Nutritional Assessment

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by Mary Ellen Posthauer, RDN, CD, LD, FAND

Several years ago when my nutrition blog began, I discussed the issue of relying on laboratory values – in particular albumin, pre-albumin and transthyretin – as markers of nutritional status. Recently, during a discussion of nutrition and wound care, a dietitian expressed her frustration with a surgeon who kept postponing corrective abdominal surgery until a patient's nutritional status improved, as evidenced by the albumin being in the normal range. However, the patient was receiving adequate calories per enteral feeding and had gained weight. The albumin level was not reflective of the nutritional status. This discussion prompted me to revisit the issue of serum proteins as markers of nutritional status.

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By Mary Ellen Posthauer, RDN, CD, LD, FAND

As we watched the bright colored ball drop at midnight in Times Square and listened to John Lennon's classic song, "Imagine", we closed out the past year and now reflect on the future. What is your greater vision of how the world could be for our clients in 2014? We are entering into a new era and in some ways uncharted territory for how health care will be delivered in the United States.

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By Mary Ellen Posthauer, RDN, CD, LD, FAND

The past few months my blog has been devoted to illustrating the value of using an etiology-based approach to diagnosing adult malnutrition in clinical settings. This approach is detailed in The Academy of Nutrition and Dietetics (Academy) and the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.): Characteristics Recommended for the Identification and Documentation of Adult Malnutrition (Undernutrition).

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By Mary Ellen Posthauer RDN, CD, LD, FAND

In September, the Journal of the Academy of Nutrition and Dietetics, Journal of Parenteral and Enteral Nutrition, and the MEDSURG Nursing Journal simultaneously published the article "Critical role of nutrition in improving quality of care: an interdisciplinary call to action, to address adult hospital malnutrition." The Alliance to Advance Patient Nutrition (Alliance) includes representatives from the Academy of Nutrition and Dietetics, the Academy of Medical-Surgical Nurses, the Society of Hospital Medicine, the American Society of Parenteral and Enteral Nutrition and Abbott Nutrition.

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By Mary Ellen Posthauer RDN, CD, LD, FAND

In last month's blog, I discussed recent research and publication of the consensus statement of the Academy of Nutrition and Dietetics (Academy) and the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.): Characteristics Recommended for the Identification and Documentation of Adult Malnutrition (Undernutrition).

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By Mary Ellen Posthauer RDN, CD, LD, FAND

We have all heard the terms Marasmus and Kwashiorkor used to classify malnutrition that stems from the classic 1974 The Skeleton in the Closet article. Current research on this topic led to the collaboration and 2012 publication of a consensus statement of the Academy of Nutrition and Dietetics (Academy) and the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.): Characteristics Recommended for the Identification and Documentation of Adult Malnutrition (Undernutrition).

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By Mary Ellen Posthauer RDN, CD, LD, FAND

Part 3 in a series discussing nutritional status and diabetic foot ulcer risk.
To read Part 1, Click Here
To read Part 2, Click Here

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By Mary Ellen Posthauer, RDN, CD, LD, FAND

After reading Laurie Swezey's blog, "Diabetic Foot - Risk Factors and Prevention", I decided to weigh in on the issue of poor glycemic control. Teamwork is an essential ingredient since achieving glycemic control is a challenge for all clinicians including the registered dietitian (RD).

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By Mary Ellen Posthauer RDN, CD, LD, FAND

As the ethnic diversity in the United States continues to increase, clinicians should understand how food, culture and religious practices impact the nutrition interventions we recommend. According to the Census Bureau in 2010 Hispanics were the largest minority group in the US followed by African Americans and then Asians. Estimates are that by 2050 the minority population will reach 54% of the US population. The Hispanic population is anticipated to triple and the number of Asians will double.

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By Mary Ellen Posthauer RDN, CD, LD, FAND

In response to Dr. Michael Miller's February blog, I would like to educate readers on the role and responsibility of the registered dietitian (RD) on the wound care team. The RD's educational and professional requirements include completing a bachelor's degree in nutrition from an accredited university, completing an accredited supervised practice program (usually 12 months) and passing the national examination to become a registered dietitian with the Commission on Dietetic Registration. All registered dietitians must maintain continuing professional educational requirements. Many RDs have a master's degree and/or have completed additional certifications in specialized areas of practice, such as certification for nutrition support (CNSD). The alphabet soup of letters for RDs is no different than the multiple initials behind many other professionals' names, including Dr. Miller's. Sorry, there is no secret handshake. Certification and licensure are state dependent just as in other health care professions. Dietetic registration and state licensure requirements also define scope of practice and define continuing education requirements. My own practice includes both the state of Indiana where I am certified to practice, and the state of Illinois, where I am licensed to practice.

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