Nutritional Status Assessment

Chapter 13: Assessing Nutritional Status

• Optimal nutritional status is achieved when nutrient intake balances daily metabolic needs.
• Malnutrition includes both undernutrition (inadequate nutrient intake or depleted reserves) and overnutrition (excessive intake leading to obesity and related risks).
• Undernutrition risk factors: low socioeconomic status, poor food choices, chronic dieting, diseases, dental issues, trauma.
• Overnutrition risk factors: cardiovascular disease, diabetes, hypertension, cancer, sleep apnea.
• Optimal hydration supports bodily functions, with a recommended intake of 64 oz of water per day.
• Dehydration results from inadequate fluid intake, leading to electrolyte imbalances.
• Overhydration involves excess fluid retention, commonly seen in patients with kidney, liver, or cardiac diseases.
• DETERMINE acronym helps identify warning signs of poor nutrition: Disease, Eating poorly, Tooth loss, Economic hardship, Multiple medications, Involuntary weight loss/gain, Needs assistance in self-care, Elderly (above 80 years).
• Somatotypes (body types) include: ectomorph (lean, difficulty gaining weight), mesomorph (muscular, easy to gain muscle), and endomorph (rounder, stores fat easily).

Chapter 14: Assessing Skin, Hair, and Nails

• Stages of pressure ulcers are classified by the depth of tissue damage:
  • Stage 1: Non-blanchable redness.
  • Stage 2: Partial-thickness skin loss.
  • Stage 3: Full-thickness skin loss with potential subcutaneous tissue involvement.
  • Stage 4: Full-thickness skin loss with exposed bone, muscle, or tendon.
  • Unstageable: Ulcer covered by slough or eschar.
• Methicillin-Resistant Staphylococcus Aureus (MRSA) is categorized as:
  • Hospital-acquired (HA-MRSA): Associated with medical procedures.
  • Community-acquired (CA-MRSA): Associated with close skin-to-skin contact.
• MRSA prevention strategies include hand hygiene, wound care, and avoiding sharing personal items.

Chapter 15: Assessing Head and Neck

• FAST acronym is used to recognize stroke symptoms: Face drooping, Arm weakness, Speech difficulty, Time to call emergency services.
• Stroke symptoms include:
  • Ischemic stroke: Sudden numbness, confusion, vision issues, severe headache.
  • Hemorrhagic stroke: Severe headache, nausea, vomiting, loss of consciousness.
• Migraine types:
  • Tension headache: Dull, tight, diffuse pain.
  • Cluster headache: Intense pain around one eye.
  • Migraine: Throbbing pain, nausea, photophobia.

Chapter 16: Assessing Eyes

• Central vision involves the macula, while peripheral vision is detected by the retina's outer edges.
• Neurologic disorders affecting vision include glaucoma (increased intraocular pressure), macular degeneration (central vision loss), and cataracts (clouding of the lens).
• Hyperthyroidism is characterized by weight loss, heat intolerance, and exophthalmos; hypothyroidism by weight gain, cold intolerance, and bradycardia.
• Eye disorders include:
  • Myopia (nearsightedness): Difficulty seeing far.
  • Hyperopia (farsightedness): Difficulty seeing near.
  • Astigmatism: Blurred vision due to corneal shape.
  • Presbyopia: Age-related farsightedness.

Chapter 17: Assessing Ears

• Common ear disorders include otitis externa (outer ear infection), otitis media (middle ear infection), and tinnitus (ringing in ears).
• Conductive hearing loss results from blockage in the outer/middle ear, while sensorineural hearing loss involves inner ear damage.

Chapter 18: Assessing Mouth, Throat, Nose, and Sinuses

• Paranasal sinuses are the frontal, maxillary, ethmoidal, and sphenoidal sinuses.
• Functions of the sinuses include reducing skull weight and providing resonance for speech.
• Abnormalities in the mouth and throat include leukoplakia (white, precancerous patches), oral candidiasis (fungal infection), and herpes simplex (cold sores).
• Tonsil grading scale:
  • 1+: Visible.
  • 2+: Midway between pillars and uvula.
  • 3+: Touching uvula.
  • 4+: Touching each other.