Malnutrition Flashcards
Malnutrition definition
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
Prevalence of malnutrition globally
500 million people affected globally by malnutrition
Marasmus
Form of severe malnutrition characterised by protein deficiency
Can occur in anyone with severe malnutrition but usually children
Muscular wasting and loss of subcutaneous fats
Kwashiorkor
Protein deficiency with adequate energy intake
Leads to oedema and ascites
Prevalence of malnutrition UK
3 million people in Britain at ant one time
Community 10% Sheltered housing and elderly 14% Hospital outpatients 20% Hospital inpatients 30% Children in hospitals up to 14%
Mechanism of malnutrition
Inadequate intake
Impaired nutrient digestion processing
Excess losses
Altered requirements
Impaired nutrient digestion and processing
Dysfunction of
- stomach
- intestine
- pancreas
- liver
Excess losses
Vomiting
NG tube drainage
Diarrhoea
Surgical drains
Fistulae
Stomas
Altered requirements
Increased metabolic demands
- inflammation
- cancer
- wounds
- burns
- brain injury
Impact of malnutrition in healthy people
Decreased skeletal muscle mass and function day 5
18% loss of mass leads to physiological disturbance
- cardiac 45% reduction in CO
- respiratory/ diaphragmatic muscle mass and contractility
- gut and immune function
Approximately 40% weight loss is fatal
Cost of malnutrition- population
Attend GP more often
Admitted to hospital more frequently
Stay on wards for longer
Succumb to infections
Get admitted to long term care
Die
How hospitals cause malnutrition
Inadequate/ unpalatable/ unsuitable food
Can’t reach food/ feed themselves
Altered taste/ poor appetite
NBM
Starved for Ix
Starved before and after surgery
Medical causes of inadequate intake
Poor diet
Poor appetite/ anorexia/ taste disturbances
Nil by mouth
Pain/ nausea
Dysphagia
Depression
Physical disability and inability to feed self
Unconscioesness
Environmental causes of inadequate intake
Inadequate food quality
Inadequate food availability outside the reach of elderly or physically incapacitated patients
No protected meal times
Inadequate training and knowledge of medical and nursing staff
Screening
Step 1: BMI score Step 2: weight loss score Step 3: acute disease effect score = Step 4: overall risk of malnutrition
