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Competencies Describe the recommended dietary
allowances for adequate nutritional intake for all age groups.
Identify nutritional differences for different age groups.
Perform a nutritional history and physical assessment.
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Competencies Perform anthropometric
measurements. Describe the most common
pathophysiologies for abnormal findings.
Describe laboratory analyses needed and their clinical significance to the nutritional assessment.
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Dietary Guidelines Recommended dietary allowances
(RDA) Food guide pyramid
Six food groups Fats, oils, and sweets: use sparingly Milk, yogurt and cheese: 2–3 servings/day Meat, poultry, fish, eggs: 2–3 servings/day
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Dietary Guidelines
Vegetables: 3–5 servings per day Fruits: 2–4 servings per day Breads, cereal, rice, pasta: 6–11
servings per day
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Nutrition Through the Life Cycle Children
Daily needs change based on age group
Infants Rapid growth and development Preferred to breast feed for first 12
months
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Nutrition Through the Life Cycle
Assess reflexes—sucking, rooting, swallowing
Assess physical development
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Infant Feeding Guidelines Introduce foods one at a time Begin with foods that are least
allergenic Avoid egg whites and citrus
fruits until 12 months old Avoid honey in infants under 12
months
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Nutritional Assessment of Infants Breastfed? How often? How long? Bottle-fed? How often? How much? Formula preparation? Storage? How does the infant respond to
eating? Constipation? Diarrhea? Is the infant ever put in bed with a
bottle?
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Nutritional Guidelines for Toddlers Physical growth slows Increased independence Small portions Offer one new food at a time Serving size 1–2 tbsp for each year
of age Routine mealtimes
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Nutritional Guidelines for Preschoolers Independence May become a picky eater Offer food choices Serve small servings Finger foods Routine mealtimes Involve in food preparation
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Nutritional Guidelines for School-Age Children Erratic growth and eating patterns Strong food preferences Balanced diet Limit highly sweetened snacks and
foods
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Nutritional Assessment of Young Children Concerns with child’s eating? Child’s food preferences? Involvement in sports? Physical
activity? Child’s meal schedule? Balanced diet? Food allergies?
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Nutritional Guidelines for Adolescents Period of rapid growth and change Fluxuating nutritional needs Concerns with body image Risks for eating disorders Adjustments to caloric needs based
on physical activity level
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Nutritional Assessment of Adolescents Participation in physical activity? Adhere to a specific diet or meal plan? Skip meals? Satisfaction with current weight? Consumption of snacks? Have you ever induced vomiting, used
laxatives, diuretics, or diet pills to control weight?
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Nutritional Guidelines for Young and Middle-Aged Adults Growth and caloric needs stabilize Eating habits may be influenced by
activity levels, life stressors Nutritional risks for development of
disease Obesity Osteoporosis (continues)
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Nutritional Guidelines for Young and Middle-Aged Adults
Type 2 Diabetes Mellitus Atheroschlerosis
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Nutritional Assessment of Young and Middle-Aged Adults Caloric intake? Adherence to specific diet? Satisfaction with current weight? Physical activity? Consumption of snacks? Typical meal patterns?
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(continues)
Nutritional Guidelines for Pregnant and Lactating Women Role of proper nutrition in
development of healthy infant Target weight gain for pregnancy Iron supplements Prenatal vitamins
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Nutritional Guidelines for Pregnant and Lactating Women Folic acid Additional caloric intake for
pregnancy and lactation Adhere to food guide pyramid Fluid consumption
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Nutritional Assessment of Pregnant Women Prepregnancy weight? Ideal body weight (IBW)? Use of supplemental vitamins? Consumption of caffeine, artificial
sweeteners, alcohol? Presence of constipation, nausea,
vomiting, or heartburn? Presence of food cravings?
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Nutritional Guidelines for the Older Adult Decreased caloric requirements Adhere to food guide pyramid,
except consume decreased portion size
Encourage to eat in a sitting position Encourage adequate fluid intake and
high fiber diet
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Nutritional Guidelines for the Older Adult Nutritional risk factors
Difficulty chewing or swallowing Decreased appetite Decreased ability to feed self Decreased taste and smell Decreased esophageal emptying time
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Nutritional Assessment of Older Adults Presence of physical limitations that
affect eating? Difficulty chewing or swallowing? Presence of dental problems? Difficulty obtaining or preparing
foods? Do you eat alone?
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Cultural Differences in Nutrition Cultural beliefs related to the
consumption of food Religious beliefs related to the
consumption of food Food restrictions Periods of fasting
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Components of a Nutritional Assessment Nutritional history Physical assessment Anthropometric measurements Laboratory data Diagnostic data
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Nutritional History General diet information
Changes in past 12 months Ability to obtain and prepare foods Food preferences Adherence to particular diet Consumption of fast foods
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Nutritional History Food intake history
24-hour recall Food diary
Calorie count Evaluation of adequacy of diet
Food guide pyramid
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Physical Assessment Head to toe Assess for subjective and
objective signs and symptoms of poor nutritional status
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Signs and Symptoms of Poor Nutritional Status Subjective data
Fatigue Weight changes Changes in appetite Weakness Changes in bowel habits
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Signs and Symptoms of Poor Nutritional Status Objective data
Weight changes Dry, rough, scaly skin Dry, cracked lips Swollen, bleeding gums Edema Decreased muscle tone
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Anthropometric Measures Height Weight Ideal body weight, percent IBW Percent weight change Triceps skinfold BMI Mid-arm circumference Waist/hip ratio
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Laboratory Data Hematocrit and hemoglobin Cholesterol and triglyceride levels Transferrin, TIBC, iron Total lymphocyte count Albumin and prealbumin Glucose Creatinine and nitrogen