MALNUTRITION AND NUTRITION ASSESSMENT Flashcards
What is the definition of malnutrition?
A state resulting from lack of uptake/intake of nutrition leading to altered body composition and body cell mass leading to diminished physical and mental function and impaired clinical outcome from diseas
Why might malnutrition occur in hospital?
Co-morbidities Disease related anorexia Metabolic response to illness/injury Excess nutritional loss Low mood/depression Inactivity Dysphagia Quality of food Inflexibility of mealtimes
What is the impact of malnutrition in hospital environments?
Increased mortality, complications (septic/post surgical), hospital stay, pressure sores, re-admissions, dependency
Decreased wound healing, response to treatment, rehabilitation potential, QOL
How is malnutrition diagnosed and who by?
Screen to identify risk by any HCP
Assess to determine cause by dietitian
Diagnosis
What are some ways malnutrition can be diagnosed?
Anthropometry (physical properties of body) Biochemistry Clinical (history, symptoms) Dietary Social/physical Nutrition requirements
In which individuals should nutrition support be considered?
Malnourished
At risk of malnutrition
What qualifies a person to be malnourished?
BMI < 18.5
or
Unintentional weight loss > 10% in past 3-6 months
or
BMI < 20 and unintentional weight loss > 5% in past 3-6 months
What qualifies a person to be at risk of malnutrition
Eaten little/nothing for > 5 days and/or likely to eat little/nothing for next 5+ days
Or
Poor absorptive capacity and/or high nutrient losses and/or increased nutritional needs from causes e.g. catabolism
What is artificial nutrition support?
The provision of enteral or parenteral nutrients to treat or prevent malnutrition
What is the aim of parental nutrition?
Return to enteral then oral feeding as soon as clinically possible
If gastric feeding is possible, what should a patient on enteral nutrition use?
Naso-gastric tube (NGT)
If gastric feeding isn’t possible, what should a patient on enteral nutrition use?
Naso-duodenal tube (NDT)
Naso-jejunal tube (NJT)
When should gastrostomy/jejunstomy be done?
Patient on enteral nutritional support for > 3 months
What are the complications associated with enteral nutrition support?
Mechanical - misplacement, blockage, buried bumper
Metabolic - hyperglycaemia, deranged electrolytes
GI - aspiration, nasopharyngeal pain, laryngeal ulceration, vomiting, diarrhoea
What must be done after placing a NGT?
Obtain an aspirate from it.
If aspirate pH =< 5.5 then NGT placed correctly (stomach)
If aspirate pH > 5.5 need to do a chest Xray to see where NGT is