Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Gastro 2 > Malnutrition and nutritional assessment > Flashcards

Malnutrition and nutritional assessment Flashcards

1
Q

What is malnutrition?

A

A state in which deficiency, excess or imbalance, of energy, protein or other nutrients, results in a measurable adverse effect on body composition, function and clinical outcome

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the relationship between age and prevalence of malnutrition?

A

Curvilinear relationship (highest rates are in youngest and oldest age groups, women>men)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What wards have the highest prevalence of malnutrition?

A

-Oncology
-Care of elderly
-GI disturbance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the 3 causes of malnutrion in hospitals?

A
  • Reduced intake (DRA)
  • Maldigestion, malabsorption
  • Altered-metabolism
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

How does disease related anorexia (DRA) work?

A

-Pro inflammatory cytokines
-Upregulate anorexigenic peptides
-Suppress hunger

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How many people on admission to hospital have malnutrition?

A

1 in 3

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the significance of malnutrition?

A

Malnutrition increases risk of mortality post op

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Where is mass mainly lost at discharge?

A

Mainly muscle mass

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are 2 causes of malnutrition?

A

-Disease related anorexia
-Metabolic response to illness/injury

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the pathway in diagnosing malnutrition?

A
  1. Screen to identify risk
  2. Assess the body through dietitian
    3.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

How can we assess an individual for malnutrition?

A

-Anthropometry= measuring size
-Body composition= fats
-Function= hand grip test
-Biochemistry= electrolytes
-Clinical= chronic illness
-Dietary= diet
-Social= poverty, socioeconomic status
-Physical signs= dentures

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

When do you know if a patient requires nutritional support?

A
  1. Malnourished
  2. At risk of malnutrition
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

How do you know if a patient is malnourished? (at least 1 of 3)

A

-BMI < 18.5kg/m²
-Unintentional weight loss > 10% past 3-6/12 days
-BMI < 20kg/m² + unintentional weight loss > 5% past 3-6/12 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

How do you know if a patient is at risk of malnutrition? (at least 1 of 2)

A

-Have eaten little/nothing for > 5 days AND/OR unlikely to eat little/nothing for next 5 days or longer
-Have a poor absorptive capacity AND/OR have high nutrient losses AND/OR have increased nutritional needs from caused such as catabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What support is given for malnutrition when oral nutrition is possible?

A

Oral nutritional support

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What support is given when oral nutrition is not possible but the GI tract is still functional and accessible?

A

Enteral feeding tube
Consent is required

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What support is given when oral nutrition is not possible and the GI tract is not functional and accessible?

A

Parenteral nutrition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the main aim of the algorithm of the treatment of malnutrition?

A

To get back to oral nutrition

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What does oral nutrition support consist of?

A

-Fortification of meals and snacks
-Altered meal patterns
-Practical support
-Oral nutritional supplements
-Tailored dietary counselling

20
Q

What does enteral nutrition consist of?

A

Putting a tube directly into the GI tract

21
Q

What is given in enteral feeding if gastric feeding is possible?

A

Naso-gastric tube (NGT)

22
Q

What is given in enteral feeding if gastric feeding is not possible?

A

-Naso-duodenal tube (NDT)
OR
-Naso-jejunal tube (NJT)

23
Q

What is used if enteral feeding is long term (> 3 months)?

A

-Gastrostomy
OR
-Jejunostomy

24
Q

What feeding is used if there is gastric outlet obstruction?

A

NJT as NGT is contraindicated

25
Q

What are complications associated with enteral feeding?

A

-Mechanical
-Metabolic
-GI

26
Q

What are examples of mechanical complications associated with enteral feeding?

A

-Misplacement
-Blockage
-Buried bumper= NGT, part of feeding tube engrains into skin

27
Q

What are examples of metabolic complications associated with enteral feeding?

A

-Hyperglycaemia
-Deranged electrolytes (at risk of refeeding syndrome)

28
Q

What is refeeding syndrome?

A

-Seen when reintroducing carbohydrates into a starved individual
-Biochemical shifts and clinical symptoms

29
Q

What are the body electrolytes and nutrient which are depleted during starvation?

A

-Potassium
-Magnesium
-Phosphate
-Thiamine= due to loss of water and thiamine is water soluble

30
Q

What happens to thiamine in referring syndrome?

A

Thiamine is a coenzyme of carbohydrate metabolism so is depleted and can lead to thiamine deficiency in a bit B depleted patient

31
Q

What problems can RFS cause?

A

-Thiamine deficiency and low electrolyte concentrations can cause clinical problems
-Carbohydrates reduce sodium and fluid excretion, expanding fluid compartment leading to refeeding oedema and fluid overload

32
Q

What are consequences of RFS?

A

-Arrhythmias, tachycardia, cardiac arrest, sudden death
-Respiratory depression
-Encephalopathy, coma, seizures, rhabdomyolysis
-Wernicke’s encephalopathy

33
Q

What is rhabdomyolysis?

A

Breakdown of muscle tissue leading to muscle fibre contents being released into blood that harm the kidney

34
Q

What is the management of RFS?

A
  1. Start feeding slowly
  2. Correct and monitor electrolytes daily following trust policy
  3. Administer thiamine from onset of feeding following trust policy
  4. Monitor fluid shifts and minimise risk of fluid and Na+ overload
35
Q

What are examples of GI complications associated with enteral feeding?

A

-Aspiration from vomiting because of obstruction
-Nasopharyngeal pain
-Laryngeal ulceration
-Diarrhoea

36
Q

What is parenteral nutrition?

A

Delivery of nutrients, electrolytes and fluid directly into venous blood

37
Q

What are the indications for the use of parenteral nutrition?

A

-Inadequate/unsafe oral and/or enteral nutritional intake
OR
-Non-functioning, inaccessible or perforated GI tract

38
Q

What are the points of access for parenteral nutrition?

A

-Central venous catheter (CVC)= tip at superior vena cava and right atrium
-Different CVCs for short/long term use

39
Q

What type of bags for parenteral nutrition are there?

A

-Ready made
-Bespoke bags made for individual needs

40
Q

How are bespoke bags for individual patient needs made?

A

MDT decides fluid and electrolyte targets

41
Q

What are the complications associated with parenteral nutrition?

A

-Metabolic
-Mechanical
-Catheter related infection

42
Q

What are examples of metabolic complications of parenteral nutrition?

A

-Deranged electrolytes
-Hyperglycaemia
-Abnormal liver enzymes
-Oedema
-Hypertriglyceridaemia

43
Q

What are examples of mechanical complications of parenteral nutrition?

A

-Pneumothorax
-Haemothorax
-Thrombosis
-Cardiac arrhythmias
-Thrombus
-Catheter occlusion
-Thrombophlebitis (swollen/inflamed vein due to blood clot)
-Extravasion (leakage of blood/ other fluids)

44
Q

What type of protein is albumin?

A

Negative acute phase protein

45
Q

What is a negative acute phase protein?

A

During inflammation plasma albumin decreases

46
Q

What is the mechanism of negative acute phase proteins?

A
  1. Inflammatory stimuli
  2. Activation of monocytes and macrophages
  3. Release cytokines
  4. Cytokines act on liver to down regulate negative acute phase proteins
47
Q

Why is albumin not a marker for malnutrition in the acute hospital setting?

A

It decreases due to inflammation so will not be halted to nutrition status

Gastro 2 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions