DTR Domain II (34%) - Nutrition Care for Individuals and Groups
LDL-Cholesterol
"Bad" Cholesterol Optimal: <100 mg/dL Near Optimal: 100-129 mg/dL Borderline High: 130-159 mg/dL High Risk: 160-189 mg/dL Very High Risk: >189 mg/dL
HDL-Cholesterol
"Good" Cholesterol Desirable Level: >40 mg/dL Negative Health Risk: >60 mg/ dL
A 45-yo woman is following the DASH diet. She is consuming 1800kcal/day. What is an appropriate nutritional goal for her based on teh DASH diet?
- 55g Total Fat w/ up to 12% Sat Fat - 80g protein - 250g CHO - 2300mg Sodium - 150mg Cholesterol - 30g Fiber
Mini Nutritional Assessment (MNA)
- A validated tool used for nutrition screening and assessment for the population > 65yo - Screens for malnutrition or risk of malnutrition - A short form used for quick determination of an individual's nutritional status -- a longer form is available for more detailed assessments
The main highlights of the 2005 Dietary Guidelines for Americans include...
- Achieve and maintain a healthy body weight and incorporate at least 60 minutes of moderate physical activity to help with weight management. - Limit fat intake to 20-35% of total calories, with less than 10% of that fat intake from saturated sources, and limit intake of trans fatty acids. - Eat less than 2300 mg/ day of sodium and consume 3 cups/ day of low fat or fat-free dairy products.
Soluble Fiber
- As soluble fiber is digested, it becomes gel-like - Soluble fiber works to slow the digestive process - Soluble fiber may help lower cholesterol levels
CHF (What is it? What type of diet?)
- Congestive Heart Failure - low sodium diet
3 diseases in which TPN is indicated
- Crohn's disease - radiation enteritis - short bowel disease
What signs and symptoms present in hair? What deficiencies do they represent?
- Dull, thin, pluckable - Zinc, malnutrition (protein or calorie)
Types of Dietary History
- Food Diary: Recorded by the individual for 3-7 days. - 24-Hr Recall: LEAST accurate way to obtain information. - Food Frequency Questionnaire: Determines how often a person eats certain foods. - Nutrient Intake Analysis: Types and amounts of foods observed to be consumed in an institutionalized environment, such as in a hospital.
Potential nutrition diagnoses for an obese male with coronary heart disease may include...
- Food and nutrition-related knowledge deficits - Physical inactivity - Excessive fat intake
galactosemia What is it? What is the primary therapy?
- Genetic disorder in which the body is unable to metabolize galactose; the build up damages the liver, brain, kidneys, and eyes. - medical nutrition therapy (MNT) is the primary therapy - no milk or milk products.
Supplemental Nutrition Assistance Program (SNAP) - Who qualifies? - What does this mean to children? - What was it formerly called? - What service does it include?
- Gross monthly income < 130% poverty level OR Net Monthly Income < 100% poverty level - Automatically qualifies children for free school lunch & breakfast programs - Formerly called the Food Stamp Program - Includes nutrition education services
Interventions aimed to modify what risk factors will reduce cardiovascular risk?
- High fat diet - Hypertension - Cigarette Smoking
Nutrition Diagnosis
- Identifies and labels nutrition issues - Is documented as problem-etiology-signs/symptoms - Delineated using standardized terminology
The purpose of nutrition screening includes...
- Identify risk factors known to be associated with nutritional issues - Identify individuals who are malnourished - Identify individuals who require a full nutrition assessment
Outcome measures for nutrition intervention for a patient with chronic obstructive pulmonary disease may include...
- Improvement in nutritional status - Improvement in activities of daily living (ADL) - Improvement in weight status
Trans-fatty Acids - how made - how used - future outlook
- Made through hydrogenation, a process that helps to prevent polyunsaturated fats from becoming rancid. - Found in commercially prepared baked goods, fried foods, processed foods, and some margarines. - The food industry has begun to alter the manufacturing of many products to omit trans fats, and many resturants have stopped using partially hydrogenated oils.
Chronic alcoholics are most likely to be deficient in what nutrients?
- Magnesium - Thiamin - Folate
The main, long-term nutritional priorities for post-cardiac transplant patients likely include...
- Monitoring and managing glucose intolerance - Weight management - Cholesterol management
What is true about the pancreas? - What does it do? - When does it do it? - What disease (other than pancreatitis) affects it?
