Nutrition Screening, Assessment, and Clinical
Indicators: Tools, Formulas, and Laboratory
Markers
According to nutrition risk must be identified in hospitalized patients within 24 hours of
admission, but does not mandate a method of screening. - ✔✔The Joint Commission
Subjective Global Assessment (SGA) - ✔✔
Screening tool which evaluates
1. Patient's history
2. Intake
3. GI symptoms
4. Functional capacity
5. Physical appearance
6. Edema
7. Weight change
Mini Nutritional Assessment (MNA) - ✔✔Screening tool used for individual >/= 65 YO and evaluates:
1. Independence
2. Medications
3. Number of full meals consumed
4. Protein intake
5. Fruits & Vegetables
6. Fluid
7. Mode of feeding
Nutrition Screening Initiative - ✔✔Screening tool specific for the elderly
,Geriatric Nutritional Risk Index (GNRI) - ✔✔Screening tool which assesses
1. Serum Albumin
2. Weight changes
Used with the elderly population
Malnutrition Screening Tool - ✔✔Screening tool which assesses
1. Recent weight loss
2. Recent poor dietary intake
Used in the acute hospitalized adult population
Nutrition Risk Screening (NRS) - ✔✔Screening tool used for medical-surgical hospitalized patients which
assesses
1. % weight loss
2. BMI
3. Intake
4. Age (>70 YO)
Malnutrition Universal Screening Tool (MUST) - ✔✔Screening tool which assesses
1. BMI
2. Unintentional weight loss
3. Effect of acute disease on intake for >5 days
What are the four steps in the Nutrition Care Process (NCP)? - ✔✔1. Assess
2. Diagnose
3. Intervene
4. Monitor & Evaluate
(ADIME)
,Assessment/Data collection - ✔✔Includes:
1. Food/nutrition-related history
2. Anthropometrics
3. Lab/medical tests
4. Nutrition-focused physical findings
5. Client history
What is Hamwi Formula for estimating IBW for women? - ✔✔Medium Frame: 100 lbs for first 5'
add 5 lbs for each additional inch
subtract 5 lbs for each inch under 5'
Small Frame: subtract 10%
Large Frame: add 10%
What is Hamwi Formula for estimating IBW for men? - ✔✔Frame Medium: 106 lbs for first 5'
add 6 lbs for each additional inch
subtract 6 lbs for each inch under 5'
Small Frame: subtract 10%
Large Frame: add 10%
What is the Adjusted IBW formula for amputations? - ✔✔IBW based on Hamwi x (100% - % amputation)
Use a range of (+/- 10%) to allow for various body frames
% Amputation:
, entire leg = 16% of body weight
above knee = 11% of body weight
lower leg with foot = 6% of body weight
entire arm = 5% of body weight
forearm with hand = 2.3% of body weight
How to calculate IBW for individual with Spinal Cord Injury (SCI) - ✔✔Quadriplegic reduce by 10-15% of
table weight
Paraplegic reduce by 5-10% of table weight
The registered dietitian should not use body mass index (BMI) or skinfold measurements to measure
body composition in persons with spinal cord injury. These methods may not provide reliable results
since they were developed based on able-bodied persons.
How do you calculate % weight change? - ✔✔It stresses significance of weight change and is used to
assess nutritional risk.
(usual weight - actual (current) weight / usual weight) x 100
What is considered significant weight loss? - ✔✔10% loss within 6 months
Arm Muscle Area (AMA) - ✔✔1. It measures skeletal muscle mass (somatic protein)
2. Important to measure in growing children
3. Standard: male 25.3 cm; female 23.2 cm
4. To determine AMA use Triceps skinfold thickness (TSF) and arm circumference (AC)
Formula to measure BMI in adults - ✔✔(weight in lbs / height in inches squared) x 703
What are the different BMI classifications for adults - ✔✔<16: Severe thinness
16-16.9: Moderate thinness
Indicators: Tools, Formulas, and Laboratory
Markers
According to nutrition risk must be identified in hospitalized patients within 24 hours of
admission, but does not mandate a method of screening. - ✔✔The Joint Commission
Subjective Global Assessment (SGA) - ✔✔
Screening tool which evaluates
1. Patient's history
2. Intake
3. GI symptoms
4. Functional capacity
5. Physical appearance
6. Edema
7. Weight change
Mini Nutritional Assessment (MNA) - ✔✔Screening tool used for individual >/= 65 YO and evaluates:
1. Independence
2. Medications
3. Number of full meals consumed
4. Protein intake
5. Fruits & Vegetables
6. Fluid
7. Mode of feeding
Nutrition Screening Initiative - ✔✔Screening tool specific for the elderly
,Geriatric Nutritional Risk Index (GNRI) - ✔✔Screening tool which assesses
1. Serum Albumin
2. Weight changes
Used with the elderly population
Malnutrition Screening Tool - ✔✔Screening tool which assesses
1. Recent weight loss
2. Recent poor dietary intake
Used in the acute hospitalized adult population
Nutrition Risk Screening (NRS) - ✔✔Screening tool used for medical-surgical hospitalized patients which
assesses
1. % weight loss
2. BMI
3. Intake
4. Age (>70 YO)
Malnutrition Universal Screening Tool (MUST) - ✔✔Screening tool which assesses
1. BMI
2. Unintentional weight loss
3. Effect of acute disease on intake for >5 days
What are the four steps in the Nutrition Care Process (NCP)? - ✔✔1. Assess
2. Diagnose
3. Intervene
4. Monitor & Evaluate
(ADIME)
,Assessment/Data collection - ✔✔Includes:
1. Food/nutrition-related history
2. Anthropometrics
3. Lab/medical tests
4. Nutrition-focused physical findings
5. Client history
What is Hamwi Formula for estimating IBW for women? - ✔✔Medium Frame: 100 lbs for first 5'
add 5 lbs for each additional inch
subtract 5 lbs for each inch under 5'
Small Frame: subtract 10%
Large Frame: add 10%
What is Hamwi Formula for estimating IBW for men? - ✔✔Frame Medium: 106 lbs for first 5'
add 6 lbs for each additional inch
subtract 6 lbs for each inch under 5'
Small Frame: subtract 10%
Large Frame: add 10%
What is the Adjusted IBW formula for amputations? - ✔✔IBW based on Hamwi x (100% - % amputation)
Use a range of (+/- 10%) to allow for various body frames
% Amputation:
, entire leg = 16% of body weight
above knee = 11% of body weight
lower leg with foot = 6% of body weight
entire arm = 5% of body weight
forearm with hand = 2.3% of body weight
How to calculate IBW for individual with Spinal Cord Injury (SCI) - ✔✔Quadriplegic reduce by 10-15% of
table weight
Paraplegic reduce by 5-10% of table weight
The registered dietitian should not use body mass index (BMI) or skinfold measurements to measure
body composition in persons with spinal cord injury. These methods may not provide reliable results
since they were developed based on able-bodied persons.
How do you calculate % weight change? - ✔✔It stresses significance of weight change and is used to
assess nutritional risk.
(usual weight - actual (current) weight / usual weight) x 100
What is considered significant weight loss? - ✔✔10% loss within 6 months
Arm Muscle Area (AMA) - ✔✔1. It measures skeletal muscle mass (somatic protein)
2. Important to measure in growing children
3. Standard: male 25.3 cm; female 23.2 cm
4. To determine AMA use Triceps skinfold thickness (TSF) and arm circumference (AC)
Formula to measure BMI in adults - ✔✔(weight in lbs / height in inches squared) x 703
What are the different BMI classifications for adults - ✔✔<16: Severe thinness
16-16.9: Moderate thinness
