NUTRITIONAL ASSESSMENT

SCREENING To determine nutritional health Look for warning signs Maintain optimal health of healthy persons Identify risks to medical treatment and recovery

SCHEMA

INITIAL SCREEN

ASSESSMENT Identify stages in the development of deficiency disease A = ANTHROPOMETRIC MEASUREMENTS B = BIOCHEMICAL ANALYSIS C = CLINICAL INFORMATION D = DIETARY INFORMATION E = EVALUATION/ENVIRONMENT

Deficiency stages

stages

ANTHROPOMETRIC MEASURE Height Weight Percent of ideal body weight Percent of usual body weight Recent weight change – unplanned 5% in 1 month 10% in 6 months

ANTHROPOMETRIC MEASURES Fatfolds – TSF (total subcutaneous fat) and total body fat MAC – midarm circumference-muscle mass and subcutaneous fat MAMC – midarm muscle mass/circumerence, skeletal muscle BIA – lean body mass

BIOCHEMICAL ANALYSIS ITEM ELEVATED DECREASED Albumin Dehydration Edema, Ca, ESRD BUN Renal failure Hepatic failure Malnutrition Na Dehydration, coma Edema, burns, diarrhea, vomiting Creatinine Renal disease Ferritin Inflammatory dis Fe def anemia FBS DM, drugs, MI, K deficiency, Insulin overdose, ETOH

CLINICAL ASSESSMENT Look at the patient Observe physical signs and symptoms of deficiencies and toxicities Hair – PCM Eyes – hyperlipidemia, vitamin deficiency Tongue – B vitamin deficiency Nails – protein and iron deficiency

DIETARY INFORMATION Nutrition history - Special diet order – compliance Relate diet to disease state Appropriateness Meeting nutritional needs Food/drug interactions: antibiotics, anticonvulsants, etc.

EVALUATION/ENVIRONMENT Summary of findings Recommendations Potential problems Socioeconomic concerns Psychosocial concerns Adequate housing Disease state affects ability to prepare food Adequate food, storage, equipment to prepare food