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Section 20: Nutritional Disorders

A 35-year-old woman (weight, 54.5 kg [120 lb]; height, 168 cm [5 ft 6 in.]) with short bowel syndrome is admitted with mild dehydration and weight loss. She has lost 4.5 kg (10 lb) in the past 4 months. Which of the following would be the most appropriate characterization of her nutrition status?

A. Normal, healthy

B. Starvation-induced malnutrition

C. Acute, disease-related malnutrition

D. Chronic, disease-related malnutrition

The answer is D. This patient has malabsorption and a chronic disease state. Her weight loss was over more than 3 months which puts her into the chronic, disease-related etiological category for malnutrition.

An interdisciplinary nutrition support team is designing a nutrition screening program for their hospital. Which of the following would be a meaningful trigger to identify a patient at high risk for nutrition-related complications?

A. Decreased oral intake for 3 days due to vomiting.

B. Significantly decreased oral intake for the past 3 weeks due to anorexia.

C. Planned weight loss of 4% of usual body weight (UBW) over the past 2 months.

D. Weight loss of 5% of UBW due to acute diarrhea-induced dehydration.

The answer is B. A patient with decreased oral intake for more than 1 to 2 weeks would meet the criteria for being at nutrition risk in most of the available nutrition screens.

Using ideal body weight (IBW), how would you characterize the nutrition status of a 50-year-old man whose weight is 60 kg (132 lb) and height is 183 cm (6 ft 0 in.)?

A. Normal, healthy

B. Mild malnutrition

C. Moderate malnutrition

D. Severe malnutrition

The answer is C. This patient’s IBW is 77.6 kg (171 lb); his actual weight is 60 kg (132 lb). His actual weight is 77% of his IBW which would be classified as moderate malnutrition.

A 69-year-old man weighs 75 kg (165 lb) and is 178 cm (5 ft 10 in.) tall. Based on his BMI, what is the best interpretation of his current nutrition status?

A. Normal, healthy

B. Overweight

C. Moderate obesity

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