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128 Cards in this Set
- Front
- Back
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Screening is
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the process of identifying characteristics known to be associated with nutrition problems.
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PURPOSE OF SCREENING
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identify individuals who are presently malnourished or at risk of future malnourishment.
The purpose is to identify those individuals who are more likely to be helped than harmed by further tests or treatment to reduce the risk of a disease or its complications. |
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screening is used for groups?
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yes. for groups and individuals.
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screening in a public health setting is for
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a defined population who may not perceive themselves at risk or already affected by a disease or its complications.
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an abnormal result in a screening.
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does not necessarily mean the individual is diagnosed with a particular disease. In any screening program, there will always be a small amout of false positives and false negatives.
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provide the most objective and quantitative data on nutritional status.
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biochemical screening
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often detect nutrient deficiencies long before anthropometric measures are altered and clinical signs/symptoms appear.
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biochemical screening
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type of connective tissue
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blood
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blood transports: 4
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oxygen, nutrients, heat, and chemical messengers
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metabolic traffic (blood ) can indicate 5
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cellular uptake/utilization: example - glucose
synthesis: albumin excretion of waste products: urea, creatinine tissue damage: aspartate aminotransferase (tests used - SGOT, AST) altered metabolism: total cholesterol, thyroid function tests |
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cellular fraction of blood:
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comprises 40-50% of the blood and includes:
red blood cells white blood cells platelets |
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hematocrit is
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percent of blood volume comprised of cells (mostly red blood cells)
aka packed cell volume |
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plasma:
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50-60% of the blood and contains:
proteins (ex- albumin) water inorganic electrolytes |
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serum is
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plasma in which clotting factors have been removed
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Things transported in the plasma: 7
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glucose
lipids amino acids hormones metobolic end products carbon dioxide oxygen |
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desirable cholesterol level
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<200 mg
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borderline high cholesterol
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200-239 mg/dL
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high cholesterol levels
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240 +
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albumin is what percent of total protein
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60%
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Liver functioning things you can test
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LDH
SGOT GGTP total protein (albumin and globulins) |
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What to test when testing for infection/nutrition
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total protein
albumin globulins A/G ratio |
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To test when testing bone metabolism
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alkaline phosphate
Phosphorus Ca |
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What to test when tesitng liver function
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BUN
createnine |
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What can be found in urinalysis 4
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(ex- chromium, iodine), protein, water-soluble B complex vitamins, and vitamin C.
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urine always reflects:
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recent dietary intake
acute status rather than chronic nutritional status |
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What to test for kidney function?
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BUN, creatinine
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What to test for liver function?
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LDH
SGOT GGTP Bilirubin total protein |
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Increases in urinary amounts can happen even in what unusual circumstance?
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Increases in urinary excretion of some nutrients can increase even when body stores are depleted.
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urinalysis typically includes all 9 things
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a description of color and appearance
specific gravity pH glucose ketone bodies protein RBC number WBC number The hormone hCG |
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when should glucose be in the urine?
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never. it means diabetes.
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If bilirubin in the urine, it means:
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gallstones, biliary strictures, cirrhosis, or hepatitis. Bilirubin should not normally be in the urine.
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Ketones in the urine indicate
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starvation, diabetes, and low CHO diets. Detectable ketones indicate that CHO are either lacking in the diet or are not being metabolized normally.
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glucosuria:
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High levels of glucose in the urin are called
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specific gravity of urine is
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A measure of how concentrated the urine is
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High specific gravity when:
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dehydration, water restriction, diarrhea, excessive sweating, vomiting, and glucosuria.
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Rbc in urine indicates:
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idney diseases, kidney stones, urinary tract infection, or prostatitis
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Normal pH of urine
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urine pH ranges from 4.6 - 8.0
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protein in the urine during ___ disease
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kidney
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urobilogen in the urine means
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liver disease or blockage of gallbladder
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2 liver diseases
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cirrhosis and hepatitus
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nitrites in urine mean
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UTI
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leukocytes in urine means
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UTI
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Blood glc normal values
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Normal fasting values are 70-109 mg/dL.
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high blood glc (fasting ) means
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diabetes or eating before test
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electorylyte panel includes
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Na, Cl, HCO3, K
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Hyponatremia is from
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drinking too much, vomiting, sweating etc
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if there is a change in chloride but not sodium it indicates
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a disturbance in the acid base balance
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Complaints, symptoms, onset, duration, location in SOAP would be under what letter?
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Subjective.
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general appearance would be recorded in SOAP under
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S
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anemias are a disease?
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no amenias are not, they are a symptom of a disease.
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megaloblastic anemia is a symptom of
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large nucleated primitive RBC precursors (e.g., seen in folic acid and vit B-12 deficiency)
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pernicious anemia is caused by
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Anemia caused by Vit B-12 deficiency as a result of lack of gastric "intrinsic factor" needed Vit B-12 absorption.
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microcytic anemia is a symptom of
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Fe deficiency
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macrocytic is a symptom of
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folic acid or vit B-12 deficiency)
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s/s of anemia 8
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Reduced O2 carrying capacity in the blood
Chest pain Shortness of breath (severe anemia can lead to lack of oxygen in heart, and a heart attack) Rapid heart rate Fatigue, tiredness Pale complexion Feeling cold Reduced athletic performance |
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IDA (iron deficiency anemia) s/s 6+
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pale, fatigue, weakness, cold
decreased work/school performance slow cognitive/social development glossitis pica change in stool color (bright red blood) |
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At risk for IDA
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women in reproductive years
pregnant or lactating women infants, children, adolescents older adults persons with poor dietary iron intake |
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most common type of anemia?
