Food-Related Issues, Nutrition Assessment, and Weight Management Vocabulary

Vocabulary flashcards covering topics on food service delivery systems, hospital diets, non-oral nutrition support, nutritional assessment methods, obesity pharmacotherapy/surgery, and eating disorders.

Clear Liquid Diet

A diet consisting of transparent foods that are liquid at room or body temperature, used to maintain hydration during illness for no more than $8$ to $24\,\text{hours}$ due to nutritional inadequacy.

Full Liquid Diet

A modified-consistency diet consisting of foods that are liquid at room temperature, prescribed for patients having difficulty chewing or swallowing solid foods while accounting for potential lactose intolerance and saturated fat concerns.

Dysphagia

Swallowing difficulty characterized by clinical signs such as drooling, pocketing of food, choking, gagging, and taking longer than $2$ to $10\,\text{seconds}$ to swallow food.

Food Allergy

An immune-mediated reaction caused by the release of histamine and serotonin, most commonly triggered in adults by $8$ major foods: eggs, milk, wheat, soy, fish, shellfish, peanuts, and tree nuts.

Food Intolerance

A non-allergic, dose-responsive reaction to foods that occurs after consuming a large amount, with lactose and gluten intolerance being the most common forms.

Enteral Feeding Routes

Anatomical pathways used to deliver enteral nutrition, categorized into nonsurgical routes (Nasogastric, Nasoduodenal, Nasojejunal) and surgically placed routes (Esophagostomy, Gastrostomy, Jejunostomy/PEG).

Continuous Enteral Feeding

A method of tube feeding administration delivered at a constant rate over a $24\text{-hour}$ period, primarily recommended for critically ill patients.

Bolus Feeding

A variation of intermittent enteral feeding where a large volume ($250$ to $500\,\text{mL}$) is delivered rapidly, which carries a risk of inducing dumping syndrome.

Gastric Residual Volume Check

An assessment performed prior to bolus feeds or during continuous enteral feeds to evaluate stomach emptying, where $200\,\text{mL}$ on two successive occasions or greater than half the previously infused volume is considered excessive.

Peripheral Parenteral Nutrition (PPN)

Short-term intravenous nutrition delivered through a peripheral vein requiring an isotonic formulation containing $5\%$ to $10\%$ dextrose and $3\%$ to $5\%$ amino acids.

Central Parenteral Nutrition (CPN)

Intravenous nutrition therapy delivering hypertonic solutions with dextrose concentrations exceeding $10\%$ into a central vein via devices such as a subclavian line, PICC, Hickman catheter, or Port-A-Cath.

Intrauterine Growth Restriction (IUGR)

Fetal growth impairment caused by placental insufficiency or maternal malnutrition, which increases long-term risk for adult hypertension, cardiovascular disease, and type 2 diabetes.

Dietetic Technician, Registered (DTR)

A healthcare professional who assists with diet histories, nutrition screening, and basic nutrition education, but is not authorized to counsel patients on complex disease modifications.

Nutrition Screening

A process required by the Joint Commission within $48\,\text{hours}$ of hospital admission (and within $14\,\text{days}$ in long-term care facilities) to detect malnutrition or nutritional risk.

Anthropometric Assessment

Noninvasive body measurement techniques used to quantify physical dimensions including height, length, weight, head circumference, and skinfold thickness.

Body Mass Index (BMI)

A standard anthropometric ratio of weight relative to height, categorized into healthy ($18.5$ to $24.9\,\text{kg/m}^2$), underweight ($< 18.5\,\text{kg/m}^2$), overweight ($\ge 25\,\text{kg/m}^2$), and obesity ($\ge 30\,\text{kg/m}^2$).

Primary Nutritional Risk

Nutritional risk caused directly by inadequate intake of nutrients, resulting in undernutrition and chronic micronutrient deficiencies.

Secondary Nutritional Risk

Nutritional risk stemming indirectly from underlying disease processes or iatrogenic side effects rather than direct dietary deficits.

Iatrogenic Malnutrition

Malnutrition inadvertently brought on by medical treatments, diagnostic testing, or prolonged restrictive diet orders such as NPO or clear liquid diets.

Metabolic Syndrome

A cluster of metabolic abnormalities involving central obesity (waist circumference $> 35\,\text{in}$ in women or $> 40\,\text{in}$ in men), insulin resistance, hypertension, and dyslipidemia.

Orlistat

A gastrointestinal lipase inhibitor (available over-the-counter as Alli) that decreases fat absorption, frequently causing adverse effects like bloating, fatty stools, and abdominal pain.

Phentermine and Topamax

A combination anti-obesity therapy pairing topiramate (a seizure medication) with phentermine (an appetite suppressant), indicated for patients with a $\text{BMI} \ge 30$ or a $\text{BMI} \ge 27$ with comorbidities.

Laparoscopic Adjustable Gastric Banding (LAGB)

A restrictive bariatric surgery involving an inflatable band placed around the upper stomach to form a $15$ to $30\,\text{mL}$ gastric pouch, associated with micronutrient deficiencies in calcium, iron, thiamin, and vitamin D.

