Nutrition

Question 1

What are malnourished patients more at risk of?

Answer 1

Poor wound healing
Wound infection
Skin breakdown

Question 2

What is the tool to assess malnourishment?

Answer 2

MUST

Malnutrition Universal Screening Tool

Question 3

What would be prescribed if the patient was unable to take in enough calories bbut able to eat?

Answer 3

Oral supplements

Question 4

What is needed if a patient is unable to take in sufficient calories orally or has a dysfunctional swallow (with no head injuries)?

Answer 4

Nasogastic tube

CXR needed to check it is placed correctly

Question 5

What is used if the oesophagus is blocked /dysfunctional?

Answer 5

Gastronomy feeding - PEG/RIG

Question 6

What is used if the stomach is inaccessible or outflow obstruction?

Answer 6

Feeding jejunostomy

Question 7

What is used if jejunum inaccessible or intestinal failure?

Answer 7

Parenteral feeding

Question 8

What does a low albumin reflect?

Answer 8

NOT MALNUTRITION

reflects chronic inflammatory process, protein losing enteropathy, proteinuria or hepatic dysfunction

Question 9

How can stoma output be reduced?

Answer 9

Reduction in hypotonic fluids to 500mls/day
Reduction in gut motility with high dose loperamide and codeine phosphate
Reduction in secretions with high dose proton pump inhibitors (a twice daily dose)
Use of WHO solution to reduce sodium losses
Low fibre diet to reduce intraluminal retention of water

Question 10

What are the risks of a high output stoma?

Answer 10

Electrolyte imbalances
Hypokalaemia
Loss of fluid causes electrolytes to leave the intestine as well