Malnutrition Flashcards
Nutrition needs not met
Primary Protein-caloric malnutrition (PCM)
aka anorexia
ii. Sustained mild to moderate inflammation
iii. Conditions include organ failure, cancer, rheumatoid arthritis, obesity, and metabolic syndrome
Chronic disease-related malnutrition
Malnutrition contributing factors
Socioeconomic factors-food insecurity
Physical illness
Impaired absorption of nutrients from GI tract
Malabsorption Syndrome
Malabsorption Syndrome May result from
i. ↓ Enzymes
ii. Drug side effects (antibiotics)
iii. ↓ Bowel surface area
iv. Fever increases BMR (burn more calories)
During starvation process, there is a decreased
BMR
sparing of skeletal muscles
decreased protein breakdown
Prolonged starvation:
97% of calories from fat and protein is conserved
Clinical findings for mild to emaciation
i. Skin, nails, hair
ii. Mouth and tongue
iii. CNS
1. Confusion, irritability
iv. Fatigue
v. Increased susceptibility to infection
vi. Anemia
Labs for malnutrition
i. Serum albumin
ii. Prealbumin (reliable for malnutrition)
iii. C-reactive protein
iv. Electrolyte levels
v. Complete blood count
vi. RBC, Hgb, lymphocyte count
Anthropometric measurements
i. Skinfold thickness – various sites
ii. Midarm circumference
iii. Compared with standard for healthy persons
iv. Functional measurements
Malnutrition assessment tools
Mini-Nutrional Assessment (MNA)
Minimum Data Set (MDS)
Outcome & Assessment Information Set (OASIS)
nursing implications
Daily calorie count
High-protein, high calorie
multiple small feedings
Once fat stores are used, body proteins are no longer spared; what happens from there?
iv. Liver function impaired
v. Protein synthesis diminished
vi. Plasma oncotic pressure ↓
vii. Shift from vascular space into interstitial
viii. Albumin leaks into interstitial space
ix. Edema results
Initially, body uses carbohydrate stores from liver and muscle to meet metabolic needs
Glycogenolysis
carb stores are
minimal; may be depleted in 18 hrs; once depleted; protein is converted to glucose for energy