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IDA
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percetn of women with Fe deficiency, and percetn anemic:
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12% deficient, 3 % anemic
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Stage 1 of IDA what is decreased?
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Ferritin
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Stage 2 (iron deficiency ertyhropoiesis) what is abnormal?
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ferritin and Transferrin saturation % are both decreased
Free erythrocyte protophorin is increased. |
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Stage 3 IDA (anemia) what is abnormal?
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ferritin decreased
Transferrin saturation % decreased free erythrocyte protoporphin increased Hb is decreased |
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stage 1 of IDA is
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Iron depletion. Only ferritin is decreased
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Stage 2 of IDA is
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iron deficiency erythropoiesis
(3 things abonormal) |
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Stage 3 of IDA is
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anemia. All 4 things abnormal.
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Who's at risk for folate deficiency?
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poor, the elderly, and in people who do not eat fresh fruits or vegetables), or eat overcooked foods. Pregnant. Alcoholics. Cancer drugs
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Folate deficiency s/s 4
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tiredness
headache sore mouth and tongue poor pallor low hb and hct, megaolblasts |
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B12 is found in what foods?
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animal products
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Who at risk for b12 deficiency?
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vegetarians
alcoholics elderly bariatric surgery lack of intrinsic factor autoimmune disorder |
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b12 aka
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cobalmin
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s/s of b12 deficiency:
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loss of appetite
diarrhea numbness/tingling paleness shortness of breath fatigue/weakness |
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Hb is affected how by each anemia?
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all 3 decrease it
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hct is affected how by each anemia?
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all 3 decrease it
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MCV is affected how by each anemia?
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Folic and B12 increase it.
Fe decreases it. |
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Serum Fe is affected how by each anemia?
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Folic and B12 increases it.
Fe anemia decreases it |
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% Transferrin saturation is affected how by each anemia?
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Decreased in Fe
variable in B12 and Folic |
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hypernatremia is a result of
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excessive water loss or dehydration.
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hyponatremia caused by
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vomiting, sweating, diuretics, kidney disease, etc) or high water intake.
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increased Cl means
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dehydration. B/c Cl works the same ways as Na. They are correlated.
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hypercholemia means
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ay indicate too much acid in the body, metabolic acidosis
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decreased Cl levels (hypocholemia) means
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metabolic akalosis
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major intracellular cation
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K
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hypokalemia caused by
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caused by diarrhea, vomiting, and excessive sweating.
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hyperkalemia caused by
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kidney disease or drugs that decrease potassium excretion.
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High BUN
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high values suggest kidney disease.( b/c made by the liver, but excreted by the kidney)
high protein diets and strenuous exercise |
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Low BUN =
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pregnancy
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Creatinine
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Creatinine is the breakdown product of creatine phosphate, a source of energy in the muscle, and is normally excreted in the urine.
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uric acid is the breakdown product of
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purines (AG)
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increased uric acid in
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gout (joint pain) and poor renal function
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what percent of Ca is in the blood?
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1%
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hypercalcemia =
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hyperparathyroidism, cancer in the bones, or high vitamin D intake
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hypocalcemia =
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hypoparathyroidism, low protein levels, or decreased levels of vitamin D
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liver panel: 6
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ALT, ALP, AST, bilirubin, albumin, and total protein.
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low protein =
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kidney or liver disorders or any condition of inadequate protein intake, digestion, or absorption
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albumin an acute protein marker?
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It is not sensitive to acute protein malnutrition or the response to nutrition therapy
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low albumin =
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stress. correlates with the severity of the illness.ncreased length of hospital stay, complications, morbidity, and mortality. used to identify high-risk patients who will likely benefit from early nutritional intervention.
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Normal albumin values
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3.5 - 5 g/dl
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mild depletion for albumin
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3 - 3.4
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moderate depletion for albumin
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2.4 - 2.9
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severe albumin depletion
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less than 2.4
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Factors that decrease albumin 6
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burns
APR severe zinc deficiency nephrotic syndrome liver failure overhydration |
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factors that increase ablumin
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glucocorticoids
anabolic steroids dehydration |
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half life of albumin
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14-20 days
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half life of prealbumin
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2-3 days
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normal preablumin
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16-40 mg/dl
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mild depletion
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10 -15
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moderate depletion prealbumin
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5 - 9
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severe depletion of prealbumin
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less than 5
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factors that decrease prealbumin
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nephrotic syndrome
liver disease hyperthyroidism severe zinc deficiency APR |
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globulins are decreased by
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immunologic deficiencies
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bilirubin increases in
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liver damage (the liver can't remove it from the blood and jaundice results)
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ALP (alkaline phosphate) is elevated when
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bone and liver damage
blockage of bile ducts pregnancy and growth in children |
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SGOT aka
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AST
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SGOT increased in these conditions:
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heart attack, liver damage (alcoholic cirrhosis, liver tumors, hepatitis, infectious mononucleosis), and skeletal muscle trauma.
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GGTP elevated when
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liver damage/disease
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LDH increased
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heart attack, liver disease, muscle disease, or damage to any tissue containing LDH. LDH levels may also be increased acutely if individuals exercised prior to the blood test.
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optimal LDL
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less than 100 mg/dl
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near optimal LDL
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100 - 129
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borderline high LDL
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130 - 160
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High LDL
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160 - 190
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very high LDL
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190 +
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High HDL
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60 +
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Men low HDL
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less than 40
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women low HDL
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less than 50
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normal TG
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less than 150
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borderline high TG
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150-200
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high TG
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200 - 500
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very high TG
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500 +
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