Preliminary Nutrition, Assessment, and Calorimetry (Laboratory/Nutrition)

Flashcards covering key concepts from preliminary nutrition, nutrition screening/assessment, indirect calorimetry, anthropometry, growth indices, clinical signs, dietary assessment, and energy/protein calculations.

What is the purpose of nutritional screening?

A first-line process to identify patients who are malnourished or at risk, usually performed by nurses and doctors.

What is a nutritional assessment?

A detailed investigation to identify and quantify specific nutritional problems.

What is indirect calorimetry?

A method that analyzes metabolic processes by measuring respiratory gases (O2 and CO2) to estimate energy requirements.

What equipment is used for indirect calorimetry?

A metabolic cart (e.g., Omnical) with a mask to measure VO2 and VCO2.

What are resting test conditions for indirect calorimetry?

Minimum five hours fasting, no physical activity, and abstinence from nicotine, caffeine, and stimulants.

What do VO2 and VCO2 measure?

Volume of oxygen consumed (VO2) and volume of carbon dioxide produced (VCO2).

What does the Respiratory Exchange Ratio (RER) indicate?

RER = VCO2/VO2; reflects substrate oxidation and energy metabolism.

What are common outputs derived from indirect calorimetry?

Nutritional parameters (carbohydrate and fat utilization), metabolic rate (REE/TEE), and aerobic fitness indicators (e.g., ventilatory thresholds, VO2 max). The common parameters are RER and energy expenditure.

What is substrate oxidation?

Catabolism of carbohydrates, fats, and proteins in the presence of O2 to produce CO2, water, and heat.

What are Atwater factors for energy per gram of macronutrients?

Carbohydrate: 4 kcal/g; Fat: 9 kcal/g; Protein: 4 kcal/g.

What is Table 13-1 about?

Criteria for identifying malnutrition risk across categories such as admission data, anthropometric data, functional data, historical information, laboratory results, and signs/symptoms.

Who are members of the Nutrition Support Team?

Physician, Dietitian, Nurse, and Pharmacist.

What does SOAP stand for in nutrition assessment?

Subjective data, Objective data, Assessment, Plan.

What is the Subjective Global Assessment (SGA)?

A nutritional screening tool used to identify malnutrition risk.

What is anthropometric data?

Physical measurements such as weight, height, BMI, MAC, TSF, MAMC, and head circumference.

What is MUAC and what does a low MUAC indicate?

Mid-upper arm circumference; a low MUAC indicates loss of fat-free mass/muscle.

What is the MAMC formula?

Mid-arm muscle circumference = MAC cm – (TSF mm × 0.314).

What is head circumference used for?

Assess brain growth in children up to 3 years old and monitor brain development in premature/small-for-gestational-age infants.

How is height typically measured in adults?

Using a stadiometer with the person standing upright; measurements are to the nearest millimeter. Head in Frankfurt plane.

What are common adult BMI categories?

Normal: 18.5–24.9; Overweight: 25–29.9; Obese: ≥30 (with broader ranges used in some tables, e.g., <16 severe deficiency).

What growth indices are used for children’s growth monitoring?

Weight-for-age (underweight screening for <2 years) and Height-for-age (stunting/chronically undernourished). BMI-for-age is also used for older children.

How is BMI calculated?

BMI = weight (kg) / (height (m))^2.

What is the salt iodine threshold for adequacy?

Iodized salt should have iodine level > 15 parts per million (ppm).

How is bilateral pitting edema assessed in a child?

Apply firm thumb pressure on both feet for three seconds; a shallow imprint indicates edema.

What clinical signs indicate nutrient deficiencies (examples)?

Bitot’s spots (vitamin A deficiency) and goitre (iodine deficiency).

What dietary assessment methods are used?

Food Frequency Questionnaire (FFQ), food records, direct observation, and dietary diversity scoring.

What is N balance and how is it calculated?

N balance = Nin – Nout; Nin = protein intake (g)/6.25; Nout = urinary nitrogen (UNN) + 3. Positive balance of ~4–6 g/day is desirable.

What are Harris-Benedict equations for BEE?

Male: BEE = 66.5 + (13.7 × wt) + (5 × ht) − (6.8 × age); Female: BEE = 65.5 + (9.6 × wt) + (1.7 × ht) − (4.7 × age); wt in kg, ht in cm, age in years.

What are the short-cut caloric requirements for maintenance and stress?

Maintenance: 30 kcal/kg; Moderate stress: 35 kcal/kg; Severe stress: 40 kcal/kg; Critical illness: 25 kcal/kg.

How are ideal body weight (IBW) formulas stated for men and women?

Female: IBW = 100 lb + 5 lb per inch over 5 ft; Male: IBW = 106 lb + 6 lb per inch over 5 ft.

What is the purpose of calculating percent IBW and percent UBW?

Percent IBW = (current weight / IBW) × 100; Percent UBW = (current weight / usual weight) × 100 to assess malnutrition risk.