Malnutrition

Question 1

What is malnutrition?

Answer 1

a sudden or chronic decrease in the intake of sufficient nutrition to support the body’s requirements for growth, healing and maintenance

Question 2

True or false: all patients admitted to hospital should be screened for malnutrition

Answer 2

True

Question 3

Give the 3 general reasons for malnutrition:

Answer 3

1) inadequate amount of nutritional intake (e.g. poor diet)
2) difficulty absorbing nutrients (e.g. Coeliac disease)
3) increased nutritional demands (e.g. post-surgery)

Question 4

Give 8 risk factors for malnutrition:

Answer 4

1) chronic illness
2) being an alcoholic
3) poor mental health
4) elderly
5) social isolation
6) long time in hospital
7) cognitive issues
8) polypharmacy

Question 5

Give 5 symptoms of malnutrition:

Answer 5

1) high susceptibility or long durations of infections
2) slow or poor wound healing
3) altered vital signs including bradycardia, hypotension and hypothermia
4) depleted subcutaneous fat stores
5) low skeletal muscle mass

Question 6

What blood marker indicates malnutrition?

Answer 6

hypoalbuminaemia (low protein intake results in reduced albumin production)

Question 7

Name 3 hospital screening tools for malnutrition:

Answer 7

1) Malnutrition Universal Screening Tool (MUST)
2) Malnutrition Screening Tool (MST)
3) Mini-Nutrition Assessment (MNA)

Question 8

Give the 4 possible management plans for malnutrition:

Answer 8

1) oral nutrition
2) nasogastric feeding
3) long-term feeding
4) parenteral nutrition

Question 9

Give two examples of oral nutritional support:

Answer 9

1) high-energy-protein supplements
2) fortified food products

Question 10

Give two examples of long-term feeding methods that rely on stomas:

Answer 10

1) gastrostomy
2) jejunostomy
(openings that allow nutritional input)

Question 11

What is pareneteral nutrition?

Answer 11

giving nutrients intravenously to bypass the usual digestion process (used in patients with intestinal failure of inaccessible digestive tracts)

Question 12

Give 6 complications associated with malnutrition:

Answer 12

1) increased risk of infections
2) poor wound healing
3) decreased muscle mass
4) growth restriction in children
5) multiorgan failure
6) death

Question 13

Describe the pathophysiology of refeeding syndrome:

Answer 13

1) in malnutrition, intracellular stores of electrolytes such as potassium and phosphate become depleted
2) after rapid re-introduction of normal nutrition, there is a shift of these electrolytes from the extracellular to intracellular compartment driven by increasing metabolism and large insulin responses
3) this can lead to a sudden drop in extracellular levels of electrolytes resulting in hypokalaemia and hypophosphatemia (increased risk of cardiac complications and seizures)

Question 14

Give 2 presentations associated with refeeding syndrome:

Answer 14

1) cardiac arrhythmias
2) seizures