Lecture Notes Week 1
Lecture Notes Week 1 NTR 218
Popular in Assessment of Nutritional Status
Popular in Natural Sciences
This 6 page Class Notes was uploaded by Bella Tommey on Wednesday September 2, 2015. The Class Notes belongs to NTR 218 at University of Texas at Austin taught by Monica Meadows in Summer 2015. Since its upload, it has received 44 views. For similar materials see Assessment of Nutritional Status in Natural Sciences at University of Texas at Austin.
Reviews for Lecture Notes Week 1
Loved these! I'm a horrible notetaker so I'll be your #1 fan this semester
Report this Material
What is Karma?
Karma is the currency of StudySoup.
Date Created: 09/02/15
NTR 218 Assessment of NTR Status 08262015 LECTURE 1 Wednesday August 26 Class information Professor Monica Meadows MonicaRDaustinutexasedu Office hours Mon 1030am1130 Wed 11001230pm Brittany Harlow TA brittanyharlowutexasedu Required materials Check materials on Canvas regularly Simple calculator is required non programmable Laptop Dennerll Medical Terminology Made Easy 4th ed Needed for lab quizzes use quizlet 3 hour long exams 100 each Lowest grade will be dropped Comprehensive nal 100 3 Assignments 75 Assignments submitted in pocket folder with no brads write name and NTR 218 in upper right corner Assignments due at beginning of class period 10 deducted per day from late assignments Keys to success Make use of office hours Use materials effectively notes and handouts lab activities and learning objectives Pay attention Focus on how the information connects between lecture and lab and the rationale behind nutritional recommendations WHY would you consult physician s orders and why is waist circumference useful to know etc Quizzes 20 point quiz covers on chapter 4 words to build 5 words to de ne 1 abbreviation to de ne Administered at the beginning of lab An optional 40 point comprehensive quiz can be taken at the end of the semester to replace 2 low scores or missed quizzes Lab breakdown Quizzes 200 Lab Exam 50 Assignments 100 Concept Map 10 Participation 20 Overview of the course Medical Nutrition Therapy subset is the nutrition care process making sure we are taking care of our patients Medical Nutrition Therapy De nition Nutritional diagnostic therapeutic and counseling services for the purpose of disease management which are provided by RDs and DTRs 4 different domains of the Nutrition Care Process 1 Nutrition assessment see what is going on with the patient collect information 2 Diagnosis know and decide what the issue is select appropriate nutrition diagnosis 3 Intervention actually look at eating habits and what we provide as the dietician to support the patient paying attention to signs and symptoms 4 MonitoringEvaluation see if things are going the way they should and then evaluating the progress Lecture 2 August 31st 2015 Nutrition Screening and Nutrition Assessment Nutrition Screenind Those preventative services in which a test or standardized examination procedure is used to identify patients requiring special intervention AAND ASPEN American Society for Parenteral and Enteral Nutrition The gold standard for nutrition support in clinical nutrition It refers to screening as a process to identify if someone is malnourished or at risk of it Typical hospital approach Patient admittedgt patient screened within 24 to 48 hours gtif problems are identi ed then decide if high or moderate riskgt then plan care If there are no problems after the screen then considered low risk and usually no further care is provided Information collected depends on the 1 Setting acute care hospital long term care facility clinic outpatient office or home health care 2 Population group elderly infants children 3 Type of data that can be easily obtained chart review patient interview 4 De nition of risk hospital outpatient 5 Goal of screening determining level of care Characteristics of a Nutrition Screening Protocol Needs to be simple and completed quickly Relies on data that are routinely gathered in a particular setting this is inexpengve Want it to include a collection of limited amount of relevant data ef cient Determines the need for nutritional assessment reliable Screening can be completed by any quali ed health care professional Screening time line Acute care within 24 hours Long term care within 14 days of admit Home care on initial RN visit screening happens by nurse rst time they visit the patients home Potential data includes chart review diagnoses height weight BMI oral intake and dependence on nutrition support and patient interview appetite usual weight recent weight loss Malnutrition Screening Tool MST The best tool validated based on subjective global assessment Useful for a heterogeneous adult patient population Started with 21 questions about all sorts of things such as appetite recent illness etc But knew it was too many questions so whittled it down to 3 questions Good measurement tool for predictive value positive 984 negative 727 accuracy Recommendations screen within 24 hours of hospitalization scores can be used to prioritize patient care patients screened at risk should be assessed by dietitian and those not at risk can be rescreened weekly There are additional tools but MST is best SGA is the other good one subjective global assessment adults based on history and physical examination DETERMINE is an assessment used for the elderly population and those living independently What could you use to screen Patients recently admitted to the hospital ask about appetite changes if they are on nutritional support if they have lost weight look at BMI Residents in an assisted living center the above things but also if they are having chewing or swallowing issues Nutrition Assessment AND A systematic process of obtaining verifying and interpreting data in order to make decisions about the nature and cause of nutrition related problems Malnutrition an acute sub acute or chronic state of nutrition in which varying degrees of over or under nutrition with or without in ammatory activity have led to a change in body composition and diminished function Not just weight but also in regards to nutrients Pathophysiological mechanisms for malnutrition what has gone wrong with physiology that has contributed to this image of malnutrition 1 lntake inadequate ingestion of nutrients Eg anorexia nervosa hyperemesis throwing up a lot even though they are trying 2 Digestion inability to break down the nutrients for absorption Eg pancreatitis gastrectomy stomach has been removed 3 Absorption inability to assimilate ingested nutrients Eg Crohn disease short bowel syndrome 4 Metabolism inability to utilize assimilated nutrients Eg inborn error of metabolism like PKU liver disease 5 Excretion increased loss of nutrients Eg dialysis or draining wounds 6 Hypermetabolism increased need for nutrients Eg burns need 2 or 3 times the number of calories before the burn or sepsis Purpose of assessment Why do we want to do this We need to see if they are actually malnourished see if they are at risk do they have limited stores or very high needs adequate no treatment required We need to identify appropriate medical nutrition therapy What do we need to do to support this individual Need to give appropriate food We must monitor ef cacy of these therapies is it working Nutrition Assessment ABCDs A Anthropometric measurements eg skin fold measurements weight for height BMI circumference measurements B Biochemical laboratory measurements eg protein stores creatinine height index C Clinical ndings medical history nutrition focused physical ndings D Dietary intake Major tissue compartments Somatic compartments fat and muscle look at your patient and see what they look like as part of the assessment anthropometric measurement Visceral Biochemical lab measurements such as liver secretory proteins and immune status you can t see these with the eye probably have to draw blood or measure urine