○ Patients consuming ethnic cuisine- accurate diet history will require familiarity with the types of foods and cooking methods used; may need to refer to registered dietitian ○ Children- obtained from parents; diets highly variable and change quickly- so should include both parent and child in the history taking; older children can just list foods they ate- at the clinic can determine amount eaten by recall ○ Adolescents- not motivated to give complete and accurate report; might need multiple probing questions ○ Elderly- memory impairment- need direct observation or inventories of food stores in the home List the food groups and recommended number of servings from each group per day (for someone eating 2000 calories per day) based on MyPyramid.gov. ○ Grains- half your grains whole – 6 ounce equivalents per day ○ 1 ounce equivalent is: 1 piece of bread, 1 cup of cereal, ½ cup cooked rice/ pasta/ cereal; ○ Vegetables- vary veggies; 2.5 cups per day ○ 1 cup of raw or cooked vegetable or vegetable juice or 2 cups of raw leafy greens is considered 1 cup ○ Fruit- 2 cups per day (one half cup of dried fruit equals one cup fresh, frozen or canned fruit) ○ Meat and Beans- 5.5 oz per day (a 3 oz serving of meat is about the size of a deck of cards; equivalent for 1 oz- ¼ cup dry beans, 1 egg, 1 tablespoon peanut butter..) ○ Milk- 3 servings per day (1 cup of milk, 1/5 oz natural cheese, 2 oz processed cheese can be considered 1 serving)
Substance Abuse (pg. 60) Given a case or scenario, differentiate the categories of substance abuse continuum. ● Physical dependence: substance use which when reduced elicits stereotypical withdrawal symptoms ● Preoccupation: frequent occurrence of unwelcomed, intrusive thoughts of using and obtain substance ● Compulsive Use: Patter of use which is especially difficult to stop using once has started ● Loss of Control: Hijacking of pleasure reward system in which substance use drives the system Analyze a patient history for presence of alcohol/drug risk factors. ● An attribute of exposure that increases the chance of a particular event ● Risky Drinking ○ Men, Age 18-24, Native American or Hispanic ● Alcohol Dependences ○ Family History ○ Psychosocial risk factors Difficult to control behavior, aggressiveness, anti-social behavior in early childhood Presence of another psychiatric disorder Early initiation of drinking Child abuse and other traumas Positive expectations/exposure to alcohol advertizing Analyze a patient presentation to determine need for ETOH screening. ● Screening: a rapid, proactive procedure to identify individuals who may have a condition or may be at risk for a condition before obvious manifestations occurs ● Levels of Prevention ○ Primary: prevent a problem before it occurs ○ Secondary: identify a problem and intervene early ○ Tertiary: reduce the impact for individuals with problems ○ Universal: for everyone ○ Selective: for those at risk ○ Indicated: for individuals with a problem ● Types of Screening ○ Single Alcohol Screening Question Men: when is the last time you had more than 5 drinks?
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- Spring '13
- Health care provider, medical interview