T3 - Malnutrition Obesity (Josh) Flashcards
When is a nutrition screening supposed to be done?
within first 24 hrs of admission
What is formula for calculating change in weight?
Usual weight MINUS current weight DIVIDED BY usual weight
then MULTIPLY by 100 for a percentage
What is formula for BMI?
Weight (kg) DIVIDED BY height (meters) squared
What would be considered significant weight loss?
anything greater than 10 percent within 6 months
BMI:
— is underweight
— is normal weight
— is overweight
— is obese
— is morbidly obese
less than 18.5
18.5 - 24.9
25 - 29.9
30 or more
40 or more
What is PEM (aka: PCM) and how many forms are their?
Protein-Energy Malnutrition (PEM)
or
Protein-Calorie Malnutrition (PCM)
3 Forms:
- Marasmus
- Kwashiorkor
- Marasmus-kwashiokor
PEM:
There are three forms.
Which form is a lack of calories where protein and body fat are wasted?
Marasmus
PEM:
There are three forms.
Which form has adequate calories, but lacks protein quality and quantity?
Kwashiorkor
***K has the Kalories, but not the protein
PEM:
There are three forms:
Which form is a combined protein and calorie (energy) malnutrition?
Marasmus-Kwashiokor
What unintentional weight loss is diagnostic for malnutrition?
5 percent or more over 30 days
10 percent of more over 6 mths
What lab is best indicator of malnutrition?
Why?
What is normal?
Prealbumin
it has a shorter half life
normal values are 15-36 mg per dL
What cholesterol levels are diagnostic for malnutrition?
less than 160
What Total Lymphocyte Count indicates malnourishment?
less than 1500
What are normal Albumin levels?
3.5 - 5
What are normal Prealbumin levels?
15-36
What is a symptom of Refeeding Syndrome?
hypophosphatemia
What is a contraindication for TEN (Total Enteral Nutrition)?
low BP that isn’t perfusing GI tract
Why is bacteria a concern with TPN?
you’re infusing glucose which bacteria love
What should you have ready if you run out of TPN?
10 percent glucose
With TPN, what are you doing regularly?
accuchecks
Central obesity is measured how?
Waist Circumference
What waist circumference is obese?
men: greater than 40
women: greater than 35
What is WHR?
Waist to Hip Ratio
- 95 or greater in men is obese
- 8 or greater in women is obese
Which shape is more of a risk factor for CV disease?
apple shaped
Which obesity med can be used to block the absorption of fat to help you lose weight?
Orlistat
Rx: 120 mg TID
OTC: 60 mg
What are the official names for Lab Band surgery?
Laparoscopic Adjustable Gastric Band (LAGB)
or
Laparascopic Sleeve Gastrectomy (LSG)
***people do gain weight back with these
What is the official name for Gastric Bypass?
Roux-en-Y Gastric Bypass (RNYGB)
What type of surgery is Gastric Bypass?
What type of surgery is Lab Band?
Malabsorption - decreases amount of absorption by limiting stomach space
Restriction - restricts amount of food entering stomach
With — surgery, they will need supplements for the rest of their lives.
Gastric Bypass
What is priority care after Bariatric Surgery?
Airway management
Abdominal Binder
Sequential compression or Heparin
Skin Assessment
Absorbent padding
Removal of Foley within 24 hrs
What are special considerations after Bariatric Sugery?
Ambulate asap
Monitor abdominal girth
6 small feeds
Prevent Dehydration
Watch for Dumping Syndrome
What is Dumping Syndrome?
after bariatric surgery, client gets food too quickly and gets tachycardia, nausea, abdominal cramping, and rapid bowel emptying
What are signs and symptoms of Vit A deficiency?
Conjunctival xerosis
Dry skin
Follicular hyperkeratosis
Purple tongue
