Nutrition Flashcards
Define Malnutrition
- Body Mass Index (BMI) of less than 18.5; or
- unintentional weight loss greater than 10% w/in the last 3-6 mnths ( or 5% if bmi less 20)
how do you screen patients with Malnutrition
MUST (malnutrition universal screeening tool)
- BMI
- Hx of unintentional weight loss 3-6 mnths
- 5 days poorly (now or in future)
What are the causes of malnutrition? give examples for each (4)
- Reduced dietry intake > Environment: failure in regular nutritious meals (hospital, living alone no support), Reduced Appetite (mental health, illness), Dysphagia (stroke, GI)
- Malabsorption > GI disorders and surgery,
- Increased losses or altered requirments > diharrea, vomiting, enterocutaneous fistulae, burns
- Increased energy expenditure > major trauma, head injury or burns (only for short period of time)
what are some consequences of Malnutrition?
Muscle > Muscle wasting + Reductive Adaptation ( downregulation of everything after short period of starvation) BUT WATCH OUT FOR REFEEDING SYNDROME
Reduced Cardioresp function > Red musc mass heart and diaphragm, nutrient/electrolyte deficiencies eg thiamine.
Reduced GI function > changes in pancreatic exocrine function, intestinal blood flow, villous architecture and intestinal permeability, ion and electrolyte secretions >diahorroea
Low immunity and wound healing > ! infections
Physcosocial effects > apathy, depression, anxiety and self-neglect.
What does a balanced diet consist of?
when is someone at nutritional risk?
Comorbidities: systemic conditions
psych: anorexia
Being immobile
Being in hospital
lifestyle factors: smoking, exercise, appetite, social
how can the MDT help with improving nutritional intake and when do you refer?
Doctors: meds review, SE drugs , look for underlying disease
Nurses/HCA: liase w/ the family (food like/dislike)
Dieticians: diet plan, prescribe supplents
SALT: helpful if dysaphagia is present
MUST score 2or more
what r 3 screening for pressure ulcers?
- Waterlow score
- European Pressure Ulcer Advisory Panel classification system. (EPUAP)
- Braden scale
what are the causes/risk factors for developing pressure area?
- malnourishment
- incontinence>>moist area causing dermatitis
- lack of mobility
- pain (leads to a reduction in mobility)
- Sensory impairment
what preventative measures can be put to reduce pressure areas?
- specialized support surfaces (better than hospital mattresses)
- monitoring devices that provide continous feedback on pressures can help w/ repositioning the ptx
- use skin moisterizers (mainly over sacrum)
- skin inspection to all bed bound ptx
- improving must score
- make sure theyre not incontinant
Who do we screen for malnutrition?
- All hosp in pt on admission within 6 hrs, and then weekly
- All outpt at first clinical apptm
ESPECIALLY
- pale
- baggy clothes
- poor wound healing
- difficulty swallowing
- reduced appetite
- altered bowel habit
- prolonged illness
