Nutrition Flashcards
What is malnutrition?
A state of nutrition in whihc there is a deficiency or excess of energy, protein, and other nutrients
How do you calculate BMI?
Weight (Kg) / Height (m) ^2
How do you classify BMI?
< 18.5 = underweight
18.5-24.9 = healthy weight
25-29.9 = overweight
30-39.9 = obese
What is the MUST score?
Malnutrition universal screening tool
Criteria
- usual weight
- height
- unintentional % weight loss
- eating regularly
0 = low risk 1 = medium risk 2 = high risk - refer to dietician
What is enteral feeding?
Any method of feeding that uses the GI tract
What is parenteral feeding?
Delivery of calories and nutrients into a vein
What is the hierarchy of feeding?
Oral supplements
- if unable to eat sufficient calories
Nasogastric tube
- if unable to take sufficient calories orally
- dysfunctional swallow
Gastrostomy (PEG)
- of oesphagus blocked/dysfunctional
Jejunal feeding
- if stomach inaccessible
- outflow obstruction
Parenteral nurtition
- if jejunum inaccessible
- intestinal failure
What are the consequences of poor nutrition?
Reduced muscle mass Suppressed immunity Increased length of stay Reduced respiratory function Reduced cardiac function
What is refeeding syndrome?
Potentially fatal shifts in fluids and electrolytes that can occur in malnourished patients
What happens in starvation?
Decreased insulin secretion
Fat and muscle metabolised
Body deplete of electrolytes
What happens upon refeeding?
Increased glucose uptake
Increased utilisation of thiamine
Increased uptake of potassium, magnesium, phosphate
What are the signs of refeeding syndrome?
Hypokalaemia
Hypomagnesaemia
Hypophosphataemia
Thiamine deficiency
Management of refeeding syndrome
Determine level of risk Check electrolytes Prescribe electrolytes as necessary Prescribe vitamin B and multivitamin Recheck electrolytes daily
How long is nil by mouth for?
6-8 hours food
2 hours clear fluids
