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Malnutrition is an imbalance between ____________
energy stores and expenditures
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Define protein catabolism
There is a breakdown by the body of other protein stores; the body is actually harvesting other protein
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Protein catabolism leads to ..... (3)
- 1. decrease in weight
- 2. decrease in muscle mass
- 3. impaired functioning of the organs (heart, lungs, GI)
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TF: You can be both malnourished and obese
True
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Marasmus
Calorie intake is low --> wasting body fats and proteins
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Kwashiorkor
Poor quality/quantity of protein, but adequate calories --> person looks okay but may have breakdown of incision lines
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Marasmic - Kwashiorkior
inadequate calories and protein
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what two groups tend to be more at risk than other groups for malnutrition
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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
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12-55% of hospitalized patients are malnourished either at the time of admission or during hospitalization. Why?
- decreased appetite
- increased metabolic demands
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True: 10-85% of ECF residents are judged to be malnourished and often come from an acute setting in this state.
True
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TF: Malnutrition has not been shown to have a long term impact on child development
False
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BMI formula
weight in lbs/ height in inches^2 * 703
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BMI categories
- -less than 18 is underweight
- -18-24 is normal
- -25-29 is overweight
- -30 is obese
- -40+ is morbidly obese
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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.
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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
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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.
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Normal for serum albumin. Time frame of sensitivity. Affected by
- >3.5g/dL
- 3 week lag time
- affected by hydration, liver, renal disease
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normal for serum transferrin.Time frame of sensitivity.
- should be > 200
- 8-10 days
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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.
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periactin
antihistimine to stimulate appetite
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megase
antineoplastic to stimulate appetite
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merinol
medicinal marijuana to decrease nausea and stimulate appetite.
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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
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