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  1. What is PCM?
    protein calorie malnutrion
  2. primary PCM
    nutritional needs are not met
  3. secondary PCM
    result of an alteration or deficit in ingestion, digestion, absorption, or metabolism
  4. What is PCM generally low in?
    protein, vitamin, and minerals
  5.  Marasmus
    • characterized by generalized loss of body fat and muscle
    • pt's appear wasted or emaciated
    • may have normal serum protein 
  6. Kwashiorkor
    • caused by a deficieny of protein intake
    • associated with edema and low serum protein levels 
  7. Marasmus-kwashirokor
    severe tissue wasting, loss of SQ fat, and dehydration
  8. causes of malnutrition
    • socioeconomic class
    • physical illness
    • incomplete diets
    • food-drug interactions
  9. Clinical manifestations
    • dry, scaly skin
    • brittle nails
    • rashes
    • hair loss
    • mouth crusting and ulceration
    • tongue changes
    • decreased muscle mass with weakness
    • confusion and irritability
    • delayed wound healing
    • susceptability to infections
    • anemia 
  10. Which body organ losses the most mass during protein deprivation?
    liver; it becomes infiltrated with fat
  11. history/physical exam
    • diet hx over the past week
    • height
    • weight
    • vital signs
    • physical state 
  12. labs
    • prealbumin-best indicator of recent/current nutritional status
    • serum transferrin-indicator of protein status
    • albumin
    • C-reactive protein--used to determine if low levels of viseral proteins are due to an inflammatory process or malnutrition
    • K-elevated in malnutrition
    • RBC & Hgb-anemia
    • total lymphocyte count decreases
    • liver enzyme levels increased 
    • serum levels of fat/water soluble vitamins decreased
  13. nursing assessment
    • screening for all pts w/in 24 hrs of admission:
    • hx of weight loss
    • prior intake before admission
    • nutirion support
    • chewing/swallowing issues
    • skin bresakdown 
  14. acute intervention
    • select high calorie, high protein foods
    • bring the pts favorite foods during hospitalization
    • between meal supplements
    • multiple, small meals 
    • appetite stimulants-megestrol acetate (Megace) or dronabinol (Marinol)
    • EN may be conidered if the pt can't take in enough orally
    • PN if EN is not possible
  15. gerontologic considerations
    • little/no appetite
    • problems eating/swallowing
    • inadequate nutrients
    • fewer than 2 meals/day
    • chronic illness
    • poor oral health: cavities, gum disease, missing teeth, dry mouth
    • physiologic changes such as decreased body mass and redistribution of fat around internal organs
    • changes in taste
Card Set:
2012-06-24 23:57:48

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