Nutrition Screening Process

9 Questions

What is the primary goal of nutrition screening?

To identify factors associated with malnutrition

Who can complete nutrition screening?

Non-RD clinical staff, including nurses and MDs

What is the best method for measuring height?

Stadiometer measurement

What is the role of electrolytes in the body?

To maintain environment for normal cell functioning

What is the first step in evaluating hyponatremia?

Evaluating the type of hyponatremia based on osmolality

What is an example of a condition that can cause hypertonic hyponatremia?

Severe hyperglycemia with dehydration

What is the characteristic of pseudohyponatremia?

Normal plasma osmolality

What is the effect of excess plasma substances in pseudohyponatremia?

Decrease in aqueous phase of plasma

When was the mandate to screen for nutrition within 24 hours of hospital admission introduced?

1990s

Study Notes

Nutrition Screening

Nutrition screening is the process of identifying patients, clients, or groups who may benefit from nutrition assessment and intervention by a registered dietitian (RD)
Can be completed by non-RD clinical staff, such as nurses, MDs, and diet technicians
The goal of nutrition screening is NOT to diagnose malnutrition, but to identify factors associated with malnutrition

Anthropometric Measurements

Height is best measured using a stadiometer
Problems with height measurements include:
- Decreases with age
- Illness or disability
Surrogate measurements for height include:
- Self-reported height
- Armspan
- Supine measurement
- Knee height

Fluid and Electrolytes

Electrolytes are substances that dissociate into positively and negatively charged ions (cations and anions) when dissolved in water
Examples of electrolytes include:
- Sodium (Na)
- Potassium (K)
- Chloride (Cl)
- Bicarbonate (HCO3-)
- Calcium (Ca)
- Magnesium (Mg)
- Phosphorus (Phos)
Electrolytes are important for maintaining normal cell functioning and regulating acid-base balance
Intracellular electrolytes include K, Mg, and Phos
Extracellular electrolytes include Na, Cl, and HCO3-

Hyponatremia: Etiology and Type

Hyponatremia evaluation should FIRST evaluate the type based on osmolality
Types of hyponatremia include:
- Hypertonic Hyponatremia
  - High plasma osmolality (>295 mOsm/kg)
  - Increase in osmotically active substances OTHER than sodium
  - Example: severe hyperglycemia with dehydration
- Pseudohyponatremia (isotonic)
  - Normal plasma osmolality (275-295 mOsm/kg)
  - Concentration of Na in plasma is normal
  - Excess plasma substances (e.g., hyperlipidemia, hyperproteinemia) expand the non-aqueous phase of plasma and decrease aqueous phase (plasma water content)
  - Na normalizes once other indices are corrected