Assessment and Nutritional Diagnosis
Core concepts
Nutrition assessment follows the ABCDs: Anthropometric, Biochemical, Clinical, and Dietary data, plus environmental/social factors. Know how to interpret BMI, weight change over time, and growth percentiles; understand common lab markers (albumin, prealbumin, hemoglobin, ferritin, glucose, lipid panel) and their limitations. Dietary assessment methods-24-hour recall, food frequency questionnaire, food records, and direct observation-each carry distinct bias profiles. The nutrition care process moves from assessment to nutrition diagnosis using standardized PES (Problem, Etiology, Signs/Symptoms) statements.
Traps
Questions love to test that a single lab value is not diagnostic in isolation: albumin and prealbumin reflect inflammation as much as nutrition status. Watch for BMI cutoffs applied to populations where they mislead (athletes, older adults, pregnancy). Distinguish a nutrition diagnosis from a medical diagnosis-diagnoses are written by the dietitian and must include etiology.
Rule of thumb
Use the PES template: state the Problem, link it with "as evidenced by" the Etiology, and confirm with Signs/Symptoms. Worked example: "Inadequate protein intake (problem) related to limited chewing ability (etiology) as evidenced by 24-hour recall showing 30 g protein/day and 2% weight loss in one month (signs)."
Study anchor
For any assessment question, ask which ABCD domain the data belongs to and whether it is sufficient alone to support a diagnosis.