DASAR KETERAMPILAN KLINIK GIZI

DASAR GIZI KLINIKOLEH

dr. HAERANI RASYID,MS,SpPD BAGIAN GIZI FKUH

Nutritional Assessment

Nutritional Assessment

Nutritional Assessment

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Screening and Nutrional Assesement

Identifikasi individu yang memerlukan asuhan nutrisi yang khusus Tentukan derajat dan penyebab terjadinya kekurangan/kelebihan gizi Tentukan resiko kemungkinan terjadinya kekurangan gizi atau terjadinya suatu komplikasi

- Pengukuran Status Gizi- Dasar Penentuan Diet Orang Sehat-Sakit

Nutritional Screening Involuntary increase or decrease in weight > 10% of usual weight over 6 months or > 5% of usual weight over 1 month Inadequate oral intake

Nutritional AssessmentSubjective Global Assessment of Nutritional Status

Body composition Biochemical data Clinical Assessment Subjective Global Assessment (SGA)

A. History1. Weight change Overall loss in past 6 months: ________ kg Change in past 2 weeks: increase Percent loss ________ no change decrease

2. Dietary intake change relative to normal No change ________ Change: duration ________ weeks ___ ____ months

Type: sub-optimal solid diet ________ full liquid diet ________ hypocaloric liquid diet _______ starvation ______ 3. Gastrointestinal symptoms (persisting more than 2 weeks) None Nausea ________ Vomiting Diarrhea ________ Anorexia _______

4. Functional capacity No dysfunction ___________ Dysfunction: duration _______ weeks _______ months ambulatory _________ bedridden _________

Type: working sub-optimally ________

5. Disease and its relationship to nutritional requirements Primary diagnosis: ____________________________ Metabolic demand / Stress: none ________ low ________ moderate ________ high ________

B. Physical Examination(for each specify: 0 = normal, 1+ = mild, 2+ = moderate, 3+ = severe) Loss of subcutaneous fat (triceps, chest) ______________ Muscle wasting (quadriceps, deltoids) _________________ Ankle edema ________ Sacral edema ________ Ascites ________

C. Subjective Global Assessment RatingWell nourished Moderately (or suspected) of being) malnourished Severely malnourished A B C

Nutritional Assessment: Body Composition Parameter Weight and height BMI = weight / height2 Triceps or subscapular thickness of skin fold Mid-arm muscle circumference and mid-arm muscle area

Nutritional Assessment: Biochemical Parameters Serum albumin Total lymphocyte count Serum transferrin Serum pre-albumin Total iron-binding capacity Serum cholesterol At Risk Level < 3.5 g/dL < 1500 cell/mm3