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  • image Malnutrition is a consequence of nutrient imbalance, overnutrition or undernutrition, and has a high prevalence in the United States.
  • image Nutrition screening is distinct from assessment and should be designed to quickly and reliably identify those who are at risk of nutrition-related poor outcomes.
  • image A comprehensive nutrition assessment is the first step in formulating a nutrition care plan for a patient who is found to be nutritionally at risk.
  • image A nutrition-focused medical, surgical, and dietary history and a nutrition-focused physical examination are key components of a comprehensive nutrition assessment.
  • image Appropriate evaluation of anthropometric measurements (e.g., weight, height) is essential in nutrition assessment and should be based on published standards.
  • image Laboratory assessment of visceral proteins is essential for a comprehensive nutrition assessment and must be interpreted in the context of physical findings, medical and surgical history, and the patient’s clinical status.
  • image The presence of micronutrient or macronutrient deficiencies or risk factors for these deficiencies can be identified by a comprehensive nutrition assessment.
  • image Patient-specific goals should be established using evidence-based criteria considering the patient’s clinical condition and the need for maintenance or repletion in adults or continued growth and development in children.
  • image Indirect calorimetry is the most accurate method to determine energy requirements, but because of cost and availability, validated predictive equations are most often used to determine energy requirements.
  • image Drug–nutrient interactions can affect nutrition status and the response to and adverse effects seen with drug therapy and must be considered when developing or assessing a patient’s nutrition care plan.

On completion of the chapter, the reader will be able to:

  1. Compare and contrast marasmus and kwashiorkor.

  2. Discuss the characteristics of an effective nutrition screening program.

  3. Evaluate a patient’s nutritional status using the Subjective Global Assessment (SGA).

  4. Evaluate a patient’s actual body weight using patient specific data, such as ideal body weight and usual body weight.

  5. Determine if a child’s growth is appropriate.

  6. Calculate body mass index given patient specific data and use it and waist circumference to assess nutrition status and nutrition-related risk.

  7. Explain the basis for and the role of bioelectrical impedance in nutrition assessment.

  8. Differentiate the role of visceral proteins (albumin, transferrin, prealbumin, and C-reactive protein) in nutrition assessment based on their half-lives, body stores, and the factors that affect their serum concentrations.

  9. Discuss the risk factors for and signs and symptoms of either the deficiency or toxicity state of each of the essential trace minerals: zinc, copper, chromium, manganese, selenium, molybdenum, iodine, and iron.

  10. Identify risk factors and signs and symptoms of vitamin deficiencies given patient specific information.

  11. Explain the importance of essential fatty acids and carnitine in human nutrition.

  12. Estimate energy requirements given patient-specific information.

  13. Recommend changes to an individual’s nutrition care plan based on results from indirect calorimetry.

  14. Evaluate the adequacy of an individual’s protein intake relative to usual requirements.

  15. Determine the appropriate amount of fat and fiber in an individual’s diet.

  16. Calculate patient-specific goals for maintenance fluids.

  17. Recommend appropriate alterations to an individual’s nutrition care plan ...

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