Nutritional screening & tools ***

Question 1

When should a nutritional screening be made to identify patients at risk of malnutrition?

Answer 1

Within the 24-48 h after the first contact, and thereafter at regular intervals.

Question 2

What is the basic finding necessary to diagnose malnutrition according to the WHO?

Answer 2

BMI < 18.5 kg/m2

Question 3

What are the basic findings necessary to diagnose malnutrition according to the ESPEN?

Answer 3

• BMI <20 kg / m2 if <70 years of age.
• BMI <22 kg/m2 if ≥ 70 years of age.
• FMMI <15 and 17 kg/m2 in women and men respectively.

Question 4

Which type of nutritional evaluation complies with the following characteristics?
- The information is easy to obtain.
- It requires no specific training: In the USA and Canada it is done by nurses.
- It requires a few minutes to be completed.
- It has a low cost.

Answer 4

Nutritional screening.

Question 5

Which type of nutritional evaluation complies with the following characteristics?
- It provides more detailed information.
- It requires specific training.
- It requires more time to collect the info.
- It has a higher cost due to the application of biochemical parameters, anthropometric measures, body composition, clinical findings, clinical history, dietetics, etc.

Answer 5

Nutritional assessment.

Question 6

What are the basic aspects addressed by a nutritional screening tool?

Answer 6

• Recent weight loss or current BMI.
• Disease severity.
• Recent food intake.
• GI symptoms / Functionality.

Question 7

Which nutritional screening tool is endorsed by ESPEN in the community?

Answer 7

Malnutrition Universal Screening Tool (MUST).

Question 8

Which nutritional screening tool is endorsed by ESPEN in the hospital?

Answer 8

Nutritional Risk Screening (NRS-2002).

Question 9

Which nutritional screening tool is endorsed by ESPEN in the elderly (>65 y)?

Answer 9

Mini Nutritional Assessment (MNA):
- Full MNA
- MNA-SF

Question 10

Which are the three parameters evaluated in the MUST?

Answer 10

• BMI
• Unintentional weight loss in the past 3-6 months.
• Acute illness with reduced food intake for ≥ 5 days.

Question 11

What are the overall risk of malnutrition scores and follow-up actions in the MUST?

Answer 11

0: Low - Routine clinical care.
1: Medium - Observe.
≥ 2: High - Treat.

Question 12

What are the four parameters evaluated in the initial screening of the NRS?

Answer 12

• BMI < 20.5
• Weight loss in the past 3 months.
• Reduced dietary intake in the last week.
• Severe illness.
  *Yes/No, if there is any Yes, the final screening is performed.

Question 13

What are the two parameters evaluated in the final screening of the NRS?

Answer 13

• Impaired nutritional status.
• Severity of disease.
  *Scores 0, 1, 2 or 3 added up.

Question 14

What are the risk of malnutrition scores and follow-up actions in the final screening of the NRS?

Answer 14

≥ 3: Nutritionally at-risk - Initiate nutritional care plan.
< 3: Weekly re-screening of the patient.

Question 15

How many items does the full MNA include?

Answer 15

18, it combines screening and assessment features.

Question 16

How many items does the MNA-SF include?

Answer 16

Only 6, but it’s quicker and as effective as the long version.

Question 17

What are the risk of malnutrition assessment scores and follow-up actions in the MNA?

Answer 17

≥ 12 points: Normal or not at risk - No need to complete assessment.
≤ 11 points: Possible malnutrition - Continue assessment.

Question 18

What are the malnutrition indicator scores in the full MNA?

Answer 18

17-23.5 points: At risk of malnutrition.
< 17 points: Malnourished
*Assessment score + Screening score.

Question 19

What are the risk of malnutrition scores in the MNA-SF?

Answer 19

12-14 points: Normal nutritional status.
8-11 points: At risk of malnutrition.
0-7 points: Malnourished.