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B.
Overview and Nutrition Basics
B.4 Nutrition Assessment
Content
Areas:
-
Overweight
and obesity
-
Malnutrition
-
Diet
history
-
Family,
medical, and social histories
-
Review
of systems
-
Physical
examination
-
Functional
status
-
Subjective
global assessment
-
Laboratory
data
-
Energy
expenditure
| After
training, the learner will be able to: |
| Knowledge
Objectives: Medical Students |
- Describe
the metabolic and medical consequences of varying degrees
of over- and under-nutrition.
- Compare
and contrast the “ABCD’s” (anthropometric, biochemical,
clinical, and dietary intake measures) of nutrition assessment.
- Describe
the impact of the altered nutritional status associated
with five common acute and five common chronic diseases.
- List
the laboratory measurements commonly used to assess the
nutritional status of patients.
- Describe
the food pyramid, explain how it could be used as a nutrition
assessment tool, and give functional definitions of portion
size in each category of the pyramid.
- Outline
a laboratory profile indicative of malnutrition, protein-energy
malnutrition, iron deficiency anemia, or megaloblastic anemia.
- Identify
the likely physical examination findings associated with
over- and under-nutrition and vitamin/mineral deficiencies
or toxicities.
|
| Knowledge
Objectives: Residents |
- Compare
and contrast use of Body Mass Index (BMI), waist circumference,
skin fold thickness, mid-arm muscle circumference, and waist-hip
ratio, and explain the usefulness of these measures in the
clinical setting.
|
| Knowledge
Objectives: Specialists |
- Compare
and contrast the utility, validity, and reliability of at
least three commonly used dietary screening/assessment methods.
- Summarize
the American Dietetic Associations (ADA) recognized functions
of a registered dietitian.
|
| Practice
Behavior Skills: Medical Students |
- Take
an appropriate patient medical history of a standardized
patient, including dietary and social histories.
- Given
height and weight, calculate the BMI, and interpret the
BMI according to published NIH guidelines.
|
| Practice
Behavior Skills: Residents |
- Conduct
an appropriate nutritional assessment on all ambulatory
and hospitalized patients, including those with acute or
chronic disease as well as healthy individuals of all ages.
- Conduct
an appropriate physical examination in a patient of any
age, including anthropometrics; select appropriate laboratory
tests and procedures to diagnose and treat nutritional conditions
such as over- and under-nutrition in hospitalized and ambulatory
patients. Identify appropriate nutritional therapies.
- Effectively
counsel patients about their nutrition, providing recommendations
matched to the patient’s age, sex, family history, chronic
conditions, activity level, family, culture, and ethnicity.
- Seek
consultation with and refer patients to a registered dietitian
or other credentialed nutrition professionals as appropriate.
|
| Attitude
Objectives: All Learners |
- Recognize
the value of nutritional assessment in the comprehensive
care of ambulatory and hospitalized patients.
- Recognize
the importance of nutrition in health maintenance, disease
prevention, and management.
- Demonstrate
a commitment to utilizing a multidisciplinary approach to
screening, assessing, and counseling individuals at nutritional
risk.
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