1. NUTRITIONAL ASSESSMENT

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

3. SCHEMA

4. INITIAL SCREEN

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

6. Deficiency stages

7. stages

8. 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

9. 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

10. 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

11. 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

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

13. 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