Roux-en-Y Gastric Bypass (RYGB)

A bariatric procedure combining gastric restriction with a bypass of the duodenum and upper jejunum, creating nutrient malabsorption and risk of dumping syndrome or anastomotic leak.

Sleeve Gastrectomy

A surgical bariatric procedure removing approximately $80\%$ of the stomach to restrict intake and alter gut hormone levels, carrying risks of long-term calcium, iron, vitamin B12, thiamin, and vitamin D deficiencies.

Refeeding Syndrome

A potentially fatal metabolic complication occurring upon reintroducing nutrition to severely malnourished patients, marked by acute intracellular fluid and electrolyte shifts (especially phosphorus) and thiamin deficiency.

Anorexia Nervosa (AN)

A psychiatric eating disorder characterized by self-imposed starvation, intense fear of gaining weight, a $\text{BMI} < 17.5$ (or weight $\le 85\%$ of former weight), lanugo, hypothermia, bradycardia, hypotension, amenorrhea, and osteopenia.

Bulimia Nervosa (BN)

An eating disorder characterized by recurrent episodes of uncontrolled binge eating within a $2\text{-hour}$ period followed by inappropriate compensatory behaviors (self-induced vomiting, laxative abuse, excessive exercise) occurring at least once weekly for $3\,\text{months}$.

Binge-Eating Disorder (BED)

An eating disorder involving recurrent episodes of rapid, excessive food consumption without regular compensatory purging behaviors, occurring at least once a week for $3\,\text{months}$ and accompanied by marked emotional distress.

ABCD Nutrition Assessment

A = Anthropometric
B = Biochemical
C = Clinical
D = Dietary

Nurse’s Role in Nutrition

Screen for decreased appetite, unintentional weight loss, hydration status, age/medical history, and illness severity; identify patients who need nutrition services.

RDN Role

Performs detailed nutrition assessments, nutrition diagnoses, specific nutrition therapies, and monitoring/evaluation.

Nutrition Care Process

Assessment → Diagnosis → Intervention → Monitoring → Evaluation.

Food-Drug Interactions

Food and nutrients can alter drug absorption, effectiveness, metabolism, excretion, or side effects. Timing of food and medications may matter.

Dysphagia Diet Levels

Level 1 = Pureed
Level 2 = Mechanically altered
Level 3 = Advanced
Level 4 = Regular

Enteral Nutrition

Nutrition delivered through the GI tract when the GI tract is functioning but the patient cannot or will not consume enough orally.

Initial Enteral Tube Placement

Verify initial tube placement using radiography.

Enteral Aspiration Precautions

Keep HOB 30–45° and verify tube placement

Most Serious Enteral Complication

Aspiration

Excessive Gastric Residual

200 mL on two successive occasions OR >½ of the previous infused amount.

Clogged Feeding Tube

Check for kinks and flush with 30–50 mL warm water according to policy.

Enteral Medication Administration

Stop feeding, flush 20 mL before and after medication, use liquid medications when possible, and do not crush extended-release or enteric-coated medications.

PPN Composition

Approximately 5–10% dextrose and 3–5% amino acids.

CPN Dextrose

Solutions with >10% dextrose are hypertonic and require a central line.

PN Complications

Technical = pneumothorax
Septic = catheter-related sepsis
Metabolic = hyperglycemia

Overweight vs Obesity

Overweight = BMI 25–29.9
Obesity = BMI ≥30

Metabolic Syndrome

Central obesity + insulin resistance + hypertension + dyslipidemia.

Waist Circumference Risk

35 inches in women or >40 inches in men.

Factors Contributing to Obesity

Genetic, physiological/endocrine/metabolic, behavioral, sociocultural, environmental, medication-related, and mental health factors.

Healthy Weight Loss Goal

A 3–5% weight loss can improve BP, cholesterol, lipids, and glucose. A 5–10% loss over 6 months is recommended.

Physical Activity for Weight Management

Progress toward 150+ minutes/week, typically 3–5 days/week.

Behavior Modification

Self-monitoring, goal setting, problem solving, stimulus control, stress reduction, cognitive restructuring, and relapse prevention

Bariatric Surgery Indications

Generally considered for BMI 35–39.9 with major comorbidities or BMI >40, particularly when nonsurgical treatment has failed and the patient is motivated and informed.

Anorexia Nervosa Manifestations

Restriction/fasting + intense fear of gaining weight + distorted body perception + significantly low weight. Findings can include lanugo, cold intolerance, bradycardia, hypotension, constipation, amenorrhea, and low bone density.

Anorexia Nutrition Therapy

Goals are to restore weight, normalize eating and hunger/fullness cues, correct nutritional deficiencies/sequelae, and establish a trusting therapeutic relationship.

Refeeding Syndrome Nursing Care

Monitor vital signs, electrolytes (especially phosphorus), and cardiac function while nutrition is gradually increased.

AN vs BN vs BED

AN = restriction + significantly low weight
BN = binge + compensatory behaviors
BED = binge + no regular compensatory behaviors

Patient-Centered Nutrition Education

Consider the patient’s goals, culture/religion, allergies/intolerances, medical conditions, eating habits, and physical limitations when developing nutrition interventions.