Chapter 63 Malnutrition and Obesity Flashcards
Drugs to stimulate appetite
Periactin, Megace
Overweight
10% over ideal body weight
Obesity
20% over ideal body mass
Morbid obesity
100% above ideal body weight
Drugs for obesity
Meridia, Tenuate, Bontril, Xenical
Hospital nutritional screening
height and weight, weight history, eating habits, ability to chew and swallow, and any recent changes in appetite or food intake
Marasmus
calorie malnutrition where body fat and protein are wasted but serum proteins are often preserved
Kwashiorkor
lack of protein quantity and quality in the presence of adequate calories. Body weight is more normal and serum proteins are low
Marasmic-kwashiorkor
combined protein and energy malnutrition. Often presents clinically when metabolic stress is imposed on a chronically starved patient
Where is protein synthesized?
the liver
malabsorption
occurs with malnutrition due to atrophy of gastric mucosa and loss of intestinal villi
H&H with malnutrition
May be low due to low albumin, anemia, infection, catabolism, or chronic disease
High values could indicate dehydration or hemoconcentration
Serum albumin
reflects nutritional status a few weeks before testing and is not the most sensitive study (should be 3.5-5.0)
Prealbumin
more sensitive indicator of protein deficiency because it has a short half life of 2 days. (normal is 15-36)
Transferrin
an iron transport protein with a short half life of 8-10 days which is also a sensitive indicator of protein status
Cholesterol levels
typically low with malabsorption, liver disease, pernicious anemia, end stage cancer, and sepsis (below 160 indicates malnutrition)
Total lymphocyte count and malnutrition
malnutrition suppresses the immune system so this level is usually decreased below 1500
Cyproheptadine (periactin)
an antihistamine to stimulate appetitie
Refeeding syndrome
complication of enteral feeding
life threatening condition brought on when nutrition is restarted for someone in a starvation state
insulin production resumes and the cells take up glucose and electrolytes from the bloodstream thus depleting serum levels
Refeeding syndrome sx
cardiovascular, respiratory, and neurological problems primarily caused by hypophosphatemia. Shallow respirations, weakness, acute confusion, seizures, and increased bleeding.
Gastric pH
0-4
6 or more indicates the feeding tube is probably in the lungs
Fat overload syndrome
Can occur with administration of Partial parenteral nutrition
Sx: fever, increased triglycerides, clotting issues, and multisystem organ failure
Drugs that can cause weight gain with long term use
Corticosteroids, estrogens, NSAIDS, antihypertensives, antidepressants, antiepileptic, oral antibiotics, psychoactive drugs
Post-op complications for gastric surgery
Anastomotic leaks are the most common serious complication and cause of death after gastric bypass surgery
Dumping syndrome
