Nutrition Flashcards
Formal assessment of nutritional status
MUST
Nutrition problems common in geriatrics
Protein deficiency
Sarcopenia
(Loss of muscle bulk difficult to spot if high BMI)
Risk factors for malnutrition
Reduced intake:
Weight loss >10% in 6 months, BMI <20, Decreased appetite, Poor oral hygiene, Change in taste, Swallowing problems, Low mood, Functional (inability to prepare nutritious meal)
Reduced absorption:
Pancreatitis, Coeliacs, Chron’s disease, Cystic fibrosis
Increased requirement:
hyper-thyroidism, Infection, Surgery, Burns
Consequences of malnutrition
Impaired immune system Slow wound healing Pressure sores Muscle wasting Increased hospital stay
Definition of malnutrition
Deficiency or excess of any nutrients that has adverse effect on tissue, function and clinical outcome
Stepwise approach to management of malnutrition
Oral nutrition
Enriched oral nutrition (full fat milk, cream, butter, cheese, syrup, jam)
Oral nutritional supplements e.g fortisip, fortijuice
Enteral feeding
Parenteral feeding
Risk factors for refeeding syndrome
Not eaten for >10 days
Initiating parenteral feeding
Anorexia nervosa
Alcoholism
Prevention of refeeding syndrome
Oral thiamine
Vitamin B complex
Multivitamins
Monitoring for refeeding syndrome
Weight Fluid balance Glucose Electrolytes - sodium, potassium, phosphate, calcium, magnesium, zinc Lipids LFTs
Symptoms of refeeding syndrome
Rhabdomyolysis RBC/WBC dysfunction Tachypnoea Arrhythmia Seizures
Management of refeeding syndrome
Parenteral phosphate
Treat complications
Indications for parenteral nutrition
Non functioning GI tract not expecting to be functioning in next 7 days
Risks of parenteral nutrition
Central line sepsis
Central venous thrombosis
Refeeding syndrome
How are NG and NJ tubes placed
NG without guidance, CXR to confirm in place before use
NJ under endoscopic guidance
What is the eatwell guide
Chart showing proportions of food groups needed for balanced diet with examples
