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ND Exam 1
Question | Answer |
---|---|
Nutrition Care Process Steps | Assessment, Diagnosis, Intervention, Monitoring and Evaluation |
Nutrition Care Process Steps Assessment | - Obtain/collect timely and appropriate data - Analyze/ Interpret with evidence-based standards - Document - Monitor changes in status |
Steps in Nutrition Assessment | 1. Review medical record 2. Interview patient or significant other 3. Examine patient (visual) 4. Evaluate data |
Nutrition Care Process Steps Diagnosis | - Identify and label problem - Determine causes/ contributing risk factors - Cluster signs and symptoms/ defining characteristics - Document "related to" "as evidenced by" |
Nutrition Care Process Steps Intervention | - Plan (formulate goals and determine a plan of action) - Implement (care is delivered and actions are carried out) - Document - Prioritize nutrition problems |
Nutrition Care Process Steps Monitoring and Evaluation | - Monitor progress - Measure outcome indicators - Evaluate outcomes - Document |
Intake Domain | Nutrition problems related to the intake of energy, nutrients, fluids, and bioactive substances through oral diet or nutrition support. Labels describe a specific nutrient or substance that is altered: "inadequate," "excessive," "inappropriate." |
Clinical Domain | Nutrition problems related to medical or physical conditions. Problems swallowing, chewing, digestion, absorption, and maintaining appropriate weight. |
Behavioral-environmental Domain | Problems related to knowledge, attitudes/ beliefs, physical environment or access to food, and food safety. |
Why conduct nutrition screening? | - To identify high risk patients - More cost efficient and effective collection and identification of at risk patients than a full nutrition assessment |
JCAHO Standard for nutrition screening | -screening within 24 hours of admission - Nutrition Dept screening within 48 hours of admission |
Sensitivity | Ability to correctly identify high risk |
Specificity | Ability to rule out non high risk |
Improve Sensitivity of Screening Tool | - Change threshold for indicators of high risk - Increase serum albumin - Decrease the number of days a pt is NPO - Add more diagnoses to high risk list |
When would you want a screening tool with a high specificity? | - Diagnostic work-up is costly or risky - Disease slowly and have another opportunity to test those with negative results - Disease is not contagious - Resources are limiting |
Subjective Global Assessment | - Observation/ Interview, Clinical Judgement, Correlates objective measures, useful, cost effective Classification: well nourished, moderately malnourished, severely malnourished |
Elbow Breadth | Frame Size: Measure of widest part of elbow when flexed 90 degrees. Caliper is used to measure the distance between epicondyles of humerus |
Ht-Wrist Circumference | Frame Size: Measure at smallest part of wrist, just above bone. R= height(cm) / Wrist circum(cm) *Compare to standard values for frame size |