DHA Clinical Dietician flashcards

32 cards. Read the term and the definition here. The deck at the top of this page is optional.

Atwater factors

Energy values used to calculate kilocalories: carbohydrate 4 kcal/g, protein 4 kcal/g, fat 9 kcal/g, and alcohol 7 kcal/g.

Nitrogen balance

Nitrogen intake minus nitrogen losses (urinary urea nitrogen plus about 4 g insensible loss). Positive balance means anabolism; negative means catabolism.

Glycemic load

Glycemic index multiplied by available carbohydrate in grams, divided by 100. It reflects both carbohydrate quality and quantity in a serving.

PDCAAS

Protein digestibility-corrected amino acid score. It compares a food's amino acid pattern to a reference and truncates the score at 1.0.

Body mass index formula

Weight in kilograms divided by height in meters squared. Adult categories: underweight below 18.5, normal 18.5 to 24.9, obesity 30 or higher.

Hamwi ideal body weight

Men: 48 kg plus 2.7 kg per inch over 5 feet. Women: 45.5 kg plus 2.3 kg per inch over 5 feet.

Percent weight change

Usual weight minus current weight, divided by usual weight, times 100. Loss over 5 percent in one month is clinically significant.

Negative acute-phase reactants

Albumin and prealbumin fall during inflammation regardless of intake, so they reflect inflammatory status more than nutritional status.

Mifflin-St Jeor equation

Men: 10W + 6.25H − 5A + 5. Women: 10W + 6.25H − 5A − 161, with W in kg, H in cm, and A in years.

CKD protein targets

Non-dialysis chronic kidney disease: about 0.6 to 0.8 g/kg/day. Hemodialysis: about 1.0 to 1.2 g/kg/day to offset dialytic losses.

Cirrhosis protein needs

Cirrhosis requires 1.2 to 1.5 g/kg/day with a late-evening snack. Protein is not restricted for encephalopathy unless another cause is identified.

Dumping syndrome diet

Small frequent meals, limited simple sugars, protein and fiber at each meal, and fluids separated from solids to slow gastric emptying.

Celiac gluten sources

Wheat, barley, and rye must be avoided for life. Oats are allowed only when certified gluten-free because of cross-contact during processing.

COPD nutrition pattern

A higher-fat, lower-carbohydrate pattern can reduce carbon dioxide production in hypercapnic patients, while overall energy intake must meet elevated work-of-breathing needs.

Gastric residual volume

Residuals up to 250 to 500 mL are generally tolerated. Routine checking is discouraged; assess abdominal exam, nausea, and vomiting instead.

Refeeding syndrome risk

Risk factors include BMI under 16, weight loss over 15 percent in 3 to 6 months, negligible intake over 10 days, or low phosphate, potassium, or magnesium.

Refeeding start rate

Begin at 10 to 20 kcal/kg/day, give thiamin before or with the first feeding, and monitor phosphate, potassium, and magnesium closely.

TPN indications

Nonfunctioning gastrointestinal tract, high-output fistula, severe malabsorption, or inability to meet needs enterally despite adequate attempts.

Enteral formula types

Polymeric for intact digestion, peptide-based for malabsorption, and elemental for severe dysfunction. Disease-specific formulas are reserved for defined indications.

Exclusive breastfeeding

Exclusive breastfeeding is recommended for about the first 6 months, followed by iron-fortified complementary foods introduced around 6 months of age.

Pregnancy energy increase

Add about 340 kcal/day in the second trimester and about 450 kcal/day in the third. Folic acid of 400 to 600 mcg/day reduces neural tube defects.

Older adult protein

Energy needs decline with age, but protein needs rise to about 1.0 to 1.2 g/kg/day to counter sarcopenia, along with adequate vitamin D and calcium.

Hunger Vital Sign

A validated two-question food insecurity screen used in community settings, with referral to SNAP, WIC, and food pantries when positive.

Temperature danger zone

41 to 135 degrees Fahrenheit (5 to 57 degrees Celsius). Hot foods are held at or above 135 F; cold foods at or below 41 F.

Two-hour rule

Discard perishable food left in the danger zone for more than 2 hours, or more than 1 hour when ambient temperature exceeds 90 F.

HACCP seven principles

Hazard analysis, critical control points, critical limits, monitoring, corrective actions, verification, and recordkeeping.

Two-stage cooling

Cool from 135 F to 70 F within 2 hours, then from 70 F to 41 F within an additional 4 hours.

Nutrition Care Process

Four standardized steps: nutrition assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring and evaluation.

PES statement

A nutrition diagnosis format stating the Problem, its Etiology, and the Signs and Symptoms that support it.

Motivational interviewing

A collaborative counseling style using open questions, affirmations, reflections, and summaries to build the patient's own change talk rather than to persuade.

PICO question

A framework for clinical questions: Population, Intervention, Comparison, and Outcome.

Sensitivity and specificity

Sensitivity is true positives divided by all with disease; specificity is true negatives divided by all without disease. Prevalence affects predictive values.