Malnutrition Flashcards
What is malnutrition?
Under or over nutrition
Malnutrition is a state in which a deficiency of nutrients such as energy, protein, vitamins and minerals causes measurable adverse effects on body composition, function or clinical outcome
What is the mechanism of malnutrition?
Inadequate intake
Impaired nutrient digestion and processing
Excess losses
Altered requirements
How does impaired nutrient digestion and absorption arise?
Dysfunction of stomach, intestine, pancreas and liver
Describe what is meant by excess losses
Vomiting NG tube drainage Diarrhoea Surgical drains Fistulae Stomas
Give examples of when requirements are altered
Increased metabolic demands during inflammation, cancer, wounds, burns, brain injury
What is the impact of malnourishment in healthy people?
Decreased skeletal muscle mass and function
Physiological disturbance- cardiac output, diaphragmatic muscle mass and contractility, gut and immune function may decrease
Why is malnutrition a problem for the NHS?
Costs lots
What is the effect on malnutrition on hospital stay?
Malnutrition increases
Hospital stay also increases
Why is it malnutrition increases during hospital stay?
Inadequate, unpalatable, unsuitable food, can’t reach the food or feed themselves, pain, dysphagia, depression, nil by mouth, poor appetite
How do we prevent malnutrition during hospital stay?
Find patients who are at risk - at the end of the bed inspection
Describe different ways of anthropometry
BMI- standardising height and weight
Weight loss score- unplanned weight loss in the past 3-6 months
Acute disease effect score- acutely unwell patient and likely to have no nutritional value for more than 5 days
Describe MUST screening
BMI + Weight loss score + acute disease effect score = overall risk of malnutrition
0 = low risk- routine treatment
1 = medium risk- observe
2= high risk- treat
