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FSHN 428- Exam 3
| Question | Answer |
|---|---|
| RULE | resist righting reflex, understand client’s motivation, listen to client, empowerment |
| Algorithm for MI session | involving, exploration, resolving, closing |
| 3 strategies of CBT | reverse negative self talk, goal setting, cognitive restructuring |
| prochaska’s stages of change | precontemplation, contemplation, preparation, action, maintenance |
| 3 strategies of person-centered | problem solving, goal setting, negative==>positive |
| 3 approaches to exploring ambivalence | find/reinforce change talk, evocative questions, summarization |
| DARN-C | desire, ability, reasons, need, commitment |
| Treatment team for eating disorders | psychotherapist, nutritionist, physician, (psychopharmacologist, rehab, family, dentist, hospitalization) |
| Normal eating | flexible, varies in response to emotions, schedule, hunger, proximity |
| Football | 5000kcal per day, gain/loss, eat frequently, before/after practice, hydration |
| Softball/baseball | lower energy needs, frequent travel, fluid intake |
| Endurance sports | high energy, carb, iron/calcium, leanness, EDs, sodium/fluid |
| Nutrition services for teams | fueling station, counseling, cooking classes, education, recipes |
| where do cardiac dietitians work? | cardiology office, cardiac rehab, health fairs, research |
| New cholesterol guidelines | no more specific goals for LDL, more statin use |
| Sodium cardiac | <2400mg, <1500 if HTN, or at least decrease it by 1000mg/day |
| Saturated fat heart disease | 5-6% of calories decreases LDL slightly compared to 14-15% |
| Type 1 diabetes program | individual education |
| Type 2 diabetes program | class/individual appointment & follow up (or individual only) |
| Gestational diabetes program | small group and individual education |
| Pre diabetes program | class |
| Outline of original diabetes education session | intake/assessment, goals/learning objectives, education, evaluation of learning and goal setting |
| 5 parts of intake/assessment | medical history, medications, knowledge, motivation, barriers, health literacy |
| 4 self care practices for diabetes | glucose monitoring, ketone testing, hypoglycemia, medical ID |
| evaluation diabetes (3) | verbal return, demonstration of ability to read label/plan menu, have patient describe the changes they plan to implement |
| most important point about platform speaking | framing the story |
| pre-preparation questions platform speaking | format, room set-up, Q&A, audience background, why is audience there? |
| Format platform speaking | where, when, how long, introduction |
| Q&A platform speaking | anticipate, practice |
| Audience background platform speaking | group dynamics, cultural influences, age |
| Why audience present platform speaking | knowledge, consensus, objective |
| Don’t mess with Texas | 15-29 year old men about littering (think about audience) |
| WIIFM | what’s in it for me |
| Tailor message | I wish my consumers knew…; phrase so benefits audience, WIIFM |
| 3 pilars of good first impression | verbal 7%, vocal 38%, visual 55% |
| verbal first impression | 7%; content, research, data |
| vocal first impression | 38%; power of the pause, vocal habits |
| visual first impression | 55%; physical, emotional, gestures, smile |
| eye/physical contact | essential for involvement, connect only for a moment, body position also important |
| 6 bad gestures | hands on hips, crossed arms, fiddling, pointing, hands in pockets, nodding (when not agreeing) |
| 6 ways to support facts | visual, data, startling statistic, analogy, story, 3rd party endorsement |
| 4 seconds | first impression |
| 4 minutes | lasting impression |
| people won’t care what you have to say unless | you care about them & their problems |
| how much time for opening? | 15% |
| anticipation (3) | question, interesting statement, sense of expectation |
| how to be relevant? | case studies, anecdotes, humor, activities, props, illustrations |
| what to not use to be relevant | studies |
| two food visual ideas | sugar, bacon in pot pie |
| rule of ___ | three! Easiest to remember |
| how much time for ending? | 10% |
| what to do at end of talk? | call to action! Review main points, DO something |
| how to make audience comfortable | share, care, connect |
| how to be comfortable with self | practice, positive, lighten up |
| framing talk | you know why you are here and you can make your audience care! |
| An ounce of ___ is worth a ____ of technique | enthusiasm, technique |
| Style vs. substance | science babe etc. |
| Income guidelines for WIC | 185% of poverty level, all members of household including baby, still eligible if on food stamps, Medicaid |
| WIC residence | must live in country, not US citizen; must have ID, proof of residence, proof of income |
| Nutrition/medical risks WIC (6) | underweight mom/kid, overweight kid, anemia, inadequate pregnancy weight gain, BF complications, medical risks (DM, delays, dental) |
| Benefits with WIC (6) | individualized programs, BF support, BF pump loan, food, screening, referrals |
| BF peer counselor program | bilingual counselor, follows until 4 months old |
| __% of all newborns eligible for WIC | 50% |
| how many WIC clients per RD? | about 400 |
| 6 things WIC has accomplished | reduced LBW, iron deficiency anemia, improved pregnancy dietary intake, improved cognitive development, cost effective |
| what’s new for WIC? (3) | online Ed, grocery store tours, group classes |
| typical RD appointment WIC | assessment, nutrition risk factor, pamphlets, goals, appointment (30 minutes) |
| 3 WIC nutrition risk factors | >95th percentile, regularly feeding sugars, any use of alcohol or drugs |
| typical WIC client (7) | single mom, children on Medicaid/SNAP, low income, bus for transportation, limited cooking skills, many life stresses, limited food supply |
