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17 Cards in this Set
- Front
- Back
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What does SOAP stand for?
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S ubjective
O bjecting A ssesment P lan |
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What is pertinent data to assess nutrition?
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Nutrition intake and Dietary Habbits
Underlying Pathology with nutritional effects End-Organ Effects Miscellaneous |
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What is some stuff to take into consideratin concerning Nutrition Intake and Dietary Habits?
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Anorexia
Taste changes Actual intake (dietary restrictions) Supplemental vitamins/minerals Food Allergies/Intolerances |
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What is good to keep in mind concering Underlying Pathology with Nutritional Effects?
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Chronic incfectinos; inflammatory diseases
Neoplastic disease Endocrine disease Chronic illness: COPD, cirrhosis, CRF Hypermetobolic state: trauma, burns, sepsis Digestive/absorptive disease Hyperlipidemia |
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Key items too look at for End Organ Effects?
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Weight changes
Skin/hair changes Excercise tolerance, fatigue Obesity GI symptoms: N/V/D |
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Other factors when assesing a patients nutritional status could be?
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Catabolic meds: steroids, immunosuppressors, radiation, chemo
Diuretics, laxatives Genetics Alcohol or drug abuse |
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One might be at a risk for malnutrition if?
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unintentional weight loss > 10% over 3 months
body weight < 90 of IBW BMI < 18 kg/m2 |
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What are the concentrations for albumin?
Normal Mild Moderate Severe Half-life Advantage disadvantages |
Albumin:
Normal: 3.5 - 5 g/dL Mild: 3 - 3.5 g/dL Moderate: 2.1 - 3 g/dL Severe: < 2.1 Half-life: 20 days Advantage: Inexpensive routine Disadvantage: May be misleading; drops with stress; Dilution with hydration is slow response |
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What are the concentrations for Transferrin?
Mild Moderate Severe Half-life Advantage Disdvantage |
transferrin:
Normal: 200 - 350 mg/dL Mild: 150 - 200 mg/dL Moderate: 2.1 - 3 mg/dL Severe: < 2.1 Half life: 7-10 days Advantage: Less affected by hydration Disadvantages: Iron status; acute phase reactants |
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What are the concentrations for Prealbumin?
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Prealbumin:
Normal: 20-40 mg/dL Mild: 12-15 Moderate: 7-11 Severe: < 7 Half life: 2.3 days Advantage: quick improvement Disadvantage: Special order; expense, turn around time, can be misleading, drops with stress |
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ABW figure for IBW with BMI to right
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<69% severe malnutrition < 16
70-79% Moderate 16-16.9 80-89% Mild 17-18.5 90-120% Normal 19-25 >120% Overweight 25-30 >150% Obese 30-40 >200% morbidly obese > 40 |
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What are indications of Marasmus?
Who typically gets this? |
cancer pts
form of severe protein malnutrition: EVERGY DEFICIECNY Low body Wt. Low Body Fat Low somatic protein WNL Visceral protein Immune function: takes months to years of being starved, weight < 80% IBW, tricepts skin fold < 3 mm, Medium arm circumfrence < 16mm REFEED WITH CAUTION |
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What are indications of Kwashiorkor?
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its insufficient protien intake but with sufficient caloric intake
Low body weight WNL body fat Low somatic protein Low Visceral Protein Immune Function: weeks, edema, albumin low, immediate nutrition |
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How to figure estimated energy requirements?
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Harris Benedict (BEE)
Indirect caloimetry must take physical state of pt into context |
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What are the energy requirements for the macronutrients:
Carbs: Fat: Protein: |
Carbs: 45-65%
Fat: 20-35% Protein: 10-35% |
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When preparing a TPN what is coalescence and Oiling out?
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Coalescence:
fat droplets aggregate into significantly larger droplets, creating irreversible separation of oil and water, unusable TNA Oiling out: there is continued coalescence with total irreversible separationof oil and water, unusable |
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What are three big problem Meds with TPNs?
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Phenytoin
Warfarin Fluoroquinolones |
