Malnutrition

WHAT YOU SHOULD KNOW:

• Malnutrition (mal-noo-TRISH-un) occurs when you do not get enough calories or nutrients to keep you healthy. Nutrients are protein, fat, carbohydrates, vitamins and minerals. Malnutrition may make your body weak. It may cause health problems such as trouble fighting infections and healing. Malnutrition may be caused by not eating enough of the right food or by having certain health conditions.
  
  
• Malnutrition usually develops in stages over a long period of time. Signs and symptoms may not appear until the later stages of malnutrition. Some signs and symptoms of malnutrition are tiredness, weakness and weight loss. Other signs and symptoms are slow or no growth in children, slow wound healing, and hair and skin changes. The treatment for malnutrition depends on the cause. You may need to increase calories in your diet by eating more food. You may also need to eat or drink a nutrition supplement or take vitamins and minerals. Your caregiver may treat you with medicines if you have a health problem that is causing your malnutrition.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

RISKS:

Malnutrition usually develops in stages over time. Malnutrition may make your body weak and cause health problems such as trouble fighting infections and healing. Severe malnutrition may cause heart problems, breathing problems, and kidney problems. It can also cause changes in the level of chemicals in your blood called electrolytes. Severe (very bad) malnutrition can even lead to death if it goes untreated. Malnutrition can be treated if you follow your caregiver's instructions.

WHILE YOU ARE HERE:

Informed consent:

A consent form is a legal document that explains the tests, treatments, or procedures that you may need. Informed consent means you understand what will be done and can make decisions about what you want. You give your permission when you sign the consent form. You can have someone sign this form for you if you are not able to sign it. You have the right to understand your medical care in words you know. Before you sign the consent form, understand the risks and benefits of what will be done. Make sure all your questions are answered.

Call button:

You may use the call button when you need your caregiver. Pain, trouble breathing, or wanting to get out of bed are good reasons to call. The call button should always be close enough for you to reach it.

Tests:

Caregivers will do a medical exam and ask you questions about your health. Some tests help caregivers find out what is causing malnutrition and how it is affecting your body. Other tests are used to help caregivers plan your treatment. Some of the tests you may need are:

• Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  
  
• Heart monitor: This is also called an ECG or EKG. Sticky pads placed on your skin record your heart's electrical activity.
  
  
• Intake and output: Caregivers will keep track of the amount of liquid you are getting. They also may need to know how much you are urinating. Ask how much liquid you should drink each day. Ask caregivers if they need to measure or collect your urine.
  
  
• Pulse oximeter: A pulse oximeter is a device that measures the amount of oxygen in your blood. A cord with a clip or sticky strip is placed on your finger, ear, or toe. The other end of the cord is hooked to a machine. Never turn the pulse oximeter or alarm off. An alarm will sound if your oxygen level is low or cannot be read.
  
  
• Urine sample: For this test you need to urinate into a small container. You will be given instructions on how to clean your genital area before you urinate. Do not touch the inside of the cup. Follow instructions on where to place the cup of urine when you are done.
  
  
• Vital signs: Caregivers will check your blood pressure, heart rate, breathing rate, and temperature. They will also ask about your pain. These vital signs give caregivers information about your current health.
  
  
• Chest x-ray: This is a picture of your lungs and heart. Caregivers use it to see how your lungs and heart are doing. Caregivers may use the x-ray to look for signs of infection like pneumonia, or to look for collapsed lungs. Chest x-rays may show tumors, broken ribs, or fluid around the heart and lungs.

Treatment:

• Caregivers: Some of the caregivers who may help to plan your treatment are:
  
  
  • Therapist: This is a caregiver that works closely with you while you are being treated. This person may be a doctor, psychologist, nurse, mental health counselor or social worker.
    
    
  • Psychiatrist: A psychiatrist is a medical doctor who works in the area of mental health. The psychiatrist is in charge of ordering your medicine. You may work closely with this doctor and other caregivers.
    
    
  • Dietitian: This is a caregiver who works in the area of nutrition. A dietitian may ask you questions about your appetite, eating habits and diet. A dietitian works with you to find the right diet plan for you.
  
  
• Diet: You may need to increase the calories in your diet by eating more food. You may need to eat high calorie, high protein snacks between meals to add food to your diet. You may also need to eat or drink a nutrition supplement if you have trouble eating enough food. The type of diet that you will follow depends on your health condition.
  
  
• Nutrition Support: If you are not able to eat food by mouth, you may need to be fed through a feeding tube or a catheter. Some of the ways that you may be fed are:
  
  
  • Nasogastric (NG) tube: An NG tube is put into your nose, and passes down your throat until it reaches your stomach. Food and medicine may be given through an NG tube if you cannot take anything by mouth. The tube may instead be attached to suction if caregivers need to keep your stomach empty.
    
    
  • PEG tubes and J-tubes: A percutaneous endoscopic gastrostomy (PEG) tube, and a jejunostomy tube (J-tube) are small, flexible tubes. The tubes are put through a small cut in your abdomen. The end of a PEG tube goes into your stomach. The end of a J-tube goes into your small intestine. You may have a GJ Tube put in. This tube goes into both your stomach and small intestine. These tubes are used to give you liquids, food, and medicine. The tubes may also be used to let air or fluids out of your stomach.
    
    
  • TPN: TPN stands for total parenteral nutrition. It is also called hyperalimentation. It provides your body with nutrition such as protein, sugar, vitamins, minerals, and sometimes fat (lipids). TPN is used when you have problems with eating or digesting food. TPN is usually put into your body through a large IV catheter, such as a central line. You may need TPN for several days or longer.
  
  
• Medicines: Your caregiver may give you the following kinds of medicines or supplements:
  
  
  • Appetite stimulants: These medicines help improve your appetite so you will want to eat more.
    
    
  • Vitamins and Minerals: Caregivers may give you vitamin or mineral supplements to increase the level of vitamins and minerals in your body. Vitamins and minerals may be given in your IV, as a shot, or by mouth.
  
  
• IV: An IV (intravenous) is a small tube placed in your vein that is used to give you medicine or liquids.
  
  
• Oxygen: You may need extra oxygen if your blood oxygen level is lower than it should be. You may get oxygen through a mask placed over your nose and mouth or through small tubes placed in your nostrils. Ask your caregiver before you take off the mask or oxygen tubing.

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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

Learn more about Malnutrition (Inpatient Care)