Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

LSS Alimentary System > 18 Malnutrition > Flashcards

18 Malnutrition Flashcards

1
Q

Q: Define malnutrition. What can it include?

A

A: state of nutrition in which a deficiency or excess (or imbalance) of energy, protein and other nutrients causes measurable adverse effects on tissue / body form (body shape, size and composition) and function and clinical outcome

The term malnutrition does include obesity, however this session will relate to “undernutrition” only.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Q: What are the basic causes of malnutrition? (3) Underlying causes? (3) Immediate causes? (2)

A

A: underlying causes: Household food insecurity
Poor social and care environment
Poor access to healthcare & unhealthy environment

basic causes: Formal and internal infrastructure
Political ideology
Resources

Inadequate food
Disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Q: What are potential consequences of being malnourished? (8)

A

A: - reduced ability to fight infection

  • muscle weakness-> falls, heart failure
  • kidney problems-> inability to regulate salt and water
  • brain-> depression, self neglect
  • reduced fertility
  • decreased ability to control temperature
  • growth failure- stunting
  • micro-nutrient deficiences eg C (scurvy), B12 (anaemia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Q: How do we diagnose malnutrition?

A

A: 1. nutritional screening

  1. nutritional assessment
  2. nutritional diagnosis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Q: What is nutritional screening? (4)

A

A: QUICK and simple, practical
During initial assessment of patient; regular intervals
By non-nutrition professional

not diagnosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Q: What is a nutritional assessment? (3)

A

A: More detailed, in-depth
Could use anthropometrics
By a dietitian or specialist nutrition nurse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Q: How would you identify malnutrition?

A

A: -body size changes- weight, weight loss, BMI

  • food intake (food diary)
  • biochemistry- urea, creatinine, albumin & CRP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Q: What does nutritional support mean? Types? (3)

A

A: “Nutrition support is nutrition therapy for people unable to get enough nourishment from food and drink”

  • if GIT is functioning-> oral dietary supplements/enteral feeding if they can’t take orally
  • if GIT is not functioning-> parenteral feeding

enteral and parenteral= artificial nutritional support

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Q: What is enteral nutrition? Access routes? (6)

A

A: Enteral tube feeding refers to the delivery of a nutritionally complete (usually everything they need) feed via a tube into the stomach, duodenum or jejunum

A tube is placed into GI tract to deliver liquid food.

Specifically named after destination from nose: nasooesophageal, nasogastric, nasoduodenal;

Or destination through percutaneously: oesophagostomy, gastrostomy, jejunostomy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Q: What is nasogastric enteral feeding for? (2)

A

A: Individuals temporarily unable to meet their nutritional requirements by oral route but with functioning GI tract

Individuals requiring nutritional support for <1 month.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Q: What is gastromic enteral feeding for? (2) Morbidity associated with it? What happens if placed inappropriately?

A

A: (destination through percutaneously)

Long term enteral feeding >1 month

i.e neurological swallowing problems eg stroke, cognitive impairment, mechanical obstruction

Low morbidity associated with placement (2%)

But when placed inappropriately, high post insertion mortality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Q: When is a jejunostomy tube (enteral feeding) needed? (3)

A

A: Upper GI obstruction or fistulae i.e. oesophagus stricture neoplastic disease of stomach/ duodenum

Early post-op feeding i.e. post-oesophagectomy, gastrectomy, pancreatoduodenectomy

Management of long term delayed gastric emptying

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Q: How do you assess energy requirement?

A

A: Indirect calorimetry: gold standard for measured energy expenditure (good for research)

but in practice:
-predictive eqn eg weight based= 25-30kcal/Kg

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Q: What can go wrong with enteral feeding? (5)

A

A: -Nausea and Vomiting:

Tube problems

Diarrhoea

Constipation

Metabolic Complications

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Q: What can cause nausea and vomiting (enteral feeding)? (4)

A

A: Medication induced
High enteral feed volume too quickly
Delayed gastric emptying (if you’re going nasogastric route)
GI obstruction / ileus (post-op patients)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Q: What a tube problems in relation to enteral feeding? (4)

