8 - Nutrition Flashcards
What are some causes of malnutrition
See image for specifics
- Reduced dietary intake
- Malaborption
- Increased losses
- Energy expenditure
What are the consequences of malnutrition on the following:
How can we screen for malnutrition?
MUST (5 Steps)
- BMI
- Unintentional weight loss
- Likelihood of future weight loss
What are the four stages of wound healing?
- Haemostasis
- Inflammation
- Proliferation
- Remodelling
How do the following factors influence wound healing and what stages are affected of the healing process:
- Oxygenation
- Infection
- Foreign body
- Venous Insufficiency
- Oxygenation: oxidative killing of bacteria, regeneration of collagen, epithelial cell migration, formation of new blood vessels
- Infection: prolonged inflammatory phase
- Foreign body: prolonged inflammatory phase
- Venous Insufficiency: venous hypertension so lack of oxygen and nutrients to area so tissue damage and breaks down
What are some local and systemic factors that can affect wound healing?
Local: oxygenation, infection, foreign body, venous insufficiency
Systemic: age, stress, ischaemia, diabetes, uraemia, obesity, steroids, NSAIDs, chemotherapy, malnutrition, immunocompromised
Why does chemotherapy affect wound healing?
- Inhibition of cell division and protein synthesis which is needed for wound healing
- Immunocompromised so susceptible to infection
Why does diabetes affect wound healing?
- Weaker immune system
- Poor circulation
- Peripheral neuropathy
- Hyperglycaemia increases risk of infection
What are some signs of wound infection?
- Fever
- Pain
- Erythema
- Heat
- Swelling
What is a pressure ulcer?
Area of damaged skin and/or tissues below as a result of being placed under pressure
Can be very painful, led to extended hospital stays and get infected and lead to sepsis
What are the common sites for pressure ulcers?
- Tailbone or hips
- Heels of the feet
- Back of head/ears
- Elbows
- Inner knees
- Shoulder
What are some screening tools used to assess pressure ulcers?
- Braden Scale
- Waterlow Scale
- Norton Scale
When should you do a pressure ulcer risk assessment?
How do you do a skin assessment on the ward?
Check pressure areas for:
- Pain and discomfort
- Skin integrity
- Colour changes, if any erythema see if blanchable
- Variations in heat, moisture, firmness
What should you do if you see a patient has non-blanching erythema on a skin assessment?
Risk of pressure ulcer so needs repositioning every 2 hours until resolves