Nutrition Flashcards
Malnutrition
State where deficiency, excess or imbalance of nutrients causes measurable adverse effects on:
- Tissue or body form (shape, size and composition).
- Function and clinical outcome.
Symptoms of malnutrition
- Weight loss/loss of appetite
- Tiredness, lack of energy, lethargy
- Depression
- Poor concentration
- Poor growth in children
Cost of malnutrition: primary care
- GP visits
- Rx costs
- Hospital referrals
- Care packages
Cost of malnutrition: secondary care
- Medical and surgical complications
- Length of hospital stay
- Readmissions
- Death
Causes of malnutrition
- Altered nutrient processing
- Excess losses
- Impaired intake
- Impaired digestion and absorption
Altered nutrient processing
- Increased metabolic demand
- Liver dysfunction
Impaired intake
- Dysphagia
- Depression/psychological stress
- Mucositis
- Poor diet
- Poor appetite
- Pain/nausea with food
- Unconsciousness
Impaired digestion and absorption
- Problems with the stomach, small intestine, pancreas and liver.
Excess losses
- Diarrhoea/vomiting
- Fistulae
- NG tube drainage
- Surgical drains
- Stoma
Consequences of malnutrition
- Decreased immunity
- Decreased CO
- Decreased renal function (loss of ability to excrete sodium and water)
- Decrease liver function
- Hypothermia
- Loss of strength
- Depression
- Secondary anorexia
- Impaired gut integrity and immunity
- Impaired wound healing
- Loss of muscle and hypoxic responses (ventilation)
Malnutrition Universal Screening Tool (MUST)
- Calculate BMI using height and weight
- Score % unplanned weight loss
- Score acute disease effect
- Add scores from steps 1-3 for complete score
- Refer to local management guidelines/policies to create an action plan.
- Score >2 is high risk (0=no risk, 1=low risk)
Nutritional Assessment
- Anthropometry
- Biochemistry
- Clinical
- Dietary
- Environment
Anthropometry
Assessment of the different component parts of the human body (bone, muscle, water and fat)
Anthropometry - what is assessed
- Bodyweight
- Height
- BMI
- Skin fold thickness
- Mid upper arm circumference (MUAC)
- Mid arm muscle circumference (MAMC)
Biochemistry
Blood tests interpreted in conjunction with a clinical examination, previous medical history, and current medications.