1: Assessing Nutritional Intake

Question 1

How do NICE define malnutrition

Answer 1

BMI less than 18.5
BMI >20: weight loss of 10% in 3-6 months
BMI <20: weight loss of 5% in 3-6 months

Question 2

What % of over-65s are malnourished

Answer 2

10

Question 3

How are patients screened for malnutrition

Answer 3

MUST (malnutrition universal screening tool)

Question 4

What is a mnemonic to remember 5 steps of MUST score

Answer 4

BUD(i)SM

Question 5

Explain first step MUST score (B)

Answer 5

BMI

BMI <18.5 = 2 points
BMI 18.5 - 20 = 1 point
BMI >20 = 0 points

Question 6

Explain second step of MUST score

Answer 6

Unintentional weight loss

>10% =  2 points 
5-10% = 1 point 
<5% = 0 points

Question 7

Explain third step of MUST score (D)

Answer 7

Disease which means individual has poor nutritional intake or means individual is unlikely to have eating in 5d = 2-points

Question 8

Explain fourth step of MUST score (S)

Answer 8

Score - add up the scores to determine risk

0 = Low risk 
1 = Medium risk 
2= High risk

Question 9

If a patient is low-risk, how are they managed

Answer 9

Routine clinical care

Question 10

If a patient was deemed low risk in hospital, when is there MUST score re-assessed

Answer 10

Weekly

Question 11

If a patient was deemed low risk in a nursing home, when is there MUST score re-assessed

Answer 11

Monthly

Question 12

If a patient was deemed low risk in a hospital, when is there MUST score re-assessed

Answer 12

Annually

Question 13

What score is a medium-risk score

Answer 13

1

Question 14

If a patient is medium risk how should they be managed

Answer 14

Document oral intake for 3-days

Question 15

If oral intake for 3d is insufficient what is done

Answer 15

Nutritional support as per guidelines

Question 16

If a patient was deemed medium risk in a hospital, when is there MUST score re-assessed

Answer 16

Weekly

Question 17

If a patient was deemed medium risk in a nursing home, when is there MUST score re-assessed

Answer 17

Monthly

Question 18

If a patient was deemed medium risk in community, when is there MUST score re-assessed

Answer 18

2-3 Monthly

Question 19

If a patient is high-risk, what should be done

Answer 19

Refer to dietician

Question 20

If a patient is high-risk, when is their MUST score re-assessed

Answer 20

Weekly

Question 21

What are two rules of maintaining nutritional intake

Answer 21

Use Oral Route where possible

‘Food-first’ approach = encourage someone to increase calorie intake in food (eg. full fat cream on potatoes before oral nutritional supplements)