Lauer- Anorexia and Cachexia at the end of life Flashcards
What is anorexia?
Reduced desire to eat
How is anorexia often reported?
abdominal pain–N/V if pt is trying to eat regular amts
What is the primary cause of anorexia?
Hypothalamus fails to respond to orexigenic signals, usually secondary to inflammatory processes
What is sarcopenia?
muscle wasting
What is cachexia?
Weight loss that exceeds the amt that can be accounted for by the increased needs of the disease
What is ACS?
A multifactorial syndrome characterized by ongoing LOSS of skeletal mass that can’t be reversed by NUTRITIONAL SUPPORT and leads to progressive functional impairment
What drives ACS?
cytokines! Leptin and grhelin are there but don’t lead to signals to start or stop eating
What are the primary sxs of ACS?
muscle loss
anorexia
fatigue
early satiety
What are interventions available when a pt will not or cannot eat?
Invasive medical feeding
Pharmaceuticals
Oral assissted feeding
When should be interventions be used to help a pt who isn’t eating?
EARLY –in pre-cachexia
when cure is possible
when pt enjoys eating
Does invasive medical means of feeding help to improve a chachexic pts functioning?
NO
Doesn’t do anything
What pharmaceuticals can be used for a cachexic pt?
methylphenidate- AD
dronabinol- increases appetite and pleasure for eating
Megestrol acetate- hypothalamic stimulation–> adipose disposition increasing fat but NOT Muscle mass
What should you do for a pt w/ advanced dementia?
offer them oral assisted feedings
Failing to follow hunger and thirst signals can result in…
INCREASED SYMPTOMS–> PEOPLE NEED TO LISTEN TO YOUR BODY
