Nutrition Disorders: Malnutrition Flashcards
What is the definition of malabsorption according to the NICE guidelines?
- a state in which a deficiency of nutrients such as energy, protein, vitamins and minerals causes measurable adverse effects on body composition, function or clinical outcome
According to the WHO does malnutrition include undernutrition that causes wasting, stunting, underweight?
- yes
According to the WHO does malnutrition include inadequate vitamins or minerals?
- yes
According to the WHO does malnutrition include being overweight or obese?
- yes
According to the WHO does malnutrition include diet-related noncommunicable diseases (non transmissable diseases) such as diabetes and CVD?
- yes
In the UK aprox how many people are malnourished?
- 3 million are underweight and not consuming enough vitamins and minerals
According to the British Association of Parentral and Entral Nutrition in 2015 what does malnutrition increase?
- all costs associate with healthcare
- prescriptions, appointments, admissions, disease associated malnutrition
In 2011-2012 what was the estimated cost of malnutrition in England?
- £19.6 billion/year
In terms of malnutrition was does the Malnutrition Carousel tell us?
- malnourished patients attend hospital are likley to have further complication when in hospital
- upon discharge they are even more malnourished which increases GP appointment, prescriptions and hospital appointments
Which bodily systems does malnutrition affect?
- all systems
- reduced muscle mass and inactivity causing falls
- pressure ulcers and blood clots
- reduced ability to cough may predispose to chest infections and pneumonia
- heart failure
Are those aged above or under 65 years of age at a greater risk of malnutrition?
- >65 year olds
Are those who are healthy or with long term health conditions at a greater risk of malnutrition?
- long-term conditions e.g. diabetes, renal failure, chronic lung disease
Are those who with a chronic progressive disease or healthy at a greater risk of malnutrition?
- chronic progressive conditions – for example, dementia or cancer
Are those who have alcohol or drug abuse at risk of malnutrition?
- yes
In starvation of over 3 month when patients have loss >40% of their body weight or has a BMI <11 and 10 in men and women, respectively, is survival common?
- no
- survival is rare
Simple starvation can be divided into 2 categories, what are they?
- short term starvation (<72 hours)
- prolonged starvation (>72 hours)
What is stress starvation?
- patients are starved combined with metabolic response to trauma, sepsis and critical illness
In stress starvation, what contributed to the overidiing of the normal adaptive responses of simple starvation that involves conserving body protein?
- over-ridden by the neuroendocrine and cytokines
In stress starvation, what happens to metabolic rate, ketosis and blood glucose?
- metabolic rate rises
- ketosis is minimal, protein catabolism accelerates to meet the demands for tissue repair
- gluconeogenesis and there is hyperglycaemia and glucose intolerance
In stress starvation, what happens to salt and water levels?
- salt and water retention is exacerbated
- may result in oedema and hypoalbuminaemia
Altered nutritional requirements is one of the causes of malnutrition. What causes an alteration in a patients nutritional requirements?
- generally due to illness or infection
Inadequate intake is one of the causes of malnutrition. What causes Inadequate intake?
- extreme diets
- poverty/drugs/alcohol
Impaired nutrient digestion and processing is one of the causes of malnutrition. What causes this?
- GIT dysfunction and/or disease
Excess losses is one of the causes of malnutrition. What causes this?
- vomiting/diarrhoea
- surgical drains
- fistulae/stomas
- pressure ulcers
There are a number of medical conditions resulting from external nutritional deficiencies, what are the 4 most common of these?
1 - iron deficiency anaemia
2 - vitamin B12 deficiency (pernicious anaemia and nerve problems)
3 - vitamin D deficiency causes rickets in children and osteomalacia in adults
4 - thiamine deficiency causes wet or dry Beriberi, Wernicke Korsakoff syndrome
Before a patient can be treated for malnutrition is screening. Why is this important and what tool is used in Kent?
- 1st step for recognising and treating malnutrition
- Malnutrition Universal Screening Tool (MUST)
What is Malnutrition Universal Screening Tool (MUST)?
- screening tool for malnutrition
- 0 = low risk
- 1 = medium risk
- 2 = high risk
If you cannot measure a patients BMI or waist circumference, what is an alternative measure?
- mid upper arm circumference