| VENA | value enhanced nutrition assessment (WIC); client centered, focus on good, increase confidence, increase critical thinking |
| Client centered techniques (4) | open ended questions, rapport, warm welcome, empathy |
| Interpersonal communication OARS | open-ended questions, affirmations, reflective listening, summarize |
| appreciative inquiry | start by talking about successes (WIC) |
| MI WIC (4) | increase motivation, empathy, change talk, 1-10 scale |
| 5 functions of kidney pertinent to kidney disease | maintain fluid/electrolyte balance, excretion of nitrogenous by-products, regulation of bone metabolism, synthesis of erythropoietin, pH balance |
| main effect of chronic kidney disease | uremia (azotemia); organ damage, poor appetite, itching, insomnia, fatigue |
| excess fluid retention (kidney) causes | heart failure/HTN |
| potassium retention (kidney) causes | hyperkalemia /cardiac arrhythmias |
| excessive phosphorus/ low 1,25 D (kidney) causes | hyperparathyroidism, non atherosclerotic heart disease, bone disease |
| 4 foods with high phosphorus | soda, seeds, legumes, nuts |
| phosphorus binders | before meals, cause constipation |
| vitamin D kidney disease | need to take active form b/c can’t convert it |
| stage 1 kidney disease | no counseling |
| stage 2 kidney disease | control underlying cause (HTN/DM etc.) |
| stage 3 kidney disease | initiation MNT (protein, phosphorus, sodium, BP, lipids) |
| stage 4 kidney disease | need to also control K+ and pH |
| stage 5 kidney disease | dialysis, limit fluids |
| protein kidney disease | <.8g/kg/day |
| sodium kidney disease | 2500mg/day; not as important as protein |
| hemodialysis | 3x per week (BUN, creatinine, K, Na filtered) |
| continuous ambulatory peritoneal dialysis | can get infections, treatment 24/7 |
| loss of protein dialysis | increased catabolism, decreased anabolism, low albumin, increased inflammation |
| initial kidney counseling session (3) | establish rapport, obtain diet history, evaluate stages of change |
| in order to help patients w/ poor self care, ___ | help them to discover the need for self change |
| follow up kidney | review lab values monthly |
| 4 main women’s health issues | body image, pregnancy, nurturing/family, menopause |
| menopause/age related | weight gain, heart disease, breast cancer, osteoporosis |
| 2 guiding principles women’s weight | look at environment, each person must take responsibility |
| what social forces are working women’s weight | external pressures to conform, stuckness (sustain talk) |
| traditional approach weight loss | doesn’t really work; externally regulated eating |
| HAES | health at every size approach; fit and fat is possible, no forbidden foods, self acceptance, improve fitness |
| First trimester | morning sickness (folate, calcium, vitamin D) |
| Second trimester | weight gain issues |
| Third trimester | GI issues, BF, tired/ankles/breathing |
| African American 2ndary motivation pregnancy | avoid heartburn |
| Hispanic 2ndary motivation pregnancy | disease prevention |
| Barriers to eating fish during pregnancy (5) | mercury, cost, unaware of benefits, preparation, taste/smell |
| Fetal programming | fetal origins of adult disease |
| Managed care | 3rd party acts as an intermediary between the person seeking care and the medical care provider |
| Why learn about reimbursement | entry level scope of responsibility for most dietitian jobs |
| Medicare | >65 years old |
| HMO | members pay premium, MD is employee of organization |
| PPO | members choose provider from list who have agreed to discount fees; MDs contact insurance organization |
| Point of service plan | (variation of HMO) patients don’t make choice about plan until seek services, have primary care who is “gate keeper” |
| Capitation | (variation of HMO) MD paid monthly per patient |
| Exclusive provider organization | like a PPO but smaller list of MDs |
| Accept assignment | healthcare provider required to accept 3rd party payment & not bill client |
| Allowable charge | max fee a 3rd party will reimburse for a service |
| CHIP | children’s healthcare insurance program; provides healthcare services to families w/ income too high for Medicaid |
| CPT | current procedural technology; list of terms and numeric codes used for billing of services |
| RDs can be in network for | managed care organizations, fee for service insurers |
| Cost effectiveness reporting | client centered; best possible care for best price |
| Medicare coverage for diabetes/dialysis/kidney transplant | one on one counseling, follow up visits |
| Medicare DSMT | diabetes self management training; must be accredited, 9 hours group training, 1 hour one on one |
| Starting private practice 6 questions | what services will you deliver, who will your clients be, what is your competition, how will you make money, office location, hours of operation |
| 3 types of organizations to join private practice | SCORE, chamber of commerce, community service organizations |
| SCORE | service corps of retired executives; consultation by seasoned local business professional |
| Example of community service organization | BBB after hours |
| Financial private practice (3) | accountant for tax, appropriate fees for services, don’t be afraid to ask for money from client |
| Legal issues private practice (2) | insurance, attorney’s advice |
| Ethical issues private practice (4) | conflicts of interest, be objective, sale of supplements, accountability for recommendations |
| Marketing private practice (4) | visibility (talks, website, social marketing), networks, preferred provider, advertise |
| FOCUS | first elicit, offer ideas, concise, use a menu, solicit more ideas |
Created by:
melaniebeale
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