CNSC flashcards

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

Ideal Body Weight (Hamwi)

Men: 48.0 kg for the first 152 cm plus 2.7 kg per extra 2.54 cm. Women: 45.5 kg plus 2.2 kg per extra 2.54 cm. Used for dosing and nutrition estimates.

Body Mass Index Formula

BMI equals weight in kilograms divided by height in meters squared. A BMI of 18.5-24.9 is normal; 25-29.9 overweight; 30 or above obesity.

Adjusted Body Weight

Calculated as ideal body weight plus 25 percent of the difference between actual and ideal weight. Applied when actual weight exceeds 125 percent of ideal for dosing.

Nitrogen Balance Equation

Nitrogen balance equals nitrogen intake minus urinary urea nitrogen minus about 4 grams of estimated non-urinary losses. A positive value suggests anabolism; negative suggests catabolism.

Indirect Calorimetry RQ

The respiratory quotient is carbon dioxide produced divided by oxygen consumed. Near 1.0 reflects carbohydrate oxidation, near 0.7 fat oxidation, and above 1.0 net lipogenesis.

Mifflin-St Jeor Equation

Men: 10 times weight in kg plus 6.25 times height in cm minus 5 times age plus 5. Women use minus 161 instead of plus 5.

Significant Weight Loss

Involuntary loss of 5 percent or more of usual body weight within one month, or 10 percent or more within six months, warrants nutrition assessment and intervention.

Visceral Protein Limitations

Albumin has a roughly 20-day half-life and prealbumin 2-3 days, but both decline with inflammation and volume shifts, so they do not reliably reflect nutrition status alone.

Refeeding Syndrome Risk Criteria

Risk includes BMI under 16, unintentional loss over 15 percent in 3-6 months, negligible intake over 10 days, low potassium, magnesium, or phosphate, or alcohol misuse.

Refeeding Syndrome Hallmark

Hypophosphatemia is the characteristic electrolyte shift, often accompanied by low potassium and magnesium. It typically appears within 72 hours of restarting feeding.

Refeeding Initiation Rate

Start feeding at 10-20 kcal per kg per day, give thiamine before or with feeding, and monitor electrolytes closely during the first several days of refeeding.

Enteral Versus Parenteral Rule

Use the gastrointestinal tract when it functions adequately. Enteral feeding preserves gut integrity, costs less, and carries fewer infection risks than parenteral nutrition.

Aspiration Risk Precautions

Elevate the head of the bed 30-45 degrees, follow protocol for residual volume checks, and consider post-pyloric feeding when gastroparesis or high aspiration risk is present.

Parenteral Nutrition Indications

Parenteral nutrition is indicated when the gut cannot function, such as high-output fistula, severe malabsorption, obstruction, or inability to meet needs enterally beyond 7-10 days.

Dumping Syndrome Phases

Early dumping occurs 15-30 minutes after eating with sweating, tachycardia, and diarrhea from rapid osmotic load. Late dumping 1-3 hours later causes reactive hypoglycemia.

CKD Protein Needs

Non-dialysis chronic kidney disease generally targets 0.6-0.8 grams of protein per kg daily. Dialysis increases needs to about 1.0-1.2 grams per kg due to treatment losses.

Hepatic Encephalopathy Protein

Routine protein restriction is not recommended. Provide about 1.2-1.5 grams per kg daily, spread across small frequent meals with a late-evening snack to limit catabolism.

Nutrition Care Process Order

The four steps are nutrition assessment, nutrition diagnosis, nutrition intervention, and nutrition monitoring and evaluation. Monitoring feeds back into reassessment when goals are unmet.

PES Statement Structure

Problem is a standardized nutrition diagnosis term, Etiology follows related to, and Signs or Symptoms follow as evidenced by. It is distinct from a medical diagnosis.

SMART Goal Criteria

Goals should be Specific, Measurable, Achievable, Relevant, and Time-bound. Each goal should connect directly to the documented nutrition diagnosis and planned intervention.

Screening Versus Assessment

Screening tools such as MST, MUST, or NRS-2002 quickly flag risk. A comprehensive assessment by the dietitian confirms malnutrition, identifies causes, and sets the care plan.

GLIM Malnutrition Criteria

Diagnosis requires at least one phenotypic criterion (weight loss, low BMI, reduced muscle mass) plus one etiologic criterion (reduced intake or absorption, or inflammation).

PDSA Improvement Cycle

Plan-Do-Study-Act is a quality improvement cycle: define a change, test it, measure results, then adopt, adapt, or abandon before standardizing.

HACCP Seven Principles

Conduct hazard analysis, determine critical control points, set critical limits, monitor them, establish corrective actions, verify the system, and keep records.

Formula Volume Calculation

Volume in milliliters equals desired kilocalories divided by formula kilocalories per milliliter. Concentrated formulas require separate calculation of additional free water.

Scope of Practice Basis

Legal scope is set by state licensure law and employer policy. Specialty certification demonstrates competence in a defined area but does not itself expand legal scope.

Four Ethical Principles

Autonomy respects patient choice, beneficence promotes good, nonmaleficence avoids harm, and justice requires fair distribution. Veracity adds the duty to be truthful.

Informed Consent Elements

Valid consent requires decision-making capacity, disclosure of risks, benefits, and alternatives, comprehension by the patient, and voluntariness. Consent may be withdrawn at any time.

HIPAA Minimum Necessary

Disclosures should be limited to the minimum information needed for the purpose. De-identification requires removal of 18 specified identifiers before research or public use.

Evidence Hierarchy Levels

Highest strength comes from systematic reviews of randomized trials, then individual randomized trials, cohort studies, case-control studies, case series, and expert opinion.

Conflict of Interest Disclosure

Financial relationships, gifts, or industry funding that could bias professional judgment must be disclosed and should not influence product selection or formulary decisions.

Continuing Competence

Maintaining competence involves continuing education units, recertification on the required cycle, and self-assessment of knowledge gaps. Unupdated practice patterns create professional and patient risk.