Malnutrition

Malnutrition

1. Pathophysiology

   • -The body first uses carbohydrates to meet metabolic needs. After carbohydrates are depleted, the body converts skeletal protein to glucose for energy. Within 5-9 days the body using fat supply for energy needs. The depletion of fat stores depends on what is available for use.

2. Contributing Factors

   • Socioeconomic - People with limited funding for food or access to poor quality for food. Physical Illnesses - Illness, surgery, injury, or hospitalization. Malabsorption syndrome - Impaired absorption of nutrients. Incomplete Diets - People who abuse alcohol and drugs, who are chronically ill, and people who have poor dietary practices are all at risk for vitamin deficiencies. Drug/Nutrient Interactions - Occasionally medications can affect who nutrients are absorbed in the body.

3. Clinical Manifestation

   • Dry, scaly skin. Brittle nails. Rashes. Hair loss. Crusting and ulceration in mouth. Muscles wasting. Weakness. Fatigue. Delayed wound healing. Increased risk of infection. Confusion. Irritability.

4. Diagnostic Studies

   • History and Physical- Body composition, history of weight loss, nutrient intake, function status, foods eaten in the past week. Dental health. Current medications. Functional status (ability to obtain and eat food). Laboratory test- Glucose, Electrolytes, lipid profile, BUN, albumin, prealbumin, CRP.

5. Nursing Diagnosis

   • Imbalanced nutrition- Less than body requirements. Feeding self-care deficit - Decrease strength and ability. Deficient fluid volume - Lack of access or absorption of fluids. Risk for impaired skin integrity - Poor nutritional state. Noncompliance - Lack of motivation.

6. Nursing Interventions

   • Determine, in collaboration with the dietitian, the number of calories and type of nutrients needed to meet nutrition requirements. Monitor appropriateness of diet orders to meet daily nutritional needs. Assist the patient with feeding as needed. Refer to physical, occupational and speech therapies. Determine the need for enteral tube feedings to ensure adequate nutrition. Determine the need for IV fluids for adequate hydration.