Lecture 22

Question 1

How do we asses the nutrition status of an individual?

Answer 1

Usually through individual consultations where we ask a series of questions

Question 2

what do the consultations require

Answer 2

-effective communication
-Accurate information gathering
-Problem solving
-Using knowledge and evidence

Question 3

You need a framework for the consultations to guide….

Answer 3

us through this process so that we not only assess the individuals nutrition status but also provide a solution to their needs

Question 4

the nutrition care process provides ….

Answer 4

a systematic, problem solving framework for nutrition related problems

Question 5

the nutrition care process facilitates

Answer 5

critical thinking and decision making

Question 6

The nutrition care process enables

Answer 6

safe, effective, high quality nutrition care

Question 7

the nutrition care process provides a standardised

Answer 7

a standardised process but does not mean all clients get the same nutrition support

Question 8

What does the central core of the nutrition care process diagram represent

Answer 8

Individual/Population interacts with Nutrition Professional

Question 9

Outer rings of the nutrtion care process

Answer 9

-Individuals environment
-Strengths and weaknesses of the practitioner
-Inputs/outputs

Question 10

Four steps of the nutrition care process

Answer 10

-Assessment
-Nutrition Diagnosis
-Intervention
-Monitoring & Evaluation

Question 11

What is meant by the patient centered care approach

Answer 11

• exploring clients history, needs, values and environment
• while promoting active client participation (collaborative approach with the client)
• via shared decision making and lifestyle education

Question 12

communication with the client should be …

Answer 12

• articulate
• accessible / understandable
• emotionally balanced
• professional

Question 13

Inputs to the process

Answer 13

Screening and Referral system

Question 14

INPUTS: What are the factors of the screening and referral system of nutrition care process

Answer 14

-identify risk factors for nutrition related problems
- use appropriate tools and methods to identify these risk factors
- may involve interdisciplinary collaboration between health professionals
-May be carried out by non-nutrition health professionals

Question 15

what does the outer ring represent in the nutrition care process

Answer 15

social and environmental factors impacting the clients ability to receive and benefit from nutrition care

• practice settings
• health care systems
• economics (may not be able to afford)
• social systems

Question 16

What are the middle rings of the nutrition care process

Answer 16

• Describes the qualities and attributions that differentiate nutrition professionals from other practitioners

Question 17

what are the professional strengths and possibly weaknesses of the nutrition professional

Answer 17

• nutrition and dietetics knowledge
• communication
• evidence based practice
• critical thinking
• documentation
• collaboration
• code of ethics

Question 18

Outputs of the nutrition care process

Answer 18

-Undertaken by non-nutrition professionals e.g researchers
-Provides quality improvement of the NCP model in healthcare setting and organisations

Question 19

what is step 1 of the nutrition care process

Answer 19

nutrition assessment (and re assessment )

Question 20

what happens during nutrition assessment (and re assessment)

Answer 20

systematically obtains, verifies and interprets relevant information against recognised standards to identify nutrition related problems

Question 21

what are the 5 domains of data to collect during nutritional assessment (ABCDE)

Answer 21

• anthropometric assessment
• biochemical data, medical tests, procedures
• clinical - nutrition focused physical findings
• diet - food/nutrition related history
• extra information - client history

Question 22

Nutritional assessment (length of time)

Answer 22

The longest part of the consultation

Question 23

what can be used to ensure that there is nothing forgotten in the consultation

Answer 23

Consultation form

Question 24

data collected during nutritional assessment should be compared to

Answer 24

evidence based standards such as eating and activity guidelines, NRV’s and food composition tables, BMI or growth standards

Question 25

what is step 2 in the nutrition care process

Answer 25

nutrition diagnosis

Question 26

what is nutrition diagnosis

Answer 26

identifies the specific nutritional problem -need to think about what?

