Nutrition and Wound Care Flashcards

1
Q

How much water should a patient consume daily for wound healing, and how does dehydration affect it?

A
  • Patients need 30–35 mL/kg of body weight daily (2.7–3.7 L/day on average).
  • Dehydration (1% body weight loss) can impair healing.
  • Minimum intake is 1.5 L/day, but more is needed for large wounds, burns, or patients on air-fluidized beds.
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2
Q

What are the primary roles of protein in wound healing?

A
  • Protein is crucial for collagen synthesis, granulation tissue formation, angiogenesis, remodeling, and immune function.
  • It also maintains osmotic pressure to prevent edema.
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3
Q

What are the recommended protein intake levels for different patient needs?

A
  • General recommendation: 1 g/kg of body weight.
  • For pressure ulcer risk: 1.25-1.5 g/kg.
  • For burns or stage III/IV pressure ulcers: 1.5-2 g/kg.
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4
Q

Describe protein malnutrition and its types.

A
  • Marasmus: Caused by protein deficiency due to deprivation or absorption issues, with significant weight loss.
  • Kwashiorkor: Decreased albumin, swelling, spared muscle, decreased immunity, and common pressure ulcers.
  • Marasmus-Kwashiorkor: Combination of both, leading to high mortality and morbidity.
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5
Q

What are the key amino acids in wound healing, and what are their roles?

A
  • Glutamine: Supports immune function and inflammation, crucial for lymphocyte proliferation and nucleotide production.
  • Arginine: Increases collagen deposition, fibroblastic activity, and immune response.
  • HMB (Hydroxy-methylbutyrate): Decreases muscle breakdown, supports immune function, and works best with arginine and glutamine.
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6
Q

How do carbohydrates contribute to wound healing and recommended intake?

A
  • They provide energy for tissue repair and regeneration, with a protein-sparing effect.
  • Recommended intake: 30-35 kcal/kg body weight.
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7
Q

What role do fats play in wound healing?

A
  • Fats provide energy, transport fat-soluble vitamins, assist with thermoregulation, and form vital components of cell membranes.
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8
Q

What are the recommended fat intake levels, and what happens with excess or deficiency?

A
  • Fats should be 20-30% of total calories.
  • Excessive intake can suppress the immune system
  • Deficiency decreases phospholipid and prostaglandin production, affecting the basement membrane.
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9
Q

How do omega-3 fatty acids affect wound healing?

A

Omega-3s have anti-inflammatory effects but may impair wound healing by weakening collagen cross-links and alignment.

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10
Q

What is the function of Vitamin A in wound healing?

A
  • It supports collagen synthesis, epithelialization, macrophage function, and skin health.
  • Increase wound tensile strength and enhance the inflammatory response.
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11
Q

What are the effects of Vitamin C deficiency on wound healing?

A
  • Deficiency can delay collagen synthesis and wound healing.
  • Vitamin C also helps control infections and reduce free radical damage.
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12
Q

How does Vitamin K affect wound healing?

A
  • Vitamin K is essential for blood clotting.
  • Deficiency can prolong the inflammatory phase of wound healing.
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13
Q

What are the roles of B-complex vitamins in wound healing?

A
  • They support immune function, white blood cell production, energy metabolism, and collagen synthesis.
  • Vitamin B6 aids histamine synthesis, while B12 prevents anemia.
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14
Q

How does Vitamin E impact wound healing?

A
  • It helps prevent cellular damage from free radicals and reduces inflammation.
  • However, excess Vitamin E can decrease collagen production and weaken wounds.
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15
Q

What is the role of iron in wound healing?

A
  • Iron is required for hemoglobin production, antibody function, collagen synthesis, and oxygen transport to tissues.
  • Deficiency can lead to tissue hypoxia, impaired cell replication, and decreased wound strength.
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16
Q

Why is zinc important for wound healing, and what are the effects of deficiency?

A
  • Zinc supports collagen synthesis, cell proliferation, and immune function.
  • Deficiency can delay wound healing and impair immune response.
17
Q

What role does copper play in wound healing?

A
  • Copper aids in hemoglobin synthesis, iron absorption, collagen cross-linking, and elastin formation with Vitamin C.
  • Deficiency leads to poor healing and immune function.
18
Q

How does magnesium contribute to wound healing?

A
  • Magnesium is a cofactor in over 300 enzyme systems, supporting bone/protein synthesis.
  • Deficiency can cause hypertension, vasoconstriction, and impaired healing.
19
Q

What is the role of calcium in wound healing?

A
  • Calcium is essential for bone formation, muscle contraction, fibrin synthesis, and neurotransmission, contributing to blood clotting.
20
Q

What is the importance of phosphorus in wound healing?

A

Phosphorus supports… vital to tissue repair.

  • bone formation
  • metabolism
  • enzyme systems
21
Q

What is the purpose of nutritional screening in wound care?

A
  • It identifies characteristics of malnutrition or nutritional risk, helping to develop appropriate interventions for patients.
22
Q

What conditions require immediate nutritional assessment and intervention?

A
  • Conditions include unintended weight loss, diseases like diabetes or COPD, immobility, swallowing difficulties, anorexia, and side effects of medications.
23
Q

How is body mass index (BMI) used in nutritional assessment?

A

BMI is compared to normative values to identify malnutrition or nutritional risk.

24
Q

What are the significant weight loss thresholds indicating malnutrition risk?

A
  • 1% decrease in a week
  • 5% decrease in a month
  • 7.5% decrease in 3 months
  • 10% decrease in 6 months.
25
Q

Why are obese patients also at risk for impaired wound healing?

A
  • Obesity can cause poor vascularity, increased inflammation, and reduced mobility, all contributing to delayed healing.
26
Q

What are the main causes of malnutrition in wound care patients?

A

Causes include lack of knowledge, poverty, and underlying health problems.

27
Q

What is the standard caloric and protein intake for patients with wounds?

A
  • 30-35 kcal/kg body weight for carbs
  • 1.25-1.5 g protein/kg body weight.
28
Q

When should a registered dietitian be consulted in wound care?

A
  • If the patient fails to improve, has severe illness, or has special nutritional needs (e.g., swallowing issues, NPO status).
29
Q

What is the Mini Nutritional Assessment (MNA)?

A

A tool used to identify malnutrition risk, especially in older adults.

30
Q

What is the Malnutrition Universal Screening Tool (MUST)?

A

A screening tool to identify malnutrition risk based on BMI, weight loss, and acute disease effect.

31
Q

How does unintended weight loss affect wound healing?

A

It can lead to loss of lean body mass, reduced immune function, and impaired tissue repair.

32
Q

How does malabsorption impact nutritional status and wound healing?

A

It prevents the absorption of vital nutrients, leading to deficiencies that delay wound repair.

33
Q

Why is protein-energy malnutrition critical in wound healing?

A

It leads to muscle wasting, decreased immunity, and reduced collagen synthesis, all of which impair wound closure.

34
Q

How can healthcare providers support patients’ nutritional needs in wound healing?

A

By educating on proper nutrition, providing meal plans, and ensuring adequate intake of water, protein, carbs, fats, vitamins, and minerals.

35
Q

What are the signs of impaired wound healing due to malnutrition?

A

Delayed epithelialization, increased infection risk, tissue breakdown, and low wound tensile strength.

36
Q

Conditions requiring nutritional assessment / intervention?

A
  • unintended weight loss
  • diabetes
  • immobility and activity
  • chewing and swallowing difficulties
  • adverse effect of medications
  • appetite decline (anorexia)