Malnutrition Flashcards
What are obvious indicators of dysphagia?
Difficult, painful chewing or swallowing Regurgitation of undigested food Difficulty controlling food in mouth Drooling Hoarse voice Coughing or choking before/ after swallowing Globus sensation Nasal regurg Feeling of obstruction Unintentional weight loss
What are less obvious indicators of dysphagia?
Change in respiratory pattern
Unexplained temp spikes
What are the indications for nutritional support?
BMI <18.5
Unintentional weight loss >10% in last 3-6 months
BMI <20 + 5% weight loss
Who is at risk of malnutrition?
Pts who have eaten little or nothing for more than 5 days + are expected to continue for next 5 days
Have a poor absorptive capacity and/or high losses or needs
What are the indications for oral nutrition support?
Pts who can swallow safely + are malnourished
Peri-op pts, post-caesarean
What is the total nutrient intake for an adult?
25-35 kcal/kg
1g protein/kg
30ml fluid/kg
If someone is malnourished, what support level should they be introduced at?
No more than 50% of requirements for first 2 days
What are the indications for enteral tube feeding?
Pts who are malnourished with inadequate or unsafe oral intake + a functional GI tract
When can PEG tubes be used for feeding?
4 hours after insertion
How are pts in ICU fed?
Through NG tube over 16-24 hours
What should be given to pts with delayed gastric emptying + not tolerating enteral feeding?
Offer motility agent
What are the indications for parenteral nutrition?
Inadequate or unsafe oral/ enteral intake
Non functional/ inaccessible GI tract
What route of access should be used for parenteral nutrition?
peripheral venous catheter for short term nutrition
Tunnelling subclavian line recommended for >30 days
How often should nutrition be delivered in parenteral nutrition?
Cyclical when using peripheral cannula
Continuous in severely ill people
What is refeeding syndrome?
Electrolyte derangements associated with massive intracellular shift of electrolytes