Question 27

nutrition diagnosis is not

Answer 27

a medical diagnosis

Question 28

In a nutritional diagnosis do we say hypertension or excessive sodium intake

Answer 28

excessive sodium intake

Question 29

what are the range of possible reasons for a nutrition diagnosis

Answer 29

- intake : energy, macronutrient, fluid, fibre etc - clinical : test results, anthropometry, observations - behavioural / environmental : lifestyle, social, knowledge, access to food - other

Question 30

Decide on the best nutritional diagnosis based on the

Answer 30

Aetiology (root cause or origin of the problem)

Question 31

how do we communicate the nutritional diagnosis in a standardised, clear and effective manner

Answer 31

PASS statements

Question 32

what does PASS statement stand for

Answer 32

problem (what ?) aetiology (why ?) signs and symptoms (how do I know ?)

Question 33

what is meant by the problem in a PASS statement

Answer 33

state the problem can the practitioner impact, improve or resolve the nutrition : if they can’t they shouldn’t provide advice on what to do

Question 34

in the PASS statement what is meant by aetiology

Answer 34

state the nutrition related factors that are contributing to or causing the problem

Question 35

what is meant by signs and symptoms in PASS statement

Answer 35

- quantifiable data, basis for monitoring and evaluation outcomes - will they indicate if the problem is resolved or improved - signs are objective data, whilst symptoms are subjective

Question 36

what is step 3 in the nutrition care process

Answer 36

nutrition intervention

Question 37

what is the basic characteristics of the nutrition intervention

Answer 37

- selection of nutritional strategies to resolve or improve the nutrition diagnosis - formulate SMART goals and determine a plan of action with the client

Question 38

what are the four categories of the nutrition intervention strategies

Answer 38

- nutrition intervention - nutrition education - nutrition counselling - coordination of nutrition care

Question 39

hat are examples of nutrition intervention strategy

Answer 39

- meals and snacks - oral or vitamin / mineral supplement - environmental - nutrition related medication management - physical activity

Question 40

what is examples of nutrition education as a nutrition intervention strategy

Answer 40

- what was provided ? - what resources were given ?

Question 41

what are examples of nutrition counselling as a nutrition intervention strategy

Answer 41

- theoretical basis, such as Cognitive Behavioural Therapy, RAVES etc - strategies, such as counselling and goal setting

Question 42

what is examples of coordination of nutrition care as a nutrition intervention strategy

Answer 42

coordination of care with other health professionals or referral

Question 43

what are SMART goals

Answer 43

a framework for designing goals so that they are attainable within a certain time frame and meaningful to the client

Question 44

what does SMART goals stand for

Answer 44

S = specific M = measurable A = achievable R = relavant T = timely

Question 45

what is step 4 in the nutrition care process

Answer 45

nutrition monitoring and evaluation

Question 46

the nutrition monitoring and evaluation determines

Answer 46

progress being made by the client and whether goals and outcomes are being achieved

Question 47

the nutrition monitoring and evaluation requires active ..

Answer 47

commitment to measuring and recording appropriate outcomes and indicators relevant to signs and symptoms

Question 48

during the nutrition care process, progress should be …

Answer 48

monitored, measured and evaluated on a planned schedule

Question 49

what are the aspects of monitoring progress

Answer 49

- is the intervention working ? - does the client understand what they are supposed to do? - identify any changes in the clients condition -> - may require gathering additional information - May require diagnosis and intervention changes

Question 50

when measuring outcomes, what needs to be measured

Answer 50

- direct nutrition outcomes (knowledge gained, behaviour changes, food and nutrient intake changes, improved nutritional status) - clinical / health outcomes (lab values, anthropometry, body composition, blood pressure etc) - client centred outcomes (satisfaction, self management) - health care cost outcomes (medication changes, health care visits, special procedures)

Question 51

what is meant by evaluating outcomes

Answer 51

- have any or what changes have occurred as a result of the intervention you put in place? - were these effective ? - explore why changes may not have been effective - document the outcome for the client

Question 52

what is a useful way to remember the steps of nutrition care process and what does it stand for

Answer 52

(ANDIME) Step 1:Assessment Step 2:Nutritional diagnosis Step 3:Interventions Step 4:Monitor &Evaluate