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Gastrointestinal > Malnutrition > Flashcards

Malnutrition Flashcards

1
Q

what is malnutrition

A

a state of nutrition in which a deficiency, excess or imbalance of energy, protein and other nutrients (vitamins and minerals) causes measurable adverse effects on tissue, body from, function and clinical outcome

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2
Q

disease related causes of malnutrition

A

decreased intake
impaired digestion and/or absorption
increased nutritional requirements
increased nutrient losses

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3
Q

how may a patient have decreased intake

A 
poor appetite 
pain on eating 
medication side effects 
dysphagia 
sore mouth
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4
Q

how may a patient have impaired digestion and/or absorption

A 
problems affecting;
stomach
intestines
pancreas
liver
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5
Q

how may a patient have increased nutritional requirements

A

catabolism infection
trauma
burns
surgery

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6
Q

how may a patient have increased nutrient losses

A

vomiting
diarrhoea
stoma losses

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7
Q

what can malnutrition increase the risk of

A

GI dysfunction
infection
wound healing

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8
Q

psychosocial causes of malnutrition

A 
self neglect
bereavement 
inability to access food
deprivation 
loneliness
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9
Q

effects of starvation on metabolic rate

A

decreases

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10
Q

effects of starvation on weight

A

slow loss - almost all from fat stores

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11
Q

effects of starvation on nitrogen losses

A

decreases

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12
Q

effects of starvation on hormones

A

early increases in catecholamines, cortisol, GH, then slow fall
insulin decreased

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13
Q

effects of starvation on water and sodium

A

initial loss, late retention

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14
Q

effects of injury on metabolic rate

A

increases

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15
Q

effects of injury on weight

A

rapid loss, 80% from fat stores, remainder from protein

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16
Q

effects of injury on nitrogen losses

A

increases

17
Q

effects of injury on hormones

A

increases in catecholamines, cortisol, GH

insulin increased but relative deficiency

18
Q

effects of injury on water and sodium

A

retention

19
Q

effects of malnutrition on impaired immune responses

A

increased risk of infection

impaired recovery when infected

20
Q

effects of malnutrition on impaired wound healing

A

surgical wound dehiscence, anastomotic breakdown, development of post-surgical fistulae

21
Q

effects of malnutrition on reduced muscle strength and fatigue

A

inactivity
poor self care
increased risk of falls

22
Q

effects of malnutrition on respiratory muscle strength

A

increased risk of chest infection

difficult to wean from ventilator

23
Q

effects of malnutrition on inactivity - especially in bed bound patient

A

increased risk of pressure sores and thromboembolism

24
Q

effects of malnutrition on water and electrolyte disturbances

A

decreased ability to excrete sodium and water

25
Q

effects of malnutrition on impaired thermoregulation

A

hypothermia

26
Q

effects of malnutrition on menstrual irregularities/amenorrhoea

A

infertility and osteoporosis

27
Q

effects of malnutrition of impaired psycho-social function

A

apathy
depression
self-neglect

28
Q

3 steps of the MUST score

A

BMI (<18.5)
weight loss score (0 if intentional)
acute disease effect score

29
Q

nutritional assessments

A

anthropometry;
mid-arm muscle circumference
triceps
grip strength

30
Q

biochemical measures of nutritional status

A

vitamins A, C, D and E
albumin
zinc

31
Q

what if referring syndrome

A

fatal shifts in fluids and electrolytes and disturbances in organ function and metabolic regulation that may result from rapid initiation of re feeding after a period of under nutrition

32
Q

metabolic features of re-feeding syndrome

A 
Hypokalaemia
Hypophosphataemia
Hypomagnesaemia
Altered glucose metabolism
Fluid overload
33
Q

physiological features of re-feeding syndrome

A 
Arrhythmias
Altered level of consciousness
Seizure
Respiratory failure
Cardiovascular collapse
Death

Gastrointestinal (71 decks)

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