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Malnutrition is an imbalance between ____________
energy stores and expenditures
Define protein catabolism
There is a breakdown by the body of other protein stores; the body is actually harvesting other protein
Protein catabolism leads to ..... (3)
- 1. decrease in weight
- 2. decrease in muscle mass
- 3. impaired functioning of the organs (heart, lungs, GI)
TF: You can be both malnourished and obese
Calorie intake is low --> wasting body fats and proteins
Poor quality/quantity of protein, but adequate calories --> person looks okay but may have breakdown of incision lines
Marasmic - Kwashiorkior
inadequate calories and protein
what two groups tend to be more at risk than other groups for malnutrition
Give two examples of disease processes that can result in malnutrition.
- 1. a malabsorptive disease
- 2. a disease that increases demand like chemo, cancer, trauma
12-55% of hospitalized patients are malnourished either at the time of admission or during hospitalization. Why?
- decreased appetite
- increased metabolic demands
True: 10-85% of ECF residents are judged to be malnourished and often come from an acute setting in this state.
TF: Malnutrition has not been shown to have a long term impact on child development
weight in lbs/ height in inches^2 * 703
- -less than 18 is underweight
- -18-24 is normal
- -25-29 is overweight
- -30 is obese
- -40+ is morbidly obese
Accurate height and weight are very important so how often do we weight patients?
you need to weight the pt on admission and then weekly.
Regarding unintentional weight loss, what is significant for (1) 30 days, (2) 60 days?
- Change in 5% in 30 days or
- 10% in 60 days
hemoglobin to hematocrit ratio. What do abnormals indicate?
- should be about 1:3.
- If that is off, it can sometimes give you an idea about dehydration.
Normal for serum albumin. Time frame of sensitivity. Affected by
- 3 week lag time
- affected by hydration, liver, renal disease
normal for serum transferrin.Time frame of sensitivity.
- should be > 200
- 8-10 days
Normal for prealbumin. Time frame of sensitivity. Affected by
- should be 23-43 mg/dL
- 2 days
- alcohol, binge drinking, chronic diseases, prednisone, some other medications.
antihistimine to stimulate appetite
antineoplastic to stimulate appetite
medicinal marijuana to decrease nausea and stimulate appetite.
What are three advantages of enteral nutrition?
- 1. cheaper that parenteral nutrition
- 2. preserves the functioning of guts (villi and microville which will shrink w/o contact with food).
- 3. used in multiple settings: home, hospital, ECF