6: Malnutrition

Question 1

What is malnutrition?

Answer 1

Excess, deficiency or imbalance of nutrition causing measurable adverse effects on health

Question 2

A large proportion of patients admitted to hospital are at risk of ___.

Answer 2

malnutrition

Question 3

Patients with atrophied muscle due to malnutrition are more likely to develop which complication of a hospital stay?

Answer 3

Pressure ulcers

Question 4

What can infection lead to in patients with malnutrition?

Answer 4

Sepsis

Question 5

Malnutrition is ___ in the short term but ___ in the long term.

Answer 5

adaptive

harmful

Question 6

What is anorexia?

Answer 6

Loss of appetite

not to be confused with anorexia nervosa which is the eating disorder

Question 7

Why can intestinal diseases like Crohn’s and Coeliac disease cause malnutrition?

Answer 7

Impaired digestion & absorption of nutrients

Question 8

Why may cells have increased nutritional requirements which, unmet, causes malnutrition?

Answer 8

Cancer (increased metabolic demand)

Question 9

Elderly people at risk of malnutrition tend to have low __ levels.

Answer 9

Vitamin

Question 10

Which plasma protein tends to be low in patients who are malnourished?

Answer 10

Albumin

Question 11

Eating food / snacks / sip feeds

Delivery of nutrition through a tube directly into the gut

Delivery of nutrition intravenously

Name each type of nutrition.

Answer 11

Oral nutrition

Enteral nutrition

Parenteral nutrition

Question 12

Under which BMI should patients receive nutritional support?

Answer 12

< 18.5

(or < 20.0 AND weight loss of 5% in past 6 months)

Question 13

A patient should be considered for nutritional support if they’ve lost __% of their body weight within 6 months.

Answer 13

10%

Question 14

If a patient is unlikely to eat for _ days or longer, they should be considered for nutritional support.

Answer 14

5

Question 15

What are some examples of oral nutritional supplements?

Answer 15

Sip feeds

Powders

Puddings

Question 16

Which type of nutrition involves delivery via a tube into the stomach, duodenum or jejunum?

Answer 16

Enteral nutrition

Question 17

Name three kinds of enteral feeding tube.

Answer 17

Nasogastric (NG)

Nasoduodenal (ND)

Nasojejunal (NJ)

Question 18

What are the indications for enteral feeding?

Answer 18

Patient is unable to take food/drink orally

BUT their GI tract works

Question 19

What are some contraindications for enteral feeding?

Answer 19

GI obstruction

Severe diarrhoea or vomiting

Proximal fistula

Intestinal ischaemia

Question 20

What is parenteral nutrtion?

Answer 20

Delivery of nutrition through a vein

Question 21

Parenteral nutrition involves feeding through (central / peripheral) veins.

Answer 21

haha got you

both

Question 22

What are the indications for parenteral nutrition?

Answer 22

Unable to take in food orally and/or enterally

Non-functioning GI tract

Question 23

The ___ ___ of patients varies depending on their age and the illness they have.

Answer 23

energy requirement

Question 24

What syndrome can be caused by excessive feeding following malnutrition?

Why does it occur?

Answer 24

Refeeding syndrome

Imbalances in fluids and electrolytes which causes cell/organ damage

Question 25

By which feeding methods is refeeding syndrome likely to occur?

Answer 25

Parenteral/enteral nutrition

tends not to occur orally due to appetite

Question 26

Why do cells fail when a malnourished person is fed too quickly?

Answer 26

Electrolyte imbalance

Question 27

In malnutrition, which elements of the diet aren’t absorbed properly?

Answer 27

Protein

Carbohydrate

Fats

Vitamins

Minerals

Question 28

Which metal ion is low in patients with malnutrition?

Answer 28

Zinc

Question 29

Refeeding syndrome is associated with (low / high) levels of electrolytes.

Answer 29

low

e.g hypokalaemia, hypophosphataemia, hypomagnesaemia