A

A: -Nasopharyngeal pain/ laryngeal ulceration. Tube blockage

  • Aspiration of feed into lungs
  • Misplacement of tube in lungs
  • Migration of tube or accidental removal
17
Q

Q: What can cause diarrhoea (enteral feeding)? (4) Constipation? (2)

A

A: -Intestinal infection

  • Osmotic over load
  • Medications
  • Malabsorption
  • Insufficient fluid/ fibre intake
  • Decreased intestinal mobility
18
Q

Q: What can cause metabolic complications (enteral feeding)? (2)

A

A: -Due to over or under feeding

-Re feeding syndrome

19
Q

Q: What is parenteral feeding? How can it be given? (2) Compared to enteral?

A

A: The administration of nutrients, either centrally or peripherally, where the gastrointestinal tract is inaccessible OR there is insufficient gastrointestinal function.

PN may be given as the sole source of nutrition support (total parenteral nutrition -TPN) OR in combination with oral or enteral nutrition to meet a patient’s nutritional requirements.

less common, more complications

20
Q

Q: Where is ‘access’ in parenteral feeding?

A

A: Peripherally inserted central catheter in arm (PICC)

eg cephalic vein

21
Q

Q: When is parental feeding used? (3)

A

A: to prevent or treat malnutrition when the gastrointestinal (GI) tract function is impaired or inaccessible and the patient is therefore unable to absorb an adequate supply of nutrients

PN should only be considered when all routes of enteral nutrition have been considered and dismissed as clinically inappropriate

The potential risk outweighs benefit for the patient if PN is used for < 5 days

22
Q

Q: What are the complications that can arise from parenteral feeding?

A

A: -Pneumothorax (collapsed lung) (insertion problem)

  • bleeding (insertion problem)
  • line sepsis
  • thrombosis in line
  • blockage in line
  • re feeding syndrome (short term metabolic problem)
  • liver disease (long term)
23
Q

Q: What are the main advantages of enteral nutrition? (5) 3 main complications?

A

A: -lower risk of death

  • less complications and easier than PN
  • food and nutrient intake can be controlled
  • no atrophy of gatsrointestinal structures through underuse (as with PN) // Maintains the internal structure and function of GI tract
  • cheaper than PN

Nausea
Vomition
Aspiration
(lower risk of complications)

24
Q

Q: What are the main advantages of T parenteral nutrition? (3) 4 main complications? cost?

A

A: -ensure nutrition when EN is inappropriate
-quicker absorption as going straight to blood stream

Blood clots
Infection
Liver failure
Causes atrophy of gatsrointestinal structures through underuse
(High risk of serious complications)

5x more expensive

25
Q

Q: What is refeeding syndrome? When does it usually occur? Mechanism (4).

A

A: syndrome consisting of metabolic disturbances that occur as a result of reinstitution of nutrition to patients who arestarved or severely malnourished

when a person has been starved for 5 or more days and then given nutrition

  1. starving for 5 or more days
  2. metabolic effects of starvation (less insulin, more glucagon, more cortisol, depletion of fats etc)
  3. feed patient (get insulin secretion after feeding and effects)
  4. refeeding syndrome (adverse- using up thiamine to deal with food intake)
26
Q

Q: Name some consequences of refeeding syndrome. (6)

A

A: -convulsions

  • renal failure
  • peripheral oedema
  • Congestive heart failure
  • cardiac arrest
  • coma
27
Q

Q: How do you manage refeeding syndrome?

A

A: -check biochemistry daily and replace electrolytes as required eg K

  • Vitamin supplementation for first 10 days of feeding: Vitamin B Co Strong/ Thiamine
  • Start nutrition support at a maximum of 10 kcal/kg/day (increasing slowly)
28
Q

Q: What is alcohol biochemically? How many metabolic pathways does it have? How does alcohol affect the body physically? (5)

A

A: C2H5OH

3

CNS – Cerebral atrophy, Peripheral neuropathy

CVS – Hypertension, Stroke
GIT – Cirrhosis, Liver Cancer
GUT – Renal failure
LMS – Gout
Endocrine &amp; Reproduction – Subfertility

LSS Alimentary System (17 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions