Ch. 15 - Malnutrition

Nutrition Exam 2

What is malnutrition?

Malnutrition is an imbalance of nutrient intake that results in deficiencies, excesses, or altered use of nutrients, leading to changes in body composition and function

What is undernutrition?

A form of malnutrition caused by inadequate intake or absorption of calories, protein, or other nutrients

What is overnutrition?

A form of malnutrition caused by excessive nutrient intake, often leading to overweight or obesity

What are the major causes of malnutrition?

Inadequate food intake

Poor nutrient absorption

Increased nutrient needs

Chronic disease

Acute illness or injury

Why is early identification of malnutrition important?

It can reduce complications, improve healing, shorten hospital stays, and improve overall outcomes

Which patients are at greater risk for malnutrition?

Older adults

Patients with chronic disease

Cancer patients

Individuals with gastrointestinal disorders

Patients with swallowing difficulties (dysphagia)

Individuals with poor appetite

Low-income or food-insecure individuals

Why are older adults at increased risk for malnutrition?

Decreased appetite

Dental problems

Difficulty swallowing

Chronic illness

Limited income

Social isolation

Why are hospitalized patients at risk for malnutrition?

Illness

Increased metabolic demands

Poor appetite

Fasting for procedures

Difficulty eating

How can gastrointestinal diseases contribute to malnutrition?

They can impair digestion and nutrient absorption

Why does cancer increase the risk of malnutrition?

Cancer and its treatments can reduce appetite, increase metabolic demands, and interfere with eating

What characteristics are commonly used to diagnose malnutrition?

Inadequate energy intake

Unintentional weight loss

Loss of muscle mass

Loss of subcutaneous fat

Fluid accumulation that may mask weight loss

Reduced functional status (often measured by handgrip strength)

Why is unintentional weight loss concerning?

It may indicate inadequate nutrition or underlying disease

Why is muscle loss an important sign?

It reflects protein depletion and decreased functional capacity

Why can edema make malnutrition difficult to recognize?

Fluid retention can hide weight loss

What simple measurement can help monitor nutritional status over time?

Body weight

What are three etiology-based categories of malnutrition?

Starvation-related malnutrition

Chronic disease-related malnutrition

Acute disease or injury-related malnutrition

What is starvation-related malnutrition?

Malnutrition caused by prolonged inadequate intake without significant inflammation

Examples: famine, eating disorders

What is chronic disease-related malnutrition?

Malnutrition associated with chronic inflammation

Examples: cancer, chronic kidney disease, COPD, heart failure

What is acute disease or injury-related malnutrition?

Malnutrition associated with severe acute inflammation

Examples: major burns, sepsis, trauma, major surgery

Which type of malnutrition is associated with burns or severe trauma?

Acute disease or injury-related malnutrition

What physical findings may indicate malnutrition?

Weight loss

Muscle wasting

Loss of subcutaneous fat

Weakness

Fatigue

Poor wound healing

Where is muscle wasting commonly assessed?

Temples

Shoulders

Clavicles

Hands

Thighs

Calves

Where is loss of subcutaneous fat commonly assessed?

Under the eyes

Triceps

Ribs

How can malnutrition affect wound healing?

It delays tissue repair and increases the risk of infection

How does malnutrition affect immunity?

It weakens immune function, increasing susceptibility to infections

What effect does malnutrition have on strength?

It decreases muscle strength and physical function

What skin. changes may be seen with malnutrition?

Dry skin

Poor skin integrity

Delayed wound healing

What hair changes may occur with malnutrition?

Thin hair

Hair loss

Brittle hair

What nail changes may occur with malnutrition?

Brittle nails

Slow nail growth

What is the purpose of a modified consistency diet?

To make eating safer and easier for patients who have difficulty chewing or swallowing (dysphgia), while ensuring they receive adequate nutrition

Which healthcare professional usually evaluates swallowing ability?

A speech-language pathologist (SLP)

What is dysphagia?

Difficulty swallowing

What is the most serious complication of dysphagia?

Aspiration, which can lead to aspiration pneumonia

What is a clear liquid diet?

A diet consisting of transparent liquids that leave little residue in the digestive tract

What foods are allowed on a clear liquid diet?

Water

Clear broth

Apple juice

White grape juice

Gelatin

Tea

Black coffee (without cream)

When is a clear liquid diet commonly prescribed?

Before surgery

After surgery (short-term)Before certain diagnostic procedures

During acute gastrointestinal illness

Why should a clear liquid diet only be used short-term?

It does not provide enough calories, protein, vitamins, or minerals to meet long-term nutritional needs

What is a full liquid diet?

A diet consisting of foods that are liquid at room temperature or become liquid when warmed

What foods are included on a full liquid diet?

Milk

Yogurt

Pudding

Cream soups

Ice cream

Nutritional supplement drinks

When is a full liquid diet commonly used?

After surgery

During transition from clear liquids to solid foods

Patients who have difficulty chewing

What is a pureed diet?

Foods blended into a smooth, pudding-like consistency that require no chewing

Which patients commonly require a pureed diet?

Stroke patients

Severe dysphagia

Neurologic disorders affecting swallowing

Why is a pureed diet safer for patients with dysphagia?

It reduces the risk of choking and aspiration

What is a mechanical soft diet?

A diet of soft, moist foods that are easy to chew

Which patients commonly receive a mechanical soft diet?

Dental problems

Missing teeth

Jaw surgery

Mild chewing difficulties

Give examples of foods allowed on a mechanical soft diet?

Ground meat

Scrambled eggs

Cooked vegetables

Soft fruits

Oatmeal

What is the goal of a soft diet?

To reduce irritation of the gastrointestinal tract while providing foods that are easy to digest

Which patients may receive a soft diet?

After gastrointestinal surgery

Patients recovering from illness

Mild digestive disorders

Why are thickened liquids prescribed?

They slow the movement of liquids, making swallowing safer and reducing the risk of aspiration

What are the three levels of thickened liquids?

Nectar-thick

Honey-thick

Pudding (spoon)-thick

Which patients commonly require thickened liquids?

Stroke patients

Parkinson disease

Neurologic disorders

Dysphagia

Which healthcare professional determines the safest liquid consistency?

The speech-language pathologist (SLP)

A patient had a stroke and coughs whenever they drink water. Which diet modification is most appropriate?

Thickened liquids and/or a pureed diet, depending on the swallowing evaluation

A patient is scheduled for surgery tomorrow morning, Which diet is most appropriate beforehand?

A clear liquid diet if ordered as part of the preoperative preparation

A patient has lost several teeth and has difficulty chewing steak. Which diet is most appropriate?

Mechanical soft diet