Nutrition in Practice Flashcards
Define malnutrition
A state of nutrition in which a deficiency or excess of energy, protein and other nutrients causes measurable adverse effects on tissue / body form and function and clinical outcome.
What can cause malnutrition?
Decreased intake due to food availability, decreased intake when food is available, increased loss of food intake e.g. diarrhoea, vomiting or malabsorption, increased nutritional requirement i.e. with infection or lack of recognition and treatment
What are the consequences of malnutrition?
Decreased respiratory and cardiac function, mobility and wound healing time. There is also an increased risk of pressure sores, infection, malabsorption, apathy and depression.
How is malnutrition diagnosed?
Using the MUST guidelines ; take the BMI, weight loss and acute disease effect into account and calculate the score in order to create an action plan for the patient
What may cause hypoalbuminaemia?
Inadequate protein intake, but it can also be caused by inflammation and sepsis associated with infection (characterised by high CRP, WBCs and fever/pyrexia)
How may infection lead to hypoalbuminaemia?
In inflammation the capillary walls become more porous and as a result the albumin drifts out into the interstitium –> low albumin levels –> reduced onocotic pressure –> oedema
How does the metabolism react in a starving state?
Glucagon levels rise and insulin levels fall. The glycogen stores are utilised but run out in 24 hours, and thereafter the body shifts to utilising protein and fats for energy and potassium, phosphate and magnesium stores become depleted as they are required as cofactors for such reactions
What is referring syndrome?
This is a potentially fatal condition that is characterised by sudden exogenous glucose availability after starvation which leads to increased insulin secretion which leads to the uptake of potassium, phosphate and magnesium from the serum in order to replenish the intracellular stores, however, because the stores are so low, there is none of these left in the blood, and this can cause severe complications
What are the clinical consequences of refeeding syndrome?
Low phosphate - seizures, paraesthesia, muscle necrosis, impaired respiratory muscle function, cardiac failure and oedema.
Low magnesium - parasethesia, seizures, ataxia, tremor, arrhythmias, abdominal pain and anorexia§
Low potassium - paralysis, paraesthesia, rhabdomyolysis, respiratory depression, arrhythmias, cardiac arrest and constipation
What is enteral nutrition?
this is nutrition that is administered through the passing/involvement of the intestines e.g. oral, NG, NJ gastrostomy or jujunostomy
What is parenteral nutrition?
This is nutrition that is administered to not involve the intestine, and therefore is IV administered
