Cultural and Nutritional Assessments

1. ethnocentrism

2. cultural imposition

3. stereotyping

4. prejudice

5. xenophobia

6. discrimination

1. past

2. present

3. future

1. destiny

2. harmony

3. mastery

1. being

2. being and becoming

3. doing

1. lineal

2. collateral

3. individual

1. biomedical

2. naturalistic (holistic)

3. magico-religious

-all events have cause and effect

-human body functions mechanically

-basis for educational programs for doctors/nurses

eg- the germ theory, sun and skin cancer

-native americans: human life is one force in nature

-forces of nature needed for balance

-health is achieved w/ this balance

eg. yin-yang theory (asian)

-therapies: acupuncture, therapeutic touch, massage therapy

-super natural forces eg. voodoo, witchcraft

-intertwined w/ folk medicine

-works b/c its humanistic, community based, performed @ home, inexpensive, comforting

-hx of identified cutural group

-values orientation

-cultural sanctions/restrictions

-communication (understanding)

-health related beliefs and practices

1. nutritional

2. educational

3. religious

-address pt. by last name

-introduce yourself by name and position

-be authentic/engaged

-use language that is culturally sensitive

-assess pt. knowledge base

-respect pt. values and beliefs

-show respect for support people

-extra time to spend w/ them

-observe pt. and family

-observe pt's perception

-listen actively

-use validation

-consider same sex RN

-ht/wt

-medical history

-dietary info

-lab data

-malnutrition or incompetence

-important test of protein stores

1. iron deficiency

2. B12 deficiency

3. folic acid deficiency

-most common

-pale, headache, tired, sensitivity to cold, loss of appetite, SOB, PICA

men: 40-54%

women: 37-47%

men: 12-16

women: 12-14

-dark, tarry stools

-take w/ vit. C

-diarrhea, constipation

-fat metabolism

-CAD risk

-cardia dz.

-main transport of protein in body

-maintains plasma oncotic pressure

malabsorption, malnutrition, liver dz.

-assess nutritional status, chronic illness, liver dz.

-serves as a transport protein for thyroxin & vit. A

-early indicator or protein stores

-sensitive to acute changes in protein status and sudden demands in protein synthesis (eg. malnutrition, chronic illness/tx, pre-op/post-op)

-iron transport protein

-carries 60-70% body's iron

-early indicator of protein stores in body

> or = to 20%

>55% inc. mortality rate

-assesses hydration status

-1.005-1.030 normal

-elevated w/ dehydration

1. 24 hr. recall

2. food diary

3. direct observation

not always reliable bc not 100% accurate

-write everything down

-more accurate but time consuming

-most reliable

-can measure

-increased LDLs (lipid levels)

-fats build up under skin--> yellow subdermal bumps/buildup

-niacin deficiency

-dilusions, diarrhea, confusion, scale skin sores, inflammed mucous membs.

-vit. C deficiency

-loss of appetite, diarrhea, fever, rapid breathing, swelling in legs, bleeding gums, skin and membrane hemorrhages, eyes protrude

-vit. A def.

-white spots in eyes

-keratomalacia- may result in permanent destruction of eye

aka xerosis

vit. A def.

-red tongue

-vit. B complex def.

-vit. B6 and B12 def.

-dec. reflexes, sensory loss, burning, tingling of hands and feet

-vit. B6 and B12 def.

-confusion and irritability

-thiamine def.

-the unconscious filling of gaps in ones memory by fabrications that one accepts as facts

1. growth and development

2. body composition

1st 5 feet=100 lbs.

every inch over=5 lbs.

1st 5 feet=106 lbs.

every inch over=6 lbs.

-vit. D def. in adults

-results in dec. Ca salts causing bones to become soft, flexible, brittle, deformed

-protein def.

-underdeveloped, flaccid

-vit. D and Ca def.

-can be fixed

-before and after tx. w/ Ca

-delayed growth, muscle weakness, bowed legs, abnormal curve in spine, pain in muscles

-occurs w/ diets consisting w/ mostly carbs and little protein

-common in poorer countries or child abuse

-change in skin pigment, dec. muscle mass, diarrhea, hair texture changes, infections, irritability, large belly, rashes, dec. growth

-assess body fat composition using electroconduction through water, muscle & fat

-must be well hydrated

-more reliable than skinfold measurements

-measures body fat at specific sites by passing infrared light through tissue, fat and ater

-noninvasive

-pressure can change results--> not most accurate

-performed on bicep

-looks @ body volume

-weighed outside tank then in water

-pulmonary func. test

-air displacement in box

-food pyramid is gone

-plate w/ protein, veggies, fruits, dairy, grains

-a higher proportion of fat in upper body, esp. abdomen

"apple"

-heart problems, stroke, etc.

higher proportion of fat in hips and thighs

"pear"

-grasp fold of skin on post. aspect of arm (triceps)

-apply calipers horizontally

-take measures x3 & average

-compare w/ standard values

-might not work on overwt. pts.

-estimates muscle mass & fat stores

-measure mid-point of upper arm

-used to compare on standard charts

-not as helpful/accurate on elderly