- Secretes insulin and glucagon - When food reaches the stomach - Cystic fibroisis
Possible nutrition interventions with a child with cancer who is not eating enough include...
- Serve small emals and snacks throughout the day to capitalize on the times the child is feeling hungry and wants to eat. - Encourage liquids mostly between meals to prevent feeling full at meals. - Let the child help make the food they will eat and have friends over to eat with the child.
Feeding a preschooler is often challenging due to food jags, pickiness, or the child's attempts to assert independence. What are effective strategies for managing a preschooler's nutrition?
- Small servings of a variety of foods should be offered on a fairly regular schedule. - Snacks and beverages should not be provided within 90 minutes of a planned meal. - The parents should not focus too heavily on what is consumed at each meal or snack becuse over the course of a day, the calorie intake will be fairly consistent if a variety of foods are offered.
Vitamin C facts: - sources - smokers - deficiency
- Sources: citrus fruits and broccoli - Smokers: consume at least 100 mg daily - Deficiency: impaired wound healing, bleeding gums, tooth loss, and leg pain
Anthropometric measurements for children should include...
- Weight for age - height or length for age - head circumference up to the age of 3
Potential interventions for an patient with Type 2 diabetes mellitus could be...
- Weight loss - Increasing physical activity - Reduced caloric intake
high phosphorus foods
- bran - pumpkin, squash, and watermelon seeds - sunflower seeds - wheat germ - cheese - sesame seeds & tahini - brazil and pine nuts - soybeans (edamame) - flax seed - bacon
What signs and symptoms present in the skin? What deficiencies do they represent?
- dermatitis, scaling, bruising - protein, calorie, essential fatty acids, vitamin C, niacin
What signs and symptoms present in the extremities? What deficiencies do they represent?
- edema, decubitis ulcers, muscle pain - protein, thiamin, vitamin C, zinc
anti-reflux diet excludes...
- fatty or fried foods - tomato sauce - alcohol - chocolate - mint - garlic - onion - caffeine
folate deficienies lead to...
- increased homocystine levels - macrocytic anemia - impaired DNA synthesis (neural tube defects)
What is the next step for an individual who does not want to begin medication to lower blood cholesterol but has not ha dsuccess with the TLC diet?
- kcal from fat < 10% - Sat Fat < 3% - Cholesterol < 5mg/day
What signs and symptoms present in the eyes? What deficiencies do they represent?
- night blindness, conjunctival inflammation - Vitamin A, riboflavin
Characteristics of metabolic syndrome include...
- serum triglycerides greater than 150 mg/dl - serum glucose greater than 110 mg/dl - waist circumference greater than 102cm in men and 88cm in women
What are the guidelines for the Therapeutic Lifestyle Changes (TLC) diet?
- sodium < 2400 mg/day - kcal from fat: 25-35% total kcal - Sat Fat < 7% -cholesterol < 200 mg/day -total kcal to achieve or maintain healthy body weight
What signs and symptoms present in the nails? What deficiencies do they represent?
- spooning, pale, brittle - iron, protein
Carbohydrate metabolism utilizes
- thiamin - riboflavin - niacin
How much protein does the Natiaonal Kidney Foundation recommend that a patient with end stage renal disease (ESRD) who has not yet started to recieve dialysis treatments consume daily?
0.6 g/kg
How much protein is recommended for a patient with cirrhosis but without evidence of encephalopathy to maintain positive nitrogen balance?
0.8-1.0 g/kg
What is acceptable pregnancy weight gain?
1 lb/month for 1st trimester + 1 lb/wk thereafter
How much protein should a patient with end stage renal disease (ESRD) who has started dialysis consume daily?
1.2-1.5 g/kg
According to the ideal body weight (±10%), how many pounds should a 55-year-old man who is 5'11" tall weigh?
106# + (6# x 11) = 172#
The Harris-Benedict equation for calculating basal energy expenditure for women is 655 + (9.6 x wt in kg) + (1.8 x ht in cm) - (4.7 x age in yrs). What is the total kcal requirement for a sedentary woman who is 65 yo, 170 cm tall, and weighs 61.29 kg?
1100-1300 kcal
The recommended amount of weight gain for an overweight pregnant woman is...
