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Hfn 416: Advances Clinical Dietetics Question Paper
Hfn 416: Advances Clinical Dietetics
Course:Bachelor Of Science In Food, Nutrition And Dietetics
Institution: Kenyatta University question papers
Exam Year:2012
KENYATTA UNIVERSITY
UNIVERSITY EXTERMINATIONS 2011/2012
SECOND SEMESTER EXAMINATION FOR THE DEGREE OF BACHELOR OF SCIENCE (FOODS, NUTRITION AND DIETETICS)
HFN 416: ADVANCES CLINICAL DIETETICS
DATE: Monday 2nd April 2012 TIME: 2.00 P.M - 4.00 P.M
______________________________________________________________________________
INSTRUCTIONS: Answer ALL the questions.
1. Discuss the steps in nutrition care process. [10 marks]
2. Discuss the tools used for assessing nutrition status. [10 marks]
3. Mrs. Irene is a 30 year old lecturer who suffered multiple fractures when she fell from a cliff
while hiking. She has been in the hospital for several days and has no appetite. She has lost 2.5
kgs in course of her hospitalization. Mrs. Irene is in traction and is immobile although the head
of her bed can be elevated to 30o. The health care team agrees that a naso duodenal tube feeding
should be instituted. It was determined that Mrs. Irene’s nutrient requirement can be met with
2200mls of formula per day.
a) What steps can the health care team take to prepare Mrs. Irene for tube feeding? [4 marks]
b) Why might naso duodenal placement of the feeding tube be preferred to nasogastric placement for Mrs. Irene? [3 marks]
c) What factors would determine Mrs. Irene’s formula selection. [4 marks]
d) The physician order specified that the feeding should be given continuously over 18 hours. Develop tube feeding schedule for Mrs. Irene. [2 marks]
e) Discuss measures that you would take to prevent contamination during formula preparation.
[6 marks]
f) After three days of feeding, Mrs. Irene developed diarrhea. Determine the possible causes and measures to correct diarrhea. [6 marks]
4. Mr. Patel is a retired news caster who first visited his doctor when he noticed that he was losing weight rapidly and was easily fatigued. He also had a lesion in his mouth that wouldn’t heal. Mr. Patel smokes a packet of cigarettes a day and has a history of alcohol abuse. After admission the doctor confirmed a diagnosis of the cancer of the mouth. The doctor would like to
prepare Mr. Patel nutritionally before proceeding with a radiation therapy. A thorough nutrition
assessment reveals that Mr. Patel is suffering from severe PEM. His weight is 60 kgs and his height is 175cm.
a) From this assessment
i) What other anthropometrical measurement would be affected? [1 mark]
ii) Given his PEM status what lab tests would you expect to find. [1 mark]
iii) How might Mr. Patel’s past history have affected his nutrition status before he developed cancer? [1 mark]
b) List two nutrition diagnosis for Mr. Patel. [2 marks]
c) After radiation therapy Mr. Patel developed poor appetite, nauseas and vomiting, dry and sore moth and chewing and swallowing problems. Develop a nutrition care plan for him high lighting the following:
i) Mr. Patel’s nutrition education needs in order to improve nutrient intake. [10 marks]
ii) Prepare a Meal Plan for Mr. Patel using the guide below. [10 marks]
Food exchange
Amount (g)
Proteins
Carbohydrates (g) Fat (g)
Energy (kcal ls)
Milk
250ml
8
12
10
170
Meat
40g
7
Neg
5
70
Pulse
30g
7
17
Neg
100
Cereal bread
20g
2
15
Neg
70
Vegetables A
100
2
7
Neg
40
B
100-150
2
7
Neg
40
Fruit
Variable
Neg
10
Neg
40
Fat
5
-
-
5
45
Sugar
5
-
5
-
20
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