Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Gastro Yr 2 > Malnutrition > Flashcards

Malnutrition Flashcards

1
Q

what is malnutrition?

A

lack of uptake or intake of nutrition = altered body compositions/ body cell mass - diminished physical + mental function from disease

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

highest prevalence of malnutrition in what age groups?

A

highest in youngest (18-19) and oldest age groups (90+)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How many people malnourished on admission ?

A

1/3 admitted to hospital malnourished on admission (big issue in the community_

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

what factors exacerbate malnutrition in the hospital?

A 
disease-related anorexia
inflexibility of mealtimes
quality of food
stress
gastro symptoms
lack of exercise
poly-pharmacy
low mood/ depression
co-morbidities - eg. dementia
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

what is the impact of malnutrition on surgery?

A

postoperative mortality 10 times greater in those who lost more than 20% body weight after op

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

evidence for link with malnutrition and poorer clinical outcomes

A

increased mortality, sepsis, post surgical outcomes, pressure sores

decreased wound healing, response to treatment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

how to screen malnutrition?

A

screening tool - low, medium, high risk

MUST tool

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

how to assess malnutrition?

A

systematic process of collecting + interpreting info to determine nature/ cause of nutrient imbalance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is anthropometry?

A

anthropometry - science that defines physical measures of a person’s size, form, and functional capacities

eg. weight, arm circumference, hand grip strength, CT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

what is the biochemistry assessment?

A

intensive monitoring

identify the nutrient imbalances

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

important of histories?

A

full medical history - meds/ past surgeries/ gastro symptoms etc
dietary history - allergies etc
social history - SES/ disabilities/ addiction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

How to measure nutrition requirements?

A

indirect calorimetry - resting metabolic rate

Avg. dietary intake that is needed for an individual

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

When should nutrition support be considered?

A

malnourished

at risk of malnutrition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

when is a patient malnourished?

A

BMI less than 18.5
unintentional weight loss of more than 10% in past 3-6 months
BMI less than 20 + weight loss more than 5% in past 3-6 months

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

when is a patient at risk of malnutrition?

A

Eaten or are likely to little/ nothing for more than 5 days

Poor absorptive capacity/ high nutrient losses/ increase nutritional needs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what is artificial nutrition support?

A

provision of enteral/ parenteral nutrients to treat or prevent malnutrition

17
Q

when is parenteral feeding considered?

A

GI tract is not functional or accessible

18
Q

why is enteral feeding better than parenteral?

A

Given GI tract accessible - this is preferred as it uses the gut

19
Q

when do you use enteral or parenteral feeding?

A

when oral nutrition is not safe or possible

20
Q

what is a NGT?

A

naso-gastric tube - when gastric feeding is possible - enteral

21
Q

what is a NDT/ NJT?

A

naso-duodenal/ naso-jejunal - when gastric feeding is not possible - parenteral

22
Q

complications associated with enteral feeding?

A

mechanical: misplaced NGT - leads to death (aspirate needs to be extracted with acidic pH)
metabolic: hyperglycaemia/ deranged electrolytes

GI: aspiration/ laryngeal ulceration etc

23
Q

what is parenteral nutrition?

A

delivery of nutrients, electrolytes + fluid directly to venous blood

24
Q

when do you use parenteral nutrition?

A

inadequate/ unsafe oral or enteral nutritional intake

non-functioning or inaccessible GI tract

25
Q

Where is parenteral nutrition administered?

A

central venous catheter inserted at tip of superior venous cava

26
Q

complications associated with parenteral feeding?

A

mechanical: line inserted wrongly - leads to pneumothorax/ thrombosis/ haemothorax etc
metabolic: deranged electrolytes, hyperglycaemia etc

Catheter related infections

27
Q

Does nutritional support help?

A

patients receiving nutritional support have lower mortality rates/ reduction in readmissions

28
Q

what is albumin?

A

most abundant circulating protein in healthy individuals

- synthesised in liver

29
Q

what does low albumin indicate?

A

poor prognosis

albumin is low when inflammation is high

30
Q

effect of inflammation on albumin?

A

inflammation stimulus = release cytokines = cytokines act on liver and down-regulate production of albumin

31
Q

Is albumin a valid marker of malnutrition in the acute hospital setting?

A

No - albumin synthesis reduces in response to inflammation (can not be used as a marker)

32
Q

what is refeeding syndrome?

A

biochemical shifts + clinical symptoms that occur in malnourished/ starved on reintroduction of nutrition

33
Q

What happens during starvation?

A 
Glycogenolysis
Protein catabolism
Ketone production
Electrolyte depletion 
Decrease in basal metabolic rate - brain uses ketones instead of glucose
34
Q

What happens when nutrition is re-introduced to a starved individual?

A

Introduction of carbs = secretion of insulin = Na/K ATPase pump which requires magnesium as co-factor

Mass cellular uptake of electrolytes

Reduces sodium and fluid excretion = refeeding oedema

hypokalaemia
Thiamine deficiency

35
Q

What constitutes high risk of Refeeding Syndrome?

A

High risk - 1 or more of BMI less than 16/ low K+/Mg2+/PO4 prior to feeding/ no nutrition for more than 10 days/ unintentional weight loss of 15% or more for 3-6 months

OR

2 or more of BMI less than 18.5/ past abuse of drugs or alcohol no nutrition for more than 5 days/ unintentional weight loss of 10% or more for 3-6 months

36
Q

What constitutes extremely high risk of Refeeding Syndrome?

A

BMI less than 14

Negligible intake for more than 15 days

37
Q

Management of Refeeding Syndrome?

A

Start with only 10-20kcal per kg

Electrolytes/ fluids monitored

Gastro Yr 2 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions