undernutrition

Question 1

define protein energy malnutrition

Answer 1

deficiencies in any or all nutrients

Question 2

define micronutrient deficiencies

Answer 2

deficiency of specific micronutrients

Question 3

what are the causes of undernutrition (5)

Answer 3

reduced intake decreased absorption decreased co-factor activity increased metabolism underlying disease

Question 4

3 types of undernutrition in children

Answer 4

acute chronic acute and chronic

Question 5

what is asymptom of acute undernutrition in children

Answer 5

rapid weight loss or failure to gain weight normally

Question 6

what is chronic undernutrition in children

Answer 6

over a long period of time, failure of linear growth

Question 7

what is acute and chronic undernutrition in children

Answer 7

result of wasting, stunting or both

Question 8

how is undernutrition in adults caused

Answer 8

micronutrient deficiencies decreased GI function underlying disease reduced intake - dysphagia, reduced appetite

Question 9

what is disease related malnutrition called

Answer 9

cachexia

Question 10

define cachexia

Answer 10

physical loss of weight and muscle mass caused by disease such as CF, AIDS, CHF

Question 11

how is cachexia treated

Answer 11

fortified foods small/often meals Prescribable and non-Prescribable supplements (ensure/complan)

Question 12

physical consequences of undernutrition

Answer 12

reduced immunity delayed healing fatigue hypothermia reduced resp. muscle function (chest infections) immobility

Question 13

physiologica; consequences of undernutrition

Answer 13

depression/anxiety self-neglect loss of libido

Question 14

two alternative feeding routes

Answer 14

nasal and abdominal

Question 15

indications for nasal feeding

Answer 15

short term (<14 days)

Question 16

types of abdominal feeds and indications `

Answer 16

gastrostomy - long term home jejunostomy - unlikely to resume to full oral intake after abdominal surgery/laparotomy PN - non-functioning gut

Question 17

advantages of nasal feeding

Answer 17

quick cheap not invasive

Question 18

disadvantages of nasal feeding

Answer 18

reflux irritation infection risk stigma easily moved/removed x-ray

Question 19

advantages of abdominal feeding

Answer 19

less stigma less migration/removal no dysphagia/reflux

Question 20

disadvantages of abdominal feeding

Answer 20

invasive sedation and abx req. irritation leakage into abdomen bowel translocation tube clogging x- ray

Question 21

common problems with enteric feeding

Answer 21

diarrhoea constipation vomiting tube blockage

Question 22

how to resolve common problems with enteric feeding

Answer 22

checking feed date, temp, rate, fibre, fluid and position of patient

Question 23

positive outcomes of enteric feeds

Answer 23

reduced hospital stay lower mortality improvement in immunity, wellbeing, healling lower complication rate improved clinical scores

Question 24

6 types of feeds

Answer 24

standard 1kcal/ml high energy 1.5kcal/ml fibre addedlow sodium low electrolyte/energy dense elemental/peptide

Question 25

one example of standard 1kcal/ml feed

Answer 25

osmolite

Question 26

examples of high energy 1.5kcal ffed

Answer 26

osmolite 1.g, ensure plus

Question 27

example of fibre added feed

Answer 27

jevity

Question 28

example of low sodium feed

Answer 28

nutrison low sodium

Question 29

example of low electrolyte/energy dense feed

Answer 29

nepro

Question 30

example of elemental/peptide feed

Answer 30

perative

Question 31

when would you use standard 1kcal feed

Answer 31

most feeds

Question 32

when would you use high energy 1.5kcal feed

Answer 32

high energy requirements fluid restriction

Question 33

when would you use fibre added feed

Answer 33

long term

Question 34

when would you use low sodium feed

Answer 34

ascites HT

Question 35

when would you use low electrolyte/energy dense feed

Answer 35

renal impairment fluid restriction

Question 36

when would you use elemental/peptide feed

Answer 36

malabsorption short gut CD