Biochemical, physical and anthropometric assessments & energy, fluid and protein requirements Flashcards
How is potassium impacted by underfeeding or chronic starvation?
Upon refeeding - insulin and carbs can drive potassium into the cell which can lead to re-feeding syndrome resulting in severe hypokalemia which can lead to death
What does a decreased Potassium level indicate?
Common in patients with nausea, vomiting, or diarrhea
What do altered sodium values indicate?
More than likely due to hydration status rather than intake ex. dehydration can cause increased sodium concentrations
What are causes of edema?
What can edema contribute to?
Protein Deficiency
low activity level
poor renal function - almost all patients with renal problems have edema
Skin breakdown
What is Ideal Body Weight?
For age 19: BMI of 20-25
For age 65 and + BMI of 22-27
What is % IBW?
How much of the patient’s IBW is their current weight at. IBW = current weight/IBW x 100
How to calculate %UBW?
Current weight/UBW x 100
How do you calculate BMI?
weight in kg / height in meters squared
How do we interpret IBW ranges?
> 200 Morbid Obesity
130-199 Obese
121-129 Overweight
90-120 Normal
80-90 Mild Malnutrition
70-79 Moderate malnutriton
<69 Severe malnutrition
What is % usual body weight?
Used to determine weight changes, describes your current weight as a percent of your usual body weight
How to interpret %UBW?
85-95 - may indicate mild malnutrition
75-84 may indicate moderate malnutrition
<74 may indicate severe malnutrition
What is % Weight change?
(UBW - Current Weight)/UBW x 100
How do you interpret % weight change?
Significant weight loss:
1 week: 1-2%
1 month: 5%
3 months: 7.5%
6 months 10%
Unlimited time 10-20%
*Severe is greater than all these ranges for the time frame indicated
What are the cutoffs for waist circumferences?
Males >40 inches
Females > 35 inches
What can you tell from a tricep skinfold?
Can indicate fat and energy depeletion
What are the activity factors?
1 - bed rest/sleep
1.2 out of bed, light activity
1.3-1.5 sedentary
1.7 Normal activity
What are the stress factors?
1.0-1.2 in hospital
1.0-1.3 in cancer patients
What are the total energy requirement recommendations for normal and obese patients?
25-35 kcal/kg for normal patients - increases or decreases with burns, trauma etc.
21kcal/kg for obese patients
What are the protein requirements for healthy vs. in hospital adults?
What are they based on?
Healthy adults: RDA 0.8 g/kg bw/day
Hospital: minimum requirement of 1g/kg/day but most patients 1.2-1.9 (can be even higher in burn vitims)
Higher end for renal disaese, liver disease and critically ill patients in ICUs
Protein requirements are calculated based on ideal weight if bw outside the normal range
What would be the protein requirements for liver patients?
Regular liver patients require 1.2g/kg/day
endstage liver failure dont make urea out of excess protein and make ammonia which could cause brain damage so need to be careful and likely lower it
What are the fluid intake requirements?
19-55 years: 35ml/kg bw/day
55-75 years: 30 ml/kg/bw/day
>75 years: 25ml/kg/bw/day
What weight should be used to calculate fluid requirements?
Always use actual weight
What are the sections of the PG-SGA?
Weight
Food Intake
Symptoms
Activities and Function
What are the PG-SGA Global Assessment Categories?
A - well nourished
B - moderate suspected malnutrtion
C - severely malnourished
