LOs - Nutrition 1. Understand concept of malnutrition a....

Info iconThis preview shows pages 1–4. Sign up to view the full content.

View Full Document Right Arrow Icon

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon

Info iconThis preview has intentionally blurred sections. Sign up to view the full version.

View Full DocumentRight Arrow Icon
This is the end of the preview. Sign up to access the rest of the document.

Unformatted text preview: Nutrition 1. Understand concept of malnutrition a. Malnutrition can be i. Inadequate access to resoures: socioeconomic, w/holding nutrition in hospitalized pts (20- 50%) ii. Failure of nutrient assimilation 1. Maldigestion (pancreatic insufficiency/biliary obstruction) 2. Malabsorption (mucosal disease/short bowel syndrome) iii. Intake of excess nutrients (morbidity/mortality) iv. Failure to meet inc requirements due to illness b. Impact i. Impaired wound healing in surgical pts, inc risk for infectious complications, inc length of hosp stay, inc mortality in HIV/AIDS, chronic liver/kidney dis, cancer, COPD, stroke, hip fracture c. Definition i. Imbalance between intake and requirement of energy (calories), protein, essential nutrients ii. If untreated, results in loss of body mass/impairment of normal bodily fxn d. Required for maintenance of body mass/fxn i. Energy homeostasis 1. Components of energy expenditure a. Mostly resting metabolic rt (energy to be alive) b. Thermogenic effect of digestion, exercise/non-exercise thermogenesis 2. Modifiers of basal energy expenditure a. Physiological=tissue growth (needs more energy) i. Nutrition repletion, pregnancy, childhood b. Pathological i. Decreased: fasting, hypothyroidism, hypothermia ii. Increased: hypermetabolism/hypercatabolism in illness ii. Adaptation to starvation 1. Body cannibalizes own tissues as energy source w/o food a. Hormonally driven, lose lean body mass 2. Maintaining glucose vital a. Glycogen depleted after 12-24 hrs b. Protein/glycogen from TG turnover then catabolized c. Prolonged starvation, alternate fuels used iii. Impact of illness on homeostasis/adaptation to starvation 1. Chronic: starvation malnutrition infxn inflammatory response stress-related catabolism 2. Acute: inflammatory response stress-related catabolism 2. Appreciate contribution of underlying illness to nutritional requirements 3. Understand nutritional assessment tools and their shortcomings a. Subjective i. Nutrition assessment: nutrition/illness severity 1. Clinical status, dietary/social history ii. Body wt and wt change 1. % ideal body wt (IBW) a. = (actual wt/IBW) x 100 2. % wt loss = [(UBW-ABW)/UBW] x 100 iii. Signif wt loss: 5% in 1 mo, 7.5% in 3 mos, 10% in 6 mos iv. Severe wt loss: >5% in 1 mo, >7.5% in 3 mos, >10% in 6 mos v. Physical assessment 1. General: edema, ascites (fluid in peritoneal cavity), cachexia (wasting), obesity, skin changes, dry mucous mbs, petichiae/ecchymoses (red/purple spot on body), poorly healing wounds, glossitis, stomatitis, cheilosis (inflammatory lesion in corner of mouth) b. Anthropometric tools i. Physical measurements to assess body habitus (predispos for disease) against std 1. Relies on age, sex, race reference values ii. Can be used to track changes in ind over time iii. Doesnt distinguish uncomplicated malnutrition body habitus changes from those caused by fluid shifts/lean body mass catabolism (hallmarks of inflammatory metabolism) iv. BMI defines level of adiposity via wt/ht 1. (+): easy to use/understand, lots of data 2.2....
View Full Document

This note was uploaded on 09/14/2011 for the course PHARM gs taught by Professor Staff during the Spring '11 term at UCSD.

Page1 / 73

LOs - Nutrition 1. Understand concept of malnutrition a....

This preview shows document pages 1 - 4. Sign up to view the full document.

View Full Document Right Arrow Icon
Ask a homework question - tutors are online