ASPEN Malnutrition Questions And Answers Latest Updates

Lab data - Indicators of inflammatory response (albumin/ prealbumin) interpret with caution Elevated CRP, WBC, blood glucose levels Negative nitrogen balance and elevated REE support systemic inflammatory response Pre albumin and albumin as markers of inflammation - Acute phase proteins- reflect inflammatory response rather than poor nutrition; do not predict weight loss, calorie restriction or nitrogen balance; will not respond to feeding interventions Dx if inflammation is present - Mild or moderate- chronic disease related malnutrition; severeacute disease or injury related malnutrition Dx is inflammation not present - Starvation related malnutrition Physical exam/clinical signs - Weight loss/ gain, fluid retention, loss of muscle or fat, macro/micronutrient deficiencies Inflammation: fever, hypothermia, systemic inflammation (tachycardia, hyperglycemia) 6 characteristics for malnutrition diagnosis - Insufficient energy intake, weight loss, loss of muscle mass, subcutaneous fat loss, fluid accumulation, hand grip strength Anthropometric data - Unintended weight loss; measure weight on admission and monitor frequently Food/nutrient intake - 24 hour diet recall- estimated calorie count; plate waste; previous periods of inadequate intake documented in patient chart Functional Assessment - Hand grip strength3 clinical diagnosis of malnutrition - Malnutrition in the context of acute illness or injury (moderate or severe) Malnutrition in the context of chronic illness (moderate or severe) Malnutrition in the context of social or environmental circumstances (moderate or severe) Energy intake <75% for 7 days in acute illness/injury - nonsevere (moderate) malnutrition Energy intake ≤50 % for 5 days in acute illness/injury - severe malnutrition Energy intake <75% for ≥1 mo in chronic illness - nonsevere (moderate) malnutrition Energy intake ≤50% for ≥1 mo in chronic illness (?) - severe malnutrition