Nutrition

Question 1

What is the MUST score?

Answer 1

A five step screening tool to identify adults who are malnourished, at risk of malnutrition or obese. It also includes management guidelines which can be used to develop a care plan

Question 2

Where can the MUST be used and by who?

Answer 2

Used in hospitals, community and other care settings. Can be used by all care workers

Question 3

In the MUST what is step 1?

Answer 3

Measure height and weight to get a BMI score using chart provided.

Question 4

In the MUST what is step 2?

Answer 4

Note percentage of unplanned weight loss in the past 3 to 6 months and score using table

Question 5

What is step 3 of the MUST?

Answer 5

Establish acute disease effect and score

Question 6

What is step 4 of the MUST?

Answer 6

Add scores from steps 1,2 and 3 to obtain overall malnutrition risk

Question 7

What is step 5 of MUST?

Answer 7

Use guidelines to develop care plan

Question 8

What is an underweight BMI?

Answer 8

Less than 18.5

Question 9

What is a normal BMI?

Answer 9

18.5 to 24.9

Question 10

What is an overweight BMI?

Answer 10

25 to 29.9

Question 11

What is an obese BMI?

Answer 11

More than 30

Question 12

In step 2 of the MUST score how much weight loss would give a score of 0,1 and 2?

Answer 12

0 = <5%
1 = 5-10%
2 = >10%

Question 13

If someone is at low risk according to MUST, with score of 0, what should be done?

Answer 13

Routine clinical care

Repeat screening weekly in hospital, monthly in care homes and annually in community for special groups e.g > 75

Question 14

If someone is a medium risk according to MUST with a score of 1, what should be done?

Answer 14

Document dietary intake for 3 days
If adequate - little concern and repeat screening later
If inadequate - set goals, improve or increase nutrition, monitor and review care plan regularly

Question 15

If someone scores 2 or more and is high risk according to MUST, what should be done?

Answer 15

Refer to dietician, nutritional support or implement local policy

Question 16

What are some causes of malnutrition?

Answer 16

Increased requirements - infection, COPD, wound healing
Increased losses - malabsorption (IBD, coeliac), vomiting, diarrhoea
Reduced intake - depression, poor appetite, pain, dysphasia

Question 17

What are some consequences of poor nutrition?

Answer 17

Impaired immune function 
Delayed wound healing
Increased risk of pressure sores
Depression 
Reduced mobility 
Reduced quality of life 
Increased hospital stay

Question 18

Before prescribing oral nutritional supplements, what should be done first?

Answer 18

A food first approach e.g add full fat cream to mashed potatoes

Question 19

Should oral nutritional supplements be taken instead of or between meals?

Answer 19

Between