ASPEN Malnutrition
6 characteristics for malnutrition diagnosis - ANSWERInsufficient energy intake, weight
loss, loss of muscle mass, subcutaneous fat loss, fluid accumulation, hand grip strength
Dx if inflammation is present - ANSWERMild or moderate- chronic disease related
malnutrition; severe- acute disease or injury related malnutrition
Dx is inflammation not present - ANSWERStarvation related malnutrition
Pre albumin and albumin as markers of inflammation - ANSWERAcute 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
Physical exam/clinical signs - ANSWERWeight loss/ gain, fluid retention, loss of muscle
or fat, macro/micronutrient deficiencies
Inflammation: fever, hypothermia, systemic inflammation (tachycardia, hyperglycemia)
Anthropometric data - ANSWERUnintended weight loss; measure weight on admission
and monitor frequently
Lab data - ANSWERIndicators of inflammatory response (albumin/ prealbumin) interpret
with caution
Elevated CRP, WBC, blood glucose levels
Negative nitrogen balance and elevated REE support systemic inflammatory response
Food/nutrient intake - ANSWER24 hour diet recall- estimated calorie count; plate waste;
previous periods of inadequate intake documented in patient chart
Functional Assessment - ANSWERHand grip strength
3 clinical diagnosis of malnutrition - ANSWERMalnutrition 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 - ANSWERnonsevere (moderate)
malnutrition
Energy intake ≤50 % for 5 days in acute illness/injury - ANSWERsevere malnutrition
Energy intake <75% for ≥1 mo in chronic illness - ANSWERnonsevere (moderate)
malnutrition
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