15-25 pounds
As a dietetic technician, you are assisting a 78-yo man with congestive heart failure with meal selection. He has gained 10 pounds over the past week and is starting Lasix. What is a reasonable goal for this patient in terms of meal selection?
2000-3000mg sodium per day, adequate potassium, and mild fluid restriction.
How many mg sodium in 1 tsp salt?
2000mg
What is a patient's total cholesterol if the have the following lab results: LDL: 150, TG: 120, and HDL: 30
204
According to the carbohydrate counting method, the following menu consists of how many carbohydrate servings? 3-oz grilled, skinless chicken breast 1/2 c green beans 1/2 c of mashed potatoes one small roll 3 tsp margarine one small piece of angel food cake
3
fat exchanges for diabetic diet (calories? grams?)
45kcal (5g) fat per serving (exchange)
How many kcal are in 300ml of 5% dextrose?
51kcal
5% dextrose (g dextrose per volume?, kcal per gram?)
5g dextrose per 100ml 3.4kcal per gram of dextrose
What is the % IBW for 5'7" female with a large frame at a current wt of 110#? (wt 1 yr ago: 140#)
74%
A full-strength tube feeding delivered at at rate of 75 ml/h has a final volume of how many milliliters?
75 ml/h x 24h = 1800ml total
Protein content of 1c milk
8 g
How many grams of carbohydrate are in the following breakfast: - 4oz orange juice - 2sl whole wheat toast w/ 2 tsp margarine + 1 Tbsp jelly - 1/2c oatmeal w/ 1/2 banana - sm cup black coffee
90
In long term care, patients are re-evaluated every...
90 days
Growth Charts: - Types & what do they chart
= Girls: Birth to 36 months - wt for age - length for age - weight for length - head circumference = Boys: Birth to 36 months - wt for age - length for age - weight for length - head circumference = Girls: 2-20 yo - BMI = Boys: 2-20 yo - BMI
A woman with Type 2 diabetes mellitus who is overweight and takes an oral agent but otherwise has good blood glucose control asks you if she can include 1-2 glasses of wine with each night's dinner. The best answer is...
A 5-oz glass of wine may be consumed
Lasix
A diuretic (water pill) that prevents your body from absorbing too much salt, allowing the salt to instead be passed in your urine. Lasix treats fluid retention (edema) in people with congestive heart failure, liver disease, or a kidney disorder such as nephrotic syndrome. This medication is also used to treat high blood pressure (hypertension).
BUN
A measure of kidney function when evaluated against creatinine levels (decreased BUN + increased creatinine = renal disease). Normal: - Adult: 10-20 mg/dl - Child: 5-18 mg/dl
Hyperemesis
A severe, debilitating nausea and vomiting in pregnancy that generally leads to more than 5 percent weight loss and may require fluid and nutritional supplement because adequate intake of food and fluids is prevented; dehydration, malnutrition, and other serious complications can result.
A nutrition screen must be completed by whom?
A trained health professional (not necessarily a RD or DTR)
Which of the following laboratory data indicates nutritional risk? A. Fasting blood glucose level of 130 mg/dL B. fasting serum cholesterol level of 199 mg/dL C. Serum albumin level of 3.5 g/dL D. Hematocrit level of 42%
A. Fasting blood glucose level of 130 mg/dL
Which of the following foods would be appropriate for a client who eats only kosher foods? A. Halibut B. Shrimp C. Catfish D. Lobster
A. Halibut
Which of the following is the most practical parameter for scerening nutrition status in elderly clients? A. weight change B. serum albumin level C. 24-hour recall D. triceps skinfold thickness
A. weight change
Documentation developed to facilitate the Nutrition Care Process (NCP) is called...
ADIME
As a dietetic technician, you are assisting in a program targeting overweight adolescents at risk for developing hypertension. What would be an appropriate goal for the program?
Address lifestyle modifications such as weight control, reducing sodium intake, increasing physical activities that are known to control blood pressure.
Which of the following grain products would be the best choice for a patient with diverticulosis? A. Sesame seed crackers B. Cream of rice cereal C. All-bran cereal D. Banana-nut bread
All-bran cereal
Potenial nutrition diagnoses for a patient with a fasting blood glucose of 135 mg/dl might include...
Altered nutrition-related laboratory values
Triglycerides (TG)
An indicator of heart disease Desirable: <150mg/ dL Borderline High: 150-199 mg/dL High: 200-499 mg/dL Very High: <499 mg/dL
A side effect of chemotherapy is muscositis and xerostomia. This can impact nutritional status because...
