1: Surgical Nutrition Flashcards
Explain why malnutrition is a problem in surgical patients
Malnutrition is associated with poorer outcomes. Surgery is a stressor that stimulates further cortisol release - leading to catabolism
Explain relationship between malnutrition and outcomes
Malnutrition = causes worse surgical outcomes (eg. wound healing)
When should patients be assessed for malnutrition and how
MUST in pre-operative assessment
If individual is unable to take sufficient calories orally what is used
Oral nutritional supplement (ONS)
If individual is unable to take sufficient calories orally with supplement or unsafe swallow what is used
NG Tube
If oesophagus is occluded (eg. atresia) what is used
Gastrostomy (PEG)
If gastric outflow is occluded, what is used
Jejunum (PEJ)
if jejunum is inaccessible what is used
Parenteral
What has been introduced to prevent malnutrition in post-surgical patients
Enhanced recovery after surgery (ERAS)
What are the 5 points of enhanced recovery after surgery
- Reduced time patient is NBM. Just clear fluids up to 2-hours before
- Pre-operative carbohydrate loading
- Minimally invasive surgery
- Rapid re-introduction of feeding post-op
- Earlymobilisation
What time-frame after surgery can patients start nutrition
24h