NFSC 670 Topics in Clinical Nutrition Fall 2016 Instructor: Mike McCafferty, MS, RD, CNSC Office: Holt 325 E-mail: mmccafferty@csuchico.edu Phone: 898-4006 Office Hours: Wednesdays 5:00 6:00 pm, after class or by appointment Prerequisites: NFSC 470; Biochemistry Required Texts: Nelms and Anderson. Medical Nutrition Therapy: A Case Study Approach, 4e, Wadsworth Pub. 2014 Nelms, Sucher, Lacey. Nutrition Therapy and Pathophysiology, 2nd or 3 rd ed. Wadsworth. 2011, 2016, or other Clinical Nutrition text Recommended: International Diet and Nutrition Terminology Reference Manual. American Dietetic Association. 2011 or encpt, 2014 Escott-Stump. Nutrition and Diagnosis-Related Care, 8 th ed. Lippincott Williams and Wilkins Pub. 2015. Pronsky. Food Medication Interactions, 15 th or newer edition. Additional readings as identified in the syllabus and during lecture Catalogue Description A review and application of selected contemporary issues in therapeutic nutrition. Role of dietitian as health care team member is considered and examined. Course Objectives Upon successful completion of this course, students will demonstrate: 1. A working knowledge of the nutrition care process 2. The ability to identify and state nutrition related problems, goals and evidence based interventions 3. A working knowledge of outcomes based research 4. The ability to assess and adjust enteral and parenteral nutrition regimens 5. The ability to interpret clinically relevant lab data 6. Familiarity with web sites and print resources pertinent to the practice of MNT Grading Point In-class & take home application activities; post tests; Participation 100
Case Study answers 50 Exams (2 @ 100 pts each) 200 Case Study Seminar 100 Final exam 100 550 Grading Scale (percent) > 90 A 80-89 B 70-79 C 60-69 D < 60 F Topics Covered (subject to change) Nutrition Care Process MNT Protocols, Evidence Based Nutrition Diabetes Renal Diseases Metabolic Stress Enteral and Parenteral Nutrition Support Clinical Nutrition Assessment Anthropometrics, pertinent lab data, effects of medications on nutritional status Problem, goal and intervention statements Seminar/Presentation Guidelines 1. Once you are assigned your case study, review the entire case study. 2. Arrange to meet with the instructor at least 2 weeks prior to your presentation to review rough draft of presentation and to discuss any difficulties or questions related to presentation preparation. By that date all answers to questions in the case study should be researched and answered to the best or your ability. 3. Presentation should be about 30-45 minutes long. 4. Use powerpoint to present your case study information. 5. Include at least 3 internet links to web pages that provide supporting information. Embellish the information in your presentation with clinical examples, videos, etc. Provide adequate information, with support from references, to enable the class to understand the rationale for MNT. 6. Prepare a < 6 page outline (not including references). Use 12 point, Times New Roman font. Number pages. Use bolded headings for sections. Outline should include references in APA format. Reference at least 5 original research articles. Be careful to only use credible sources. 7. All case study presentations and outline should include: Post test: (5 questions) Handout with outline. Multiple choice, true or false or single fill-in questions only. At least 3 learning objectives for your seminar Introduction to your patient (brief description, diagnosis and background info).
Pathophysiology of disease Assessment of case study data (in assessment format) Anthropometric assessment Estimated nutritional Requirements Intake adequacy assessment (kcal, protein, fluid, micronutrient) Gastrointestinal status/meal or feeding tolerance assessment Interpretation of pertinent lab values Evaluation of nutritionally relevant medications Skin assessment/physical exam data Malnutrition classification Nutrition diagnosis (PES format) Nutrition goals (specific and measurable) Nutrition Interventions Plan for Monitoring and Evaluation Initiate Q&A with class during or after presentation is finished and before post-test Email your finalized outline as an attached file to each person in the class and to the instructor by the Monday before your presentation or bring copies for all class members on the day of your presentation. Hand in your case study answers the day of your presentation.
Course Schedule/Seminar Topics (subject to change) Date Topic Readings August 24 Course Overview/Nutrition Care Process Overview (ADIME/PES)Nutrition Assessment: History/Physical, Anthros August 31 September 7 Assessing energy, Fluid and Protein needs and intake adequacy. Assessing diet and feeding tolerance. Interpreting Lab Values. Nutritionally relevant medications, Food Drug Interactions Nelms: pages 14-32; Chapter 6. ADA Evidenced Based Library: encp or IDNT. www.eatright.org. Nelms pages 34-58; Journal Articles 1. Journal Article # 2. Nelms pages 54-57; Chapter 11. September 14 Malnutrition Classification /Physical Assessment. Article #3; Nelms: pages 58-61 September 21 Enteral Nutrition Nelms: Ch 5; Journal Articles 4, 5 September 28 Exam 1 October 5 Parenteral Nutrition Nelms: Ch 5; Journal articles 4,5 October 12 Case Study 2PES Nelms: 253-262 workshop October 19 CS: 6CS: 8 Nelms: 322-328 October 26 Nelms: 415-420Nelms: CS: 11CS: 12 437-459 November 2 November 9 November 16 November 23 November 30 December 7 December 14 Exam 2 CS: 17 CS: 18 CS: 23 CS: 27 No Class CS: 29 CS: 31 CS: 33Final Exam Review Final Exam Nelms: pages 482-506; Journal Article 6Nelms: 530-549 Nelms: 617-622; 354-358Nelms: Chapter 21 Nelms: Ch 22: 683-687; 696-697Nelms: 691-692; JA 7,9 Nelms: 352-354; Chapter 23 Journal Articles (posted on Blackboard): 1. Nutrition Assessment Tutorial 2. The Use of Prealbumin and C-Reactive Protein for Monitoring Nutrition Support in Adult Patients Receiving Enteral Nutrition
3. Consensus Statement: Characteristics Recommended for the Identification and Documentation of Adult Malnutrition 4. Guidelines for Parenteral and Enteral Nutrition 5. Safe Practice for Parenteral Nutrition 6. Management of Hyperglycemia in Type2 Diabetes: A Patient-Centered Approach 7. A.S.P.E.N. Clinical Guidelines: Nutrition Support of Hospitalized Adult Patients With Obesity 8. Vasoactive Substances in Critically Ill Patients 9. Guidelines for Nutrition Support in Critically Ill Patients.