46. Nutrition in Medicine Flashcards
Distinguish between malnutrition and undernutrition.
What are the most vulnerable groups for undernutrition?
Whar are some consequences of undernutrition in:
a) community
b) hospital
Undernutrition is a form of malnutrition resulting from a reduced supply of food or from inability to digest, assimilate, and utilise the necessary nutrients (macro, micro, trace)
Chronic disease, old, recently discharged, low income, socially isolated
a) falls, depression, infection risk, dependency
b) increased morbidity/stay length/dependancy/mortality/care costs
What are the 3 main causes of disease-related undernutrition?
What is used to assess nutrition in hospital?
1) Reduced nutritional intake (anorexia, side effects of treatment, pain, dysphagia, physical disability, NbM, cancer)
2) Increased nutritional requirements (inflammation/infection, pyrexia, tissue healing, metabolic effects)
3) Increased nutritional losses (malabsorption, wound exudate/burns)
NICE/MUST score once a week. 0 = low risk. 1 = medium risk (observe). 2/more = high risk (treat)
Is albumin a marker of malnutrition?
List some levels of nutritional support in hospital (low to high).
What are the laws regarding nutritional support?
No, although can be low in malnourised pts. Illness monitor, NOT nutrition monitor.
Increased intake of normal diet. Prescribable supplements. Specialist enteral feeds. NG/gastronomy tube. Parenteral nutrition (directly into vein)
ETF (enteral tube feeding) and PN (parental nutrition) are not basic care - they are deemed medical treatments. No distinction between withholding and withdrawing artificial nutrition. Good practice needs MDT. Competent pt has right to refuse artifical hydration.