Anorexia, reduced food intake and weight loss can occur die to mouth pain and dryness.
Which of the following cases indicates nutritional risk? A. A nursing home patient sable on a tube feeding regimen. B. Diarrhea for 1 week with a 10 pound weight loss. C. A 3 yo girl with a sore throat and poor appetite for 2 days. D. A 21 yo male who is drinking protein shakes in an attempt to build muscle.
B. Diarrhea for 1 week with a 10 pound weight loss.
Why is prealbumin not used as an end point for protein repletion therapy?
Because prealbumin is affected by both calorie and protein intake.
What are similar about WIC and food stamps (SNAP)?
Both are under the USDA.
The best feeding plan for a normal 3-month old infant is...
Breastfeeding on demand
Which of the following statements by the dietetic technician is most appropriate during a counseling session on infant feeding with new mothers? A. "There is no specific sequence of food additions that must be followed." B. "When cereal is introduced, it can be thinned with cow's milk." C. "Introduce solid foods when the infant is between 4 and 6 months of age." D. "The addition of solid foods wil help calm a colicky baby."
C. "Introduce solid foods when the infant is between 4 and 6 months of age."
Which of the following patients is the highest priority for nutrition care? A. A child who is anemic B. A college football player who is dehydrated C. A pregnant adolescent who has hyperemesis D. An elderly adult who is scheduled for elective surgery.
C. A pregnant adolescent who has hyperemesis
Which of the following observations about a new female resident of an extended-care facility should be entered into the medical record by the dietetic technician? A. Her mother died of cancer at a young age. B. Her physician told her she had sugar in her urine when she was pregnant with her second child. C. Her favorite desserts are ice cream and pudding, but she has gas and diarrhea when she eats them with milk. D. She and her husband always had a big garden , and she prefers fresh vegetables.
C. Her favorite desserts are ice cream and pudding, but she has gas and diarrhea when she eats them with milk.
While screening a a patient, the dietetic technician notices an order for parenteral nutrition in the chart. The technician should...
Complete the screening process and refer the patient to a dietitian.
Ileostomy
Connection of an ostemy pouch to the ilium (small intestine) due to the removal of the colon (Crohn's, cancer, etc.)
Renal Labs
Creatinine (Cr) and Blood Urea Nitrogen (BUN) - If both are elevated ==> compromised renal function - If only BUN is elevated ==> dehydration possible Cr Normal: 0.7 to 1.3 mg/dL for men and 0.6 to 1.1 mg/dL for women BUN Normal: 5-20 mg/dL
While serving as a dietetic technician, you are tasked with visititng in a long-term care facility during mealtime in order to observe dauily food intake. Which of the following observations are you least likely to make during these meal rounds? A. A patient with dementia consumes less than 50% of breakfast and lunch during a 2-day period. B. A patient who is S/P major cardia surgery is not able to effectively use utensils provided to self-feed. C. A patient who is ordered supplemental beverages with meals in order to increase caloric intake does not drink the supplements during the 2-day observation. D. A patient recovering from a stroke appears to tolerate a puree diet and may be able to tolerate an advance to a soft diet.
D. A patient recovering from a stroke appears to tolerate a puree diet and may be able to tolerate an advance to a soft diet.
Which of the following menus would be appropriate for a patient who is on a low-potassium diet? A. Meat loaf, sweet potatoes, creamed peas, and applesauce. B. Pork chop, seasoned rice, acorn squash, and canned peas. C. Roast beef, boiled potato, broccoli, and canned apricots D. Baked chicken, buttered noodles, green beans, and canned peaches.
D. Baked chicken, buttered noodles, green beans, and canned peaches.
Which of the folowing menus would be best or a patient who is to follow a high-calcium diet? A. Cheese omelet, broccoli, and fresh fruit B. Macaroni and cheese, stewed tomatoes, and garden salad C. Tuna casserole, pineapple cream cheese salad, and green beans D. Fish chowder, green salad with feta cheese, and fruit-flavored yogurt
D. Fish chowder, green salad with feta cheese, and fruit- flavored yogurt
Which of the following physical conditions would not be considered a nutritional risk factor? A. Obesity B. Stage IV Decubitus Cancer C. Cancer D. Fractured Femur
D. Fractured Femur
Which of the following choices represent acceptable food selections for a mother who is using a WIC EBT for herself and her breastfeeding infant? A. fresh fruits and vegetables, white bread, whole milk, tofu B. Yogurt, cheese, peanut butter, orange drink C. White potatoes, rice milk, corn flakes, canned tuna D. Oatmeal, chocolate milk, eggs, canned kidney beans
D. Oatmeal, chocolate milk, eggs, canned kidney beans
Total Serum Cholesterol
Desirable: <200 mg/dL Borderline Risk: 200-239 mg/dL High Risk: >239 mg/dL
As a dietetic technician, you are planning menus for a nursing home. What tools are you likely to use during this process?
Dietary Reference Intake (DRI)
What is the relationship between dietary intake and serum cholesterol?
Dietary saturated fats tend to increase cholesterol and monounsaturated fats tend to decerase it.
Xerostomia
Dry mouth
A low-income elderly couple consume a low-protein diet due to problems with their teeth. The couple could improve their protein intake by consuming more of which foods?
Eggs, peanut butter, and skim-milk cheeses
Which of the following are examples of omega-3 polyunsaturated fatty acids?
Eicosapentaenoic Acid (EPA) Docosahexaenoic Acis (DHA)
The nutritional priority for a patient with newly diagnosed Type 1 diabetes mellitus is...
Establishment of a meal plan followed by coordination of the medication regimen so that it matches the meal plan and exercise habits of the patient.
hyperphagia
Excessive hunger
Folic acid requirements are increased during pregnancy because...
Folic acid helps prevent neural tube defects
What type of diet is used to treat celiac disease?
Gluten free
HgbA1c
Glycated Hemoglobin - Reflects glucose control over the last 3 months. Normal = 4-6%
You are working at the local health department initiating health promotion programs. What department of the Department of Health and Human Services may provide guidance for program development?
Healthy People 2012
The most appropriate biochemical test result for screening clients of a public health clinic for anemia would be...
Hematocrit
The purpose of nutrition screening in the hospital is to...
Identify patients at high risk who require intervention.
The best initial nutrition intervention for a person with metabolic syndrome is...
Implementing the TLC diet and increasing physical activity to a minimum of 30 mins daily.
Albumin (ALB)
Indicates depleted visceral protein status & decreased dietary protein intake. Not reliable in presence of inflammation. Evaluate against C Reactive Protein 1/2 life = 14-21 days high ==> dehydration low ==> burns, protein malnutrition, fluid overload Normal: 3.5-5.0 g/dL Deficit Levels: Mild: 3.0-3.5 g/dL Moderate: 2.4-2.9 g/dL Severe: <2.4 g/dL
prealbumin
Indicates depleted visceral protein status & decreased dietary protein intake. Not reliable in presence of inflammation. Evaluate against C Reactive Protein 1/2 life = 2-4 days high ==> dehydration low ==> burns, protein malnutrition, fluid overload Normal: 15.7-29.6 mg/dL Deficit Levels: Mild: 12-15 mg/dL Moderate: 8-10 mg/dL Severe: <8 mg/dL
Oral Glucose Tolerance
Indicates glucose tolerance after ingestion (risk of gestational diabetes) Normal: <140 mg/dL Imapaired: 140-199 mg/dL Diabetes: >200 mg/dL
The dietetic technician observes that a patient has no lower dentures and consumes only the soft and liquid portions of the regualr diet. The technician should first...
Interview the patient about food preferences.
The diet history of a 31-year-old woman reveals tha the woman does not drink milk. The technician should first determine whether the patient...
Is allergic to dairy products.
How to calculate cholesterol
LDL = cholesterol - HDL - VLDL VLDL = TG/5
What is the first intervention for reducing the risk of heart disease?
Lifestyle changes
What lifestyle change is most beneficial to a person with hypertension?
Lose weight (if overweight)
What is the recommended initial nutrition intervention for diverticulitis?
Low fiber
Hamwi Method for Ideal Body Weight
Men: 106# (1st 5 ft) + (6# x additional inch) Women: 100# (1st 5ft) + (5# x additional inch)
Which of the following dietary protocols is most important when monitoring a patient who has pancreatitis?
Minimize the intake of fat
A 78-yo man is recovering from a stroke. The speech language pathologist has recommended a NDD level 3 diet for him. This diet consists of...
Moist semisolid foods that require some chewing ability
Midarm Circumference Measurement is an indicator of...
Muscle and subcutaneous adipose tissue. The accepted measure of nutritional status - esp elderly
Creatinine (Cr)
Normal: 0.7 to 1.3 mg/dL for men and 0.6 to 1.1 mg/dL for women.
Fasting Glucose
Normal: 70-99 mg/dL pre-diabetes: 100-125 mg/dL diabetes: >125 mg/dL
Hemoglobin (HGB)
Number of red blood cells in whole blood. High ==> Dehydration Low ==> Anemia, Hemorrhage Normal Values: Men: 14-17 g/dL Women: 12-15 g/ dL
Hematocrit (HCT)
Percentage of red blood cells in a given volume of blood. High ==> Dehydration Low ==> Anemia, Hemorrhage Normal Values: Men: 39-49% Women: 33-43%
What disease is indicated by extreme hyperphagia with abnormal bizarre eating habits?
Prader-Willi syndrome
What dietary protocols would be appropriate for a patient who has undergone an ileostomy?
Restrict intake of high fiber foods.
A person who does not eat animal products is most likely afiliated with which religious denomination?
Seventh-Day Adventist
% Weight Change Interpretations for: - 1 week - 1 month - 3 months - 6 months
Significant Weight Loss (more is SEVERE weight loss): - 1 week: 1-2% - 1 month: 5% - 3 months: 7.5% - 6 months: 10%
A young woman is pregnant, has a 2yo child, and has a low income. Which nutrition program should the dietetic technician suggest?
Special Supplemental Nutrition Program for Women, Infants, and Children
Muscositis
Swelling and soreness inside the mouth that can lead to pain, difficulty swallowing, and the possibility of infection.
Two men are the same age and weight, but one man is 5'7" and the other is 6' tall. What can be determined about their resting metabolic rate?
The resting metabolic rate is higher for the taller man.
Whan are AI's set
When there is inadquate information to set an EAR.
High potassium foods
White Beans Dark Leafy Greens (spinach, kale) White Potato with Skin Apricots Acorn Squash Yogurt Fish Avocado Mushroom Banana
The risk of coronary atery disease ion postmenopausal women is increased, primarily due to...
a decreased level of estrogen
IBW adjustments for small or large frames
add or subtract 10% from Hamwi formula
Loose stools in patients receiving tube feeding is caused by...
administering the feeding at too rapid a rate.
What has the greatest effect on the basal metabolic rate?
basal energy expenditure
What is the only symptom of vitamin E deficiency seen in humans?
breakage of red blood cell membranes
What does low cholesterol indicate in the elderly? What is considered to be low?
cholesterol <160 mg/dl in the elderly indicates malnutrition
A 75-year-old man living at home is admitted to the emergency department with confusion and weakness. Assessment reveals oliguria and an approximate deficit of 5% of his usual weight. The patient's symptoms are most likely to be the result of...
dehydration
Nursing staff reports that a patient who has poorly fitted dentures is haing difficulty chewing food. The dietetic technician should...
determine the patient's food tolerances
The primary nutrition concern for a patient with prolonged vomiting is...
electrolyte loss
Which condition requires small, frequent feedings?
esophageal reflux
While completing a clinical assessment, a dietetic technician notices that a child has bowed legs. The technician would most importantly review the food frequency questionnaire for...
fortified dairy products (Vit D)
A common nutrition problem of the US population is low intake of...
fruits & vegetables
pernicious anemia is likely after
gastric bypass surgery
The end product of sucrose digestion is...
glucose and fructose
Diet for celiac disease
gluten free
What measurement is the least useful in evaluating recent under- or over-nutrition in children?
height-for-age
Potassium (K)
high ==> RENAL FAILURE, renal (kidney) disorder, ACE inhibitors, and acidosis low ==> diarrhea, vomiting, alkalosis, and alcoholism Normal: 3.6-5 mEq/L ANY INCREASE OR DECREASE CAN RESULT IN HEART FAILURE
Sodium (Na)
high ==> dehydration and renal (kidney) disease low ==> heart failure and edema Normal: 135-145 mEq/L
Calcium (CA1)
high ==> hyperparathyroidism, hyperthyroidism, and cancer low ==> hypoparathyroidism, renal (kidney) disease, hypoalbuminemia, overhydration, and low vitamin D Normal: 8.8-10 mg/dL
Blood Urea Nitrogen (BUN)
high ==> renal (kidney) disease and dehydration low ==> renal (kidney) disease and pregnancy Normal: 5-20 mg/dL
diets for reactive hypoglycemia are...
