ABCN CNP cheat sheet

4 kcal/g carbohydrate, 4 kcal/g protein, 9 kcal/g fat, 7 kcal/g alcohol.

Atwater general factors: carbohydrate 4, protein 4, fat 9 kcal/g; use specific factors for foods with high fiber or unusual amino acid profiles.

BMI = weight (kg) / height (m)^2; BMI = 703 × weight (lb) / height (in)^2.

Essential amino acids (9): histidine, isoleucine, leucine, lysine, methionine, phenylalanine, threonine, tryptophan, valine.

Nitrogen balance = nitrogen intake − (urinary + fecal + integumentary nitrogen losses); positive in growth and pregnancy, negative in catabolic states.

AMDR: carbohydrate 45–65%, fat 20–35%, protein 10–35% of energy for adults.

RDA is set at mean requirement plus 2 SD (approximately 97.5th percentile of requirement); EAR is the median requirement.

Glycemic index compares 2-hour blood glucose response of a 50-g available carbohydrate portion to a reference food; glycemic load = GI × available carbohydrate (g) / 100.

Nutrition care process sequence: assessment, diagnosis, intervention, monitoring/evaluation, and documentation.

PES statement format: Problem (intake, clinical, behavioral-environmental) related to Etiology as evidenced by Signs/Symptoms.

Anthropometric thresholds: BMI <18.5 underweight, 18.5–24.9 normal, 25–29.9 overweight, ≥30 obesity.

Percent weight change = (usual weight − current weight) / usual weight × 100; >5% in 1 month or >10% in 6 months is clinically significant.

Albumin and prealbumin are negative acute-phase reactants; they reflect inflammation, not reliably nutritional status.

Estimated energy needs commonly start at 25–30 kcal/kg and protein at 0.8–1.0 g/kg for stable adults, adjusting for stress and activity.

24-hour recall depends on memory and may not represent usual intake; food frequency questionnaires estimate habitual intake but carry recall and portion bias.

Handgrip dynamometry and bioelectrical impedance are functional/body composition measures affected by hydration and disease status.

Intervention domains: food/nutrient delivery, nutrition education, nutrition counseling, and coordination of care.

IDDSI framework: liquids at levels 0–4 (thin to extremely thick) and foods at levels 3–7 (liquidized to regular).

Dysphagia texture modification reduces aspiration risk; thickened liquids increase fluid needs and may reduce intake.

Consistent carbohydrate intake (commonly 45–60 g per meal) supports glycemic control in diabetes; carbohydrate counting matches insulin to intake.

Protein-energy malnutrition in chronic kidney disease: pre-dialysis protein 0.6–0.8 g/kg; dialysis 1.0–1.2 g/kg.

Enteral nutrition: gastric feeding is preferred when tolerated; post-pyloric feeding reduces aspiration risk in gastroparesis or severe reflux.

Refeeding syndrome risk factors include BMI <16, unintentional loss >15% in 3–6 months, low electrolytes, and minimal intake >5–10 days; start low and replete phosphate, potassium, magnesium.

Motivational interviewing uses open questions, affirmations, reflections, and summaries to build change talk rather than give direct advice.

Monitoring indicators must be measurable, relevant to the nutrition diagnosis, and compared against defined goals.

Documentation formats include ADIME (assessment, diagnosis, intervention, monitoring/evaluation) and SOAP (subjective, objective, assessment, plan).

Reassessment intervals should be set by acuity; hospitalized patients commonly weekly or more often, outpatients per visit cycle.

A goal is evaluable only if it specifies indicator, target value, and timeframe.

Evaluation determines whether the intervention is working; if not, revise the intervention or the diagnosis rather than re-documenting unchanged goals.

Medical record entries must be dated, timed, signed, and contain only objective, verifiable content.

Quality improvement uses plan-do-study-act cycles with defined measures and baseline data.

