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Putting the 2019 Nutrition Recommendations for Pressure Injury Prevention and Treatment into Practice

Advances in Skin & Wound Care: September 2020 - Volume 33 - Issue 9 - p 1-2
doi: 10.1097/01.ASW.0000693884.17540.5e
  1. Compared with previous editions of the Clinical Practice Guideline for Prevention and Treatment of Pressure Ulcers/Injuries (CPG), the 2019 edition has
    1. more recommendations.
    2. fewer recommendations.
    3. about as many recommendations.
  2. All of the nutrition recommendations in the 2019 CPG
    1. are supported by level A evidence.
    2. received a positive strength of recommendation rating.
    3. received lower strength of evidence ratings than the 2014 recommendations.
  3. Indirect evidence reported by Bourdel-Marchasson et al (2000) and Roberts et al (2014) demonstrates that providing nutrition supplements to malnourished individuals at risk of pressure injury (PI) results in
    1. improved energy intakes.
    2. fewer PIs.
    3. significant weight gain.
  4. Studies by Houwing et al (2003) and Hartgrink et al (1998) showed which of the following effects on PI after ingesting high-calorie and high-protein nutrition supplements?
    1. greater incidence
    2. reduced incidence
    3. no significant effect
  5. In reference to a higher consumption of energy and protein reducing the incidence of PI for individuals who were malnourished or at risk of malnutrition and also at risk of PI, the nutrition small working group involved in the development of the 2019 CPG
    1. did not find high-quality research evidence to support this intervention.
    2. advised against optimizing energy and protein intake for these individuals.
    3. cited recent randomized controlled trials in support of energy and protein consumption.
  6. For older adults, adults with acute or chronic diseases, and critically ill adults who do not have a chronic wound, evidence-based clinical guidelines recommend higher energy requirements and a daily protein intake of at least
    1. 0.5 g protein/kg body weight.
    2. 1 g protein/kg body weight.
    3. 2 g protein/kg body weight.
  7. According to Banks et al (2013) and others, increasing energy and protein intake in adults at risk of PI who are malnourished or at risk of malnutrition results in
    1. increased costs of care.
    2. little difference in risks.
    3. reduced lengths of hospital stay.
  8. The results from a 2009 to 2015 survey using the Malnutrition Screening Tool reported that about one-third of non-ICU acute care patients in the US
    1. were at risk of malnutrition.
    2. were seriously malnourished.
    3. had a long history of malnutrition.
  9. The 2019 CPG emphasized the importance of actively screening individuals whose clinical condition worsens for indicators of
    1. systemic infection.
    2. integumentary fragility.
    3. declining nutrition status.
  10. The 2019 CPG nutrition chapter provides implementation considerations specific to screening for malnutrition, the characteristics of malnutrition in children and adults, components of a comprehensive nutrition assessment, and
    1. individualized nutrition care planning.
    2. timelines for implementing changes.
    3. standardizing nutrition delivery.
  11. The 2019 CPG recognizes that individuals who are malnourished, with PIs or at risk of developing them, or with any significant change in condition should be referred to a
    1. social worker to assess for food insecurity.
    2. primary care physician for a comprehensive physical examination.
    3. registered dietitian/nutritionist for an in-depth nutrition assessment.
  12. The 2019 CPG reflects the shift in clinical nutrition care interventions to provide malnourished and frail adults with
    1. prehabilitation prior to surgery.
    2. increased hydration via free water intake.
    3. liberalization of medically necessary dietary restrictions.
  13. To help reduce the rates of postoperative wound infection and insulin resistance, Kielhorn et al (2018) and others recommend that patients ingest which of the following up to 2 hours prior to surgery?
    1. high-protein drinks
    2. carbohydrate beverages
    3. copious amounts of water
  14. For adults with a stage 2 or worse PI who are malnourished or at risk of malnutrition, the 2019 CPG recommends providing oral nutritional supplements (ONSs) or enteral formulas that contain
    1. zinc.
    2. iron.
    3. folate.
  15. Cereda et al (2015) demonstrated that when patients consume a high-calorie, high-protein, disease-specific ONS containing specifically indicated nutrients for more than 4 weeks, the likelihood of their PI healing
    1. doubles.
    2. triples.
    3. quadruples.
  16. Sorita and Thongprayoon (2015) stated that lengthy periods of fasting prior to diagnostic testing and surgery
    1. reduce appetite.
    2. increase appetite.
    3. have no effect on appetite.
  17. To rate or score food attributes of ONSs provided in a facility, the author suggests that nursing and medical staff rate them on taste, aroma, and
    1. cost.
    2. texture.
    3. nutrition value.
  18. Mai and Hoffman (2012) noted that, in some healthcare settings, it may be possible to invite individuals at risk of malnutrition to participate in
    1. clinical trials.
    2. self-assessments.
    3. product taste tests.
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