Nutrition Assessment DecisionHealth营养评价decisionhealth.pptVIP

* Forearm Forearm: often better site than upper arm for assessing fat Upper arm fat disposition changes as women age * Wasting in the hands * The calf muscle Grip the calf Normal: muscle obvious, top of calf is larger than bottom Abnormal: muscle reduction, “stick legs, ankles the same as upper leg * The Legs showing muscle wasting * Quadriceps and Knees * The Ankles Good indicator of edema, but only in patients who walk Check for sacral edema as well. Overnourished patients can be harder to assess * The back side In hospitalized patients, the back may not be easily accessible. Vitamin C Deficiency Petechia Cork Screw Hair Nutrition Assessment is Complex Putting the pieces together is challenging Step-wise approach to assessment Call 744-4612 anytime for consults (seen within 24 hours) Call RD directly if urgent ICU – assigned by team Acute Care – assigned by floor Clinical Dietitians at HMC Where to find nutrition information in ORCA Admit Nursing History Weight trending Dietitian and Dietetic Technician Notes Enteral and TPN Flow Sheets Discharge nutrition counseling * Nutrition Assessment in the Inpatient SettingPatient’s with Pressure UlcersFor HMC Wound Care Nurses Katie Farver RD, CNSD Harborview Medical Center Seattle, Washington kef@u.washington.edu 8-11-09 Components of Nutrition Assessment Diet History Medical History Weight History Body Comp Biochemical Data Physical Assessment *Eating Habits *Potential Deficiencies *Reasons for sub-optimal intake *Food Resources *Conditions effecting digestion or ability to eat *Drug-nutrient interactions *Actual, Usual and BMI *Skinfold *Bio- Electrical Impedance *Serum Proteins (albumin prealbumin, CRP) *Vitamin and mineral assays *Loss of subcu fat *Muscle wasting *Concave appearance *Hair *Nails Diet History Quality and quantity of food Intake prior to admit/during admit Quality and quantity of nutrition Support intake prior to admit/during admit Medical History Sample conditions effecting intake