Scope of practice is defined by state licensure law, employer policy, and credentialing; the most restrictive applicable rule governs.

Autonomy, beneficence, nonmaleficence, justice, and veracity are core ethical principles applied to nutrition care decisions.

Informed consent requires capacity, disclosure of risks and alternatives, understanding, and voluntariness.

Confidentiality is governed by HIPAA; minimum necessary disclosure applies to care coordination.

Conflicts of interest, including industry sponsorship, must be disclosed and managed; they do not automatically disqualify a practitioner.

Referral is required when a request falls outside competence or licensure; declining is not abandonment if referral is offered.

Mandatory reporting duties (e.g., suspected abuse, certain communicable diseases) override confidentiality obligations.

Hazard Analysis Critical Control Point principles: hazard analysis, critical control points, critical limits, monitoring, corrective actions, verification, recordkeeping.

Temperature danger zone is 41–135°F (5–57°C); food must pass through it quickly and be held outside it.

Food cost percentage = food cost / food sales × 100; labor cost percentage is calculated the same way.

Prime cost = food cost + labor cost; it is the main controllable cost driver in foodservice operations.

Production forecasting converts census or historical sales into quantities using portion size and yield percentage.

Yield percentage = edible portion weight / as-purchased weight × 100; as-purchased quantity = edible portion / yield percentage.

Therapeutic diet manuals standardize modifications; a diet order must be verified against the current prescription before tray assembly.

Inventory turnover = cost of goods sold / average inventory value; higher turnover generally indicates fresher stock and less capital tied up.

Evidence hierarchy (high to low): systematic reviews/meta-analyses, randomized controlled trials, cohort studies, case-control studies, case series, expert opinion.

PICO structures a clinical question: population, intervention, comparison, outcome.

Randomization reduces selection bias; blinding reduces detection and performance bias.

Relative risk = incidence in exposed / incidence in unexposed; attributable risk = incidence in exposed − incidence in unexposed.

Number needed to treat = 1 / absolute risk reduction.

p < 0.05 indicates statistical significance, not clinical importance; effect size and confidence intervals inform applicability.

Sensitivity = true positives / (true positives + false negatives); specificity = true negatives / (true negatives + false positives).

Continuing education requirements are set by the credentialing body and state licensure; evidence appraisal skills are needed to translate new findings into practice.

Hazard Analysis Critical Control Point principles: hazard analysis, critical control points, critical limits, monitoring, corrective actions, verification, recordkeeping.

Temperature danger zone is 41–135°F (5–57°C); food must pass through it quickly and be held outside it.

Food cost percentage = food cost / food sales × 100; labor cost percentage is calculated the same way.

Prime cost = food cost + labor cost; it is the main controllable cost driver in foodservice operations.

Production forecasting converts census or historical sales into quantities using portion size and yield percentage.

Yield percentage = edible portion weight / as-purchased weight × 100; as-purchased quantity = edible portion / yield percentage.

Therapeutic diet manuals standardize modifications; a diet order must be verified against the current prescription before tray assembly.

Inventory turnover = cost of goods sold / average inventory value; higher turnover generally indicates fresher stock and less capital tied up.

Evidence hierarchy (high to low): systematic reviews/meta-analyses, randomized controlled trials, cohort studies, case-control studies, case series, expert opinion.

PICO structures a clinical question: population, intervention, comparison, outcome.

Randomization reduces selection bias; blinding reduces detection and performance bias.

Relative risk = incidence in exposed / incidence in unexposed; attributable risk = incidence in exposed − incidence in unexposed.

Number needed to treat = 1 / absolute risk reduction.

p < 0.05 indicates statistical significance, not clinical importance; effect size and confidence intervals inform applicability.

Sensitivity = true positives / (true positives + false negatives); specificity = true negatives / (true negatives + false positives).

Continuing education requirements are set by the credentialing body and state licensure; evidence appraisal skills are needed to translate new findings into practice.