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Malnutrition Disease Process

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Malnutrition Disease Process
Malnutrition
Shannon Jensen
IHCC

Dawn Fry
Clinical 4
December 20, 2010

Pathophysiology: When metabolic needs cannot be met due to lack of food, the body initially uses carbohydrates rather than protein or fat to meet metabolic needs. Backup reserves of carbohydrates are stored in the liver in small amounts. These reserves may be totally depleted within 18 hours of continuous use. Once this is gone, protein will then be used. Protein is first converted to glucose for energy. Within 5 to 9 days, the body will rely solely on body fat to supply needed energy.

Causes: There is a wide variety of causes of malnutrition. An elderly person with dementia may forget to eat or to buy food. Poverty may cause a lack of food or lack of nutritious food. People in third world countries often do not have access to healthy foods. Other causes may be alcoholism, excessive dieting, throat or mouth cancer, decreased mobility, malabsorption, dialysis, fistulas, corticosteroid or oral antibiotic use, hypermetabolism, burns, trauma, or a lack of oral intake for 5-10 days for a variety of reasons.

Incidence: Incidence of malnutrition in America is low, thought to be as low as 10% nationwide. Death from malnutrition in our country is extremely rare. Worldwide death from malnutrition among children under age 5 is thought to be as high as 50%.

Prognosis: Prognosis is very good for patients with malnutrition in America. Most incidents are temporary and are a result of another condition. The malnutrition is very treatable with food, nutritional supplements such as Ensure, or parental feedings depending on the cause.

Textbook | Patient | Signs and symptoms:Weight loss, reduced bmi, dry and brittle hair, pale mucous membranes, peripheral edema, sore, smooth tongue, impaired mobility, skin breakdown, diarrhea, risk of infection, risk for falls, weakness, fatigue. | Weight loss, skin breakdown of feet bilaterally, fatigue, weakness, extreme risk for falls, dry



References: Ackley, Betty J., Ladwig, Gail B. 2008. Nursing Diagnosis Handbook. Mosby Elsevier, St. Louis, MO. Jarvis, Carolyn, 2008. Pocket Companion Physical Examination and Health Assessment. Saunders Elsevier. St Louis, MO. Lewis, Heitkemper, Dirksen, O’Brien, Bucher, 2007. Medical-Surgical Nursing. Mosby Elsevier. St. Louis, MO. Lippincott, Williams, Wilkins, 2011. Nursing 2011 Drug Handbook. Lippincott Williams and Williams, Ambler, PA. Pagana, Pagana, 2009. Diagnostic and Laboratory Test Reference Mosby Elsevier. St. Louis, MO. Palmer, R. 2006. Management of common clinical disorders in geriatric patients: malnutrition. Medscape Today, 7 June 2006. Available: http://www.medscape.com/viewarticle/534768. Originally published in APC Medicine Online. Pearson, A., Wiechula, R., Court, A. and Lockwood, C. 2005. The JBI model of evidence-based healthcare. International Journal of Evidence Based Healthcare, The Joanna Briggs Institute. 2006. Systematic reviews - the review process, Levels of evidence. Vanderkroft, D., Collins, C., Fitzgerald, M., Lewis, S. and Capra, S. 2007. Minimizing under nutrition in the older patient. International Journal of Evidence Based Healthcare

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