Nutrition Flashcards
how would someone who is malnourished and dehydrated present?
Skin hanging off muscles No fat between fold of skin Hair rough and wiry Pressure sores Sores at corner of mouth BMI Anthropomorphic indices: skin fold, grip strength
how much fluid is required per day
2-3L
increased requirements for those with large output stomas, NG aspirated, diarrhoea, fever
what patients do we restrict fluid intake
oedema
hepatic and renal failure
how much energy do we need per day
1800-2400 kcal
how much protein do we need per day
0.5g
what patients require extra protein
extensive burns
sepsis
major trauma
how much major minerals do we need in 1 day
60-100 mmol
GI effluents = increase
fluid overload or hypernatraemia or kalaemia = decrease
which GIT feeding method requires increased calcium and magnesium
enteral - only a proportion of the minerals are absorbed by the gut
which GIT feeding methods requires increased vitamins
paraenteral
what system is used to assess a patient’s nutritional status
MUST (malnutrition universal screening tool)
done via questionare, weekly
how many steps are there in the MUST score
5 steps
1) BMI (height and weight)
2) % unplanned weight loss in past 3-6 months
3) acute disease effect and score
4) overall risk of malnutrition by adding 1,2,3
5) management guidelines to develop a care plan
what are the 3 levels of risk in step 5 of MUST - management guidelines
low risk 0 - routine clinical care
medium risk 1 - observe patient
high risk >2 = treat with dietician, increase nutritional intake
what is enteral feeding
food is placed directly into the GI Tract via a tube
what are the short term and long term enteral feeding tubes
short - NG (<4weeks)
long - gastrostomy (PEG) or jejunostomy (>4weeks)
what are the indications for enteral feeding
- unsafe swallow - stoke, parkinsons
- inability to meet oral requirements - anorexia, dementia
- oesophageal stricture
- post major upper GI surgery
- post op ileus
