Ch. 12 Malnutrition

What is malnutrition?

Malnutrition is caused by a lack of adequate nutrients or an imbalanced intake of nutrients and can be identified in clients who are underweight, overweight, or obese.

What are the consequences of malnutrition?

Malnutrition is a major cause of morbidity and mortality, decreased quality of life, and increased health care costs.

What conditions must a client meet to be diagnosed with malnutrition?

A client must have at least two of the following: inadequate intake of calories, loss of muscle mass, loss of subcutaneous fat, unintentional weight loss, decreased handgrip strength, or weight loss masked by edema.

What is protein-energy malnutrition (PEM)?

PEM is a calorie deficit due to inadequate intake of protein, carbohydrates, and fat and can be starvation-related, especially in children and older adults.

What distinguishes marasmus from kwashiorkor?

Marasmus is characterized by inadequate intake of calories and protein, while kwashiorkor is due to lack of protein intake or poor-quality protein despite adequate calorie intake.

What are some examples of chronic disease-related malnutrition?

Chronic disease-related malnutrition can occur due to conditions like chronic alcohol use disorder, which affects appetite and nutrient absorption.

What is the preferred method of nutritional support for clients with acute disease-related malnutrition?

Oral diet is preferred if possible, and enteral nutrition (EN) is favored over parenteral nutrition (PN) if the GI tract is functioning.

How do high metabolic states, such as from burns or trauma, affect caloric needs?

High metabolic states increase caloric and nutrient needs, requiring calorie-dense and protein-dense food to meet increased demands.

What factors contribute to malnutrition in older adults?

Dental problems, decreased senses, gastrointestinal issues, multiple medications, and social isolation can all contribute to malnutrition in older adults.

What should be monitored in clients at risk for malnutrition?

Monitor appetite, daily weights, intake and output, and laboratory studies such as electrolytes, BUN, creatinine, and albumin levels.

What is refeeding syndrome?

Refeeding syndrome may occur when carbohydrates are reintroduced into the diet of malnourished clients, leading to electrolyte imbalances and potential complications.

What interventions can be taken to increase calorie and protein intake?

Add calorie-dense foods like butter or cream, and increase protein intake with cheese, nuts, or protein-rich foods.

What role does indirect calorimetry play in nutrition assessment?

Indirect calorimetry provides the most accurate predictive assessment of caloric needs for clients, helping to tailor nutritional support.

What are the key goals of nutritional support in malnourished clients?

To decrease morbidity from infections, length of stay in critical care units, and improve overall nutritional status.