Nutrition - 229 Flashcards
(27 cards)
State 5 consequences of malnutrition on the body and how this could increase mortality
1) Decreased muscle mass -> cardiac failure
2) Decreased visceral proteins -> respiratory failure
3) Impaired immunity -> infection
4) Impaired wound healing -> pressure sores, wound breakdown
5) Multiple organ failure!
Name 3 methods of nutritional support
Eating more
Food supplements
Artificial support, e.g. parenteral & enteral feeding
What is enteral feeding?
It delivers nutritionally complete food straight into the stomach, duodenum or jejunum.
Name one requirement before you can feed someone enterally
They must have a functioning gut
Name 3 indications for enteral feeding
Unable to meet caloric requirements with normal food,
unintentional weight loss of >10% within 3/12, hypermetabolic state
Name 3 advantages of enteral feeding
1) Nutrients used more effectively
2) Preserves intestinal mucosal structure
3) Prevents biliary sludge
4) Comfortable
5) Independent of swallowing problems/appetite
What is parenteral feeding?
Intravenous feeding, either centrally or peripherally
Name 2 indications for parenteral feeding
Non-functioning gut
Gut rest required (e.g. post op)
Name some complications of parenteral feeding
Line sepsis, thrombophlebitis, fluid overload, hyperglycaemia, re-feeding syndrome
What is the most abundant free amino acid in the body? What is it important for?
Glutamine
Nitrogen metabolism, enterocytes, gut mucosa, immune cells, acid-base balance
What proteins/vitamins/minerals deplete during starvation?
Protein, K, P, Mg, Zn, Thiamine
Phosphate and magnesium levels both deplete during starvation - what is the relevance of this?
They are needed for ATP production
What is thiamine used for?
Carbohydrate metabolism
Refeeding leads to what kind of movement?
Intracellular
What transports glucose, K, Mg, and P into cells during refeeding syndrome? What does this lead to?
Insulin.
Oedema
What do you monitor daily in someone who you think is at risk of refeeding syndrome?
Na, K, urea, creatinine, Mg, P.
What is the most common cause of short bowel syndrome?
Surgical removal
In newborns, what is one of the most common causes of surgical removal of bowel resulting in SBS?
Nectrotizing enterocolitis -> ischaemia and necrosis of the GI tract.
What happens immediately following jejunal resection? How is this then fixed?
Temporary decrease in nutrient absorption. Functional adaptation takes place and the ileum adapts to increase absorption
What hormone is an important regulator of intestinal epithelial differentiation?
Thyroid hormone
What happens to the ileum following jejunal resection?
The villi increase in length, diameter and function -? epithelial hyperplasia.
What is essential for stimulating ileal adaptation?
The delivery of nutrients enterally
Are ghrelin levels high or low in patients with SBS?
Low
The administration of what aa enterally increases ileal adaptation? (following jejunal resection)
Sulphur amino acids
