is recommended | 2.4L for Women, 3.7L for Men in 24 hrs |
indicators of malnutrition | wit loss of 5% in 30 days or 10% in 180 days |
underweight BMI | <18.5 |
average BMI | 18.5-24.9 |
overweight BMI | 25-29.9 |
obese BMI | >30 |
caloric needs for open wound or at risk for PI | 30-35 cal/kg/day |