Nutrition and Wound Care Flashcards
How much water should a patient consume daily for wound healing, and how does dehydration affect it?
- 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.
What are the primary roles of protein in wound healing?
- Protein is crucial for collagen synthesis, granulation tissue formation, angiogenesis, remodeling, and immune function.
- It also maintains osmotic pressure to prevent edema.
What are the recommended protein intake levels for different patient needs?
- 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.
Describe protein malnutrition and its types.
- 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.
What are the key amino acids in wound healing, and what are their roles?
- 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.
How do carbohydrates contribute to wound healing and recommended intake?
- They provide energy for tissue repair and regeneration, with a protein-sparing effect.
- Recommended intake: 30-35 kcal/kg body weight.
What role do fats play in wound healing?
- Fats provide energy, transport fat-soluble vitamins, assist with thermoregulation, and form vital components of cell membranes.
What are the recommended fat intake levels, and what happens with excess or deficiency?
- 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.
How do omega-3 fatty acids affect wound healing?
Omega-3s have anti-inflammatory effects but may impair wound healing by weakening collagen cross-links and alignment.
What is the function of Vitamin A in wound healing?
- It supports collagen synthesis, epithelialization, macrophage function, and skin health.
- Increase wound tensile strength and enhance the inflammatory response.
What are the effects of Vitamin C deficiency on wound healing?
- Deficiency can delay collagen synthesis and wound healing.
- Vitamin C also helps control infections and reduce free radical damage.
How does Vitamin K affect wound healing?
- Vitamin K is essential for blood clotting.
- Deficiency can prolong the inflammatory phase of wound healing.
What are the roles of B-complex vitamins in wound healing?
- They support immune function, white blood cell production, energy metabolism, and collagen synthesis.
- Vitamin B6 aids histamine synthesis, while B12 prevents anemia.
How does Vitamin E impact wound healing?
- It helps prevent cellular damage from free radicals and reduces inflammation.
- However, excess Vitamin E can decrease collagen production and weaken wounds.
What is the role of iron in wound healing?
- 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.
Why is zinc important for wound healing, and what are the effects of deficiency?
- Zinc supports collagen synthesis, cell proliferation, and immune function.
- Deficiency can delay wound healing and impair immune response.
What role does copper play in wound healing?
- Copper aids in hemoglobin synthesis, iron absorption, collagen cross-linking, and elastin formation with Vitamin C.
- Deficiency leads to poor healing and immune function.
How does magnesium contribute to wound healing?
- Magnesium is a cofactor in over 300 enzyme systems, supporting bone/protein synthesis.
- Deficiency can cause hypertension, vasoconstriction, and impaired healing.
What is the role of calcium in wound healing?
- Calcium is essential for bone formation, muscle contraction, fibrin synthesis, and neurotransmission, contributing to blood clotting.
What is the importance of phosphorus in wound healing?
Phosphorus supports… vital to tissue repair.
- bone formation
- metabolism
- enzyme systems
What is the purpose of nutritional screening in wound care?
- It identifies characteristics of malnutrition or nutritional risk, helping to develop appropriate interventions for patients.
What conditions require immediate nutritional assessment and intervention?
- Conditions include unintended weight loss, diseases like diabetes or COPD, immobility, swallowing difficulties, anorexia, and side effects of medications.
How is body mass index (BMI) used in nutritional assessment?
BMI is compared to normative values to identify malnutrition or nutritional risk.
What are the significant weight loss thresholds indicating malnutrition risk?
- 1% decrease in a week
- 5% decrease in a month
- 7.5% decrease in 3 months
- 10% decrease in 6 months.
Why are obese patients also at risk for impaired wound healing?
- Obesity can cause poor vascularity, increased inflammation, and reduced mobility, all contributing to delayed healing.
What are the main causes of malnutrition in wound care patients?
Causes include lack of knowledge, poverty, and underlying health problems.
What is the standard caloric and protein intake for patients with wounds?
- 30-35 kcal/kg body weight for carbs
- 1.25-1.5 g protein/kg body weight.
When should a registered dietitian be consulted in wound care?
- If the patient fails to improve, has severe illness, or has special nutritional needs (e.g., swallowing issues, NPO status).
What is the Mini Nutritional Assessment (MNA)?
A tool used to identify malnutrition risk, especially in older adults.
What is the Malnutrition Universal Screening Tool (MUST)?
A screening tool to identify malnutrition risk based on BMI, weight loss, and acute disease effect.
How does unintended weight loss affect wound healing?
It can lead to loss of lean body mass, reduced immune function, and impaired tissue repair.
How does malabsorption impact nutritional status and wound healing?
It prevents the absorption of vital nutrients, leading to deficiencies that delay wound repair.
Why is protein-energy malnutrition critical in wound healing?
It leads to muscle wasting, decreased immunity, and reduced collagen synthesis, all of which impair wound closure.
How can healthcare providers support patients’ nutritional needs in wound healing?
By educating on proper nutrition, providing meal plans, and ensuring adequate intake of water, protein, carbs, fats, vitamins, and minerals.
What are the signs of impaired wound healing due to malnutrition?
Delayed epithelialization, increased infection risk, tissue breakdown, and low wound tensile strength.
Conditions requiring nutritional assessment / intervention?
- unintended weight loss
- diabetes
- immobility and activity
- chewing and swallowing difficulties
- adverse effect of medications
- appetite decline (anorexia)