high in complex carbohydrate and low fat
What foods should be avoided on a renal diabetic diet?
high sodium, potassium, and phosphorus foods
The best community support service for a client who has difficulty with self-feeding is...
home health services
catecholemines released during stress can lead to...
hyperglycemia
The dietetic technician is to monitor the food intake of an underweight patient to determine if a tube feeding is needed. The most practical way to monitor the patient's food intake is to...
institute a calorie count with the assistance of the nursing service.
Medicaid guidelines are based on...
low income level only
MAOI food restrictions
low tyramine diet Restrict: - aged cheeses - cured meats - Fermented cabbage (sauerkraut and kimchee) - Soy sauce, fish sauce and shrimp sauce. - Yeast-extract spreads (Marmite) - Improperly stored foods or spoiled foods. - Broad bean pods (fava beans)
oliguria
low urine output
circumference measurements estimate
muscle mass
densitometry measures...
muscle mass
A patient in the hospital recovering from a heart attack wants assistance with his menu selection. He os looking to increase fiber in his diet as he has klearned that certain types of fiber more efficiently reduce cholesterol levels. Which food is the most beneficial?
oatmeal
The best way to determine demographic characteristics of a rural elderly population is to...
obtain local census information
A body mass index of 28 is considered to be...
overweight
What laboratory value is used to monitor visceral proteins in wasting disease?
prealbumin
A patient who requires 2500kcal daily to maintain weight consumes 2300 kal daily and gains 2# in 2 days. This suggests...
retained fluids
RBP
retinol binding protein used to determine visceral protein mass in health-related nutritional studie half-life: 8-10 hours
A deficiency of Vitamin D results in...
rickets
Vitamin D Deficiency
rickets ==> bowed legs in children
Ketogenic diets are used to treat...
seizures
Protein digestion begins in the...
stomach
The weight-for-length measurement of a 5-month old infant suddenly changes from the 65th to the 95th percentile. The dietetic technician should first investigate...
the accuracy of documentation on the growth grid.
triglycerides are transported to the liver through...
the lymphatic system
Body Mass Index (BMI)
weight in kg/ (height in cm)^2 Underweight: <18.5 Normal: 18.5-24.9 Overweight: 25-29.9 Class I Obese: 30-34.9 Class II Obese: 35-39.9 Morbid Obesity: >40 - NOT the best way to measure the amount of body fat on an individual. - Men typically have less fat than women even if their BMI's are the same. - Competitive athletes may have a higher BMI because they may have higher muscle mass. - Although the BMI is calculated the same way, BMI's for children are interpreted differently that that of adults, using age and gender specific percentiles.
The plot for a prepubescent girl on a weight-for-age growth chart is at 75th percentile. The child is...
within the normal range for weight.
AI
•Adequate Intake (AI): the recommended intake based on experimentally or observed approximations of nutrient intake by groups of healthy individuals, which are assumed adequate. These are used when RDA's can't be determined.
National Dysphagia Diet (NDD) Levels
•NDD Level 1: Dysphagia-Pureed (homogenous, very cohesive, pudding-like, requiring very little chewing ability). •NDD Level 2: Dysphagia-Mechanical Altered (cohesive, moist, semisolid foods, requiring some chewing). •NDD Level 3: Dysphagia-Advanced (soft foods that require more chewing ability). •Regular (all foods allowed).
What is the difference between the EAR and RDA?
•Recommended Dietary Allowance (RDA): the average level of daily dietary intake which is sufficient enough to meet nutrient requirements of 97- 98 percent of healthy persons in particular life stages and gender groups. •Estimated Average Requirement (EAR): used as the basis for RDA and is a value of daily nutrient intake which is estimated to meet requirements for half of healthy people in a gender group or life stage. Both are DRI's
UL
•Tolerable Upper Intake Level (UL): a highest level of nutrient intake daily that will not pose a risk of adverse effects for most people in the population. As you increase intake above the UL your risk for adverse reactions increase. This is the major difference between the DRI's and the old RDA's as they never offered the highest level that could be consumed.
