The ASPEN/AND Consensus Statement on Malnutrition defines three etiology-based types of malnutrition. Complete this table from Consensus Statement Figure 1. MEMORIZE THIS CHART No Is inflammation present? Type of Malnutrition Starvation-Related Example of disease states or conditions associated with this type of malnutrition Pure chronic starvation, Anorexia Nervosa Chronic Disease-Related Organ failure, pancreatic cancer, RA, sarcopenic obesity Yes, Marked Inflammatory Acute disease or injury- Major infection, burns, trauma, Response Yes, Mild to Moderate Degree related closed head injury List body sites used for assessing loss of muscle mass. Next to each site list the muscles associated with each body site. temporalis muscle pectoralis major, deltoid, trapezius deltoid latissimus dorsi, trapezius, and deltoid Temples Clavicles Shoulders Scapula interosseous Thigh quadriceps Calf gastrocnemius True or False. Complete these tables from Consensus Statement Table 1 to determine malnutrition severity. MEMORIZE THESE CHARTS Hand Clinical Characteristic Malnutrition in the Context of Acute Illness or Injury Malnutrition in the Context of Chronic Illness Malnutrition in the Context of Social or Environmental Circumstances Energy Intake **EER-estimated energy requirement Nonsevere Severe Nonsevere Severe (moderate) Nonsevere Severe (Moderate) <75% 5 days >Imon >1 mon >-3 mon >-I mon of EER for >7 days Malnutrition in the Contest of Malnutrition in the Contest of Chronic Illness Clinical Acute Illness orinjury Nonsevere Severe Characteristic (Moderate) Malnutrition in the Context of Social or Environmental Circumstances % Nomevere (moderate) % Time % Severe Nansevere (moderate) % Severe Time % Interpretation of 1-2 wk >2 $ 5 Imo >5 5 7.5 3 mo >7.5 7.5 3mo >7.5 7.5 3m >7.5 10 6 mo >10 10 6mo >10 20 20 1 yr 20 < < List all clinical characteristics of mainutrition that are defined in the ASPEN/AND Consensus Statement on Malnutrition. Put a star next to characteristics which require a NFPE. Insufficient energy intake Weight loss **Loss of muscle mass **Loss of subcutaneous fat **Localized or generalized fluid accumulation (that may mask weight loss) **Diminished functional status as measured by hand-grip strength What is the minimum number of clinical characteristics that must be met for a patient to be diagnosed with malnutrition? two Which of the clinical characteristics is the primary criterion for malnutrition? Insufficient energy intake A patient presents with some clinical characteristics indicating severe malnutrition and some clinical characteristics indicating nonsevere/moderate malnutrition. What level of severity should the patient be diagnosed with? Nonsevere/moderate How many body sites must have loss of subcutaneous fat for a person to meet the clinical characteristic of "loss of subcutaneous fat"? two According to the Consensus Statement, serum albumin and prealbumin are useful when diagnosing malnutrition. False Define sarcopenia. Loss of muscle mass / lean body mass (primary definition) Also - Failure to thrive and functional disability (strength and exercise capacity) List possible consequences of malnutrition in hospitalized patients. Increased risk of morbidity: sites) increased risk of pressure ulcer development increased risk of infections (including surgical sites) increased risk of falls impaired wound healing (pressure ulcers and surgical Increased risk of mortality Readmissions More frequent admissions Longer hospital stays Mr. Al B. Querque, a 53YOM is transferred to your rehab hospital from an acute care hospital where he had a four week admission. • In the acute care facility, the doctor determined the patient had marked inflammation. . When you obtain a diet history, you estimate his intake for the last four weeks has been meeting 44% of his daily estimated energy requirements. • He denies nausea, vomiting or other Gl issues. • Prior to his admission to the acute care hospital, he states he was eating normally and his weight has been stable at 184 pounds. • • • During your initial nutrition assessment at the rehab hospital, your NFPE indicates moderate loss of subcutaneous fat to three body sites and moderate loss of muscle mass to four body sites Height is 5 feet 11 inches Weight at admission to acute care hospital was 184 pounds Weight at admission to Rehab hospital is 168 pounds Discuss whether or not Mr. Al B. Querque meets ASPEN/AND Consensus Statement criteria for malnutrition. Justify your response. Include in your response: • Clinical characteristics of malnutrition that Mr. Al B. Querque has . Etiology and type of his malnutrition • Possible diseases/conditions that Mr. Al B. Querque has Severity of the malnutrition. Cite parameters from the Consensus Statement to justify your assessment..