Artificial Feeding Flashcards
what sort of patients are affected by malnutrition
40% of patients malnourished on acute admission
up to 70% of patients malnourished on discharge
statistically if people go down 30% of their body weight what happens
2/3 of those die
total starvation occurs between 60-70 days
what are the consequences of poor nutrition
physical - reduced muscles mass and function, reduced CO, DVT risks
immune - increased risk of infection, altered gut function - translocation of gut bacteria
physiological - depression, irritable, reduced mental concentration
how do you assess malnutrition
MUST - Malnutrition universal screening tool
assessment of malnutrition risk and itself
what are the three measurements of must
BMI (weight/height ^2)
recent weight loss
acute illness with or likely to be nutritional intake
the score for BMI has three tiers
between 0 and 2
0 = obese
what are the colours of BMI
green is greater than 20
yellow is 18.5-20
red is BMI less than 18.5
overall what is the score ratio for must
bmi - 0 1 2 recent weight loss 0,1,2 no intake for previous 5 days 0,1,2 overal out of 6 0 low, 1 medium, anything above 2 is high
what high risk medical conditions are associated with risk of malnutrition
dysphagia
poor absorption in the gut
high nutrient loss
increased nutritional needs
what types of people need artificial feeding
can’t eat - stroke and head/neck surgery
can’t eat enough - runs - sepsis - pre-operativer malnutrition
shouldn’t eat - bowel obstruction, leaks after surgery, prolonged paralytic ileum
what is fortisip / fortijuice
200 ml bottle
provides, minerals, protein, calories and vitamins
what are the type injection routes for artificial feeding
enteral - into gut
parenteral - into vein
why do you need enteral feeding
persistant or poor oral intake
dysphagia
head injury
but requires functioning gut
what are short term enteral feeding
naso gastric feeds
naso-jejunal feeds if gastric outlet / obstruction /delayed emptying
usually last less than four weeks
what are long term enteral feeding techniques
percutaneous endoscopic gastrostomy
Radiologically inserted gastrostomy (used if cancer is in upper GIT)
what is TPN in artificial feeding
total parenteral nutrition
feeding into the vein - mainly used for acute action
long term may be a mixture of both methods
what are the prior requirements for the use of TPN
inability to establish any other route for nutrition
inability to meet nutritional requirements via the oral or enteral routes
what will be in TPN solution
protein glucose and fats electrolytes vitamins trace elements (tailored to individuals needs)
what are the routes for intravenous feeding
short-term - peripheral feeding midline (Basal or cephalic vein)
medium term - central feeding PICC (neck)
long term - tunnelled lines - hickman (through chest)
what are some complications of PN
infection (usually from midline) high blood sugar electrolyte disturbance abnormal liver test refeeding syndrome
what is refeeding syndrome
too much too soon
patients at risk are malnurishoued, no recent intake, alcoholic
causes fluid shifts and electrolyte shifts
what was the initial documentation of refeeding
joesoph flavius
deaths from jews who were trapped and then escape, ate too much and died
what happens to your body during starvation
decrease in insulin secretion and increase in glucagon
switch from glucose to ketones for energy
glycogen stores used and BMR decreases
atrophy or organ and reduced lean body mass
what are the physiological consequences of starvation
deficiency of vitamins and trace elements
reduced k, magnesium, phosphate leading to impaired cardiac, intestinal and renal reserve
serum electrolytes maintained within normal limits
