Nutrition

Question 1

Define malnutrition.

Answer 1

A state of nutrition in which an imbalance of energy, protein, and other nutrients causes measurable adverse effects on tissue / body form and function and clinical outcome.

Question 2

Describe the symptoms of malnutrition.

Answer 2

• Little or no appetite
• Weight loss – clothes too large, dentures too big, rings/ jewellery too big.
• Low energy and feeling tired.
• Poor Concentration
• Unable to perform normal tasks
• Altered mood
• Reduced physical ability.

Question 3

Describe how to identify a patient who is at risk of malnutrition.

Answer 3

Nutritional screening should be completed on all adult patients within 24 hours of admission to hospital.

The Malnutrition Universal Screening tool (MUST) is used.

Question 4

Describe how to carry out a Malnutrition Universal Screening tool (MUST).

Answer 4

1. BMI
2. Weight loss
3. Acute disease effect

Question 5

What does a score of 0 from a Malnutrition Universal Screening tool (MUST) mean?

Answer 5

Low risk of Malnutrition

Question 6

What does a score of 1 from a Malnutrition Universal Screening tool (MUST) mean?

Answer 6

Medium Risk of Malnutrition

Question 7

What does a score of 2 or >2 from a Malnutrition Universal Screening tool (MUST) mean?

Answer 7

High Risk of Malnutrition

Question 8

Describe how to manage a patient with a MUST score of 2.

Answer 8

• Refer to the dietitian
• Start a nutritional care plan
• Strict food record charts – include amounts eaten.
• Ward snacks, milky drinks, snacks from family.
• For dementia patients – Would finger foods help? Does the patient need assistance at meal times? Do they manage better with different food consistencies? Is a large meal off putting?

Question 9

Describe how to manage a patient with a MUST score of 0.

Answer 9

Repeat MUST score in 1 weeks time.

NOTE: If in care home to monitor MUST monthly, community patients at risk, MUST should be monitored annually.

Question 10

Describe some causes for nutritional decline.

Answer 10

• Normal age-related changes. - Illness.
• Impairment in ability to eat.
• Dementia.
• Medications.
• Restricted diets.
• Limited income.
• Reduced social contact.

Question 11

Describe how to assess pressure areas.

Answer 11

Any assessment should include an examination of the patients’ skin.