PRESENTATION ON IATROGENIC MALNUTRITION

IATROGENIC MALNUTRITION

Iatrogenic: This is an illness caused by medical examination or treatment. That is, a complication that happens to a person after getting medical treatment. It is usually induced inadvertently or unintentionally [Accidentally] in a patient by a physician.

Malnutrition:This basically means poor nutrition. It may be an excess of important of important nutrient in the body or the lack thereof.

Therefore, Iatrogenic Malnutrition can be defined as protein- calorie malnutrition brought on by treatments, medications and hospitalization. It could be the side effect of some form of medication or treatment procedure. The word “IATROGENIC” derives from a Greek term meaning “brought by the healer or physician”.

                                THE CAUSES OF IATROGENIC MALNUTRITION

1.      Activities of health care professionals: Malnutrition increases in patients during hospitalization by low rate of nutrition. The potential cause maybe inadequate medical staff awareness about the importance of nutrition in hospitalized patients. Some physicians prescribe some adverse drug effect.

2.      The length of hospital stay: The nutritional status of patients is known to worsen during hospital stay which is partly due to poor recognition by the medical staff and adverse clinical routine.

3.      Inadequate nutrient intake: Nutritional intake of patients often decreases during hospitalization. Patient appetite usually decreases during illness due to pain, nausea and weakness.

4.      Failure to recognize and document problem.

5.      Unclear accountability, leadership, inadequate assistance and support at most times in the hospital. All these as a result of lack of knowledge and lack of specialist in clinical nutrition.

           

EFFECT OF IATROGENIC MALNUTRITION

1.      Bad response to treatment: One of the major effects of iatrogenic malnutrition is bad response to treatment due to over use leading to resistance and depletion of nutrient in the body.

2.      Loss of weight: Due to loss/deviation from normal physiology as a result of depletion of nutrient and resistance to drugs and loss of weight.

3.      Complication to internal organs: As a result of malnutrition internal organs loss their normal working condition. Examples of which are; too high or too low of the heart, the liver not performing the functions of detoxification, the kidney nephron not  absorbing enough nutrients and much more.

4.      Thrombus: Malnutrition can lead to thrombus in the blood as a result of blood protein and enzyme malfunction which can lead to paralysis.

5.      Mental deviation: Iatrogenic malnutrition can lead to mental deviation in the form of aggressiveness, suicide thought, mania, schizophrenia and much more of mental deviation. 

TREATMENTS/MANAGEMENT OF IATROGENIC MALNUTRITION IN PATIENTS.

1.      The treatment of malnutrition usually consists of replacing missing nutrients, treating symptoms needed and underlying medical conditions.

2.      Managing nutritional status: This enables a clinical nutrition or registered dietician to confirm the presence of malnutrition.

3.      Assess the effect of the disorder and formulate diet that will restore adequate nutrition.

4.      Also by taking adequate care of malnourished, poor and sick patients.

RECOMMENDATION/NURSING IMPLEMENTATION/INTERVENTION

1.      Early detection of malnutrition by routine screening of vulnerable groups [E.g. those with chronic diseases, the elderly and children] can do much to identify those who would benefit from dietary support measures and nutrition intervention.

2.      In case of patient who can eat orally between meal snacks and liquid nutrient  supplement can be helpful.

3.      Nutrition education and training of health care professionals should be advocated as this would create awareness in the minds of those professionals, thereby enhancing nutritional procedures and reducing the incidence to iatrogenic malnutrition.

4.      Provision of multi-vitamins or single nutrient supplement.

5.      Clinicians should also initiate feeding at low calorie levels and monitor the magnesium and electrolyte levels of the patient when necessary.

6.      Avoidance of excessive fluid, administration is also important in patient with cachexia [severely malnourished].

CONCLUSION

In conclusion, iatrogenic malnutrition in patients is found majorly in males. The elderly and children were the most susceptible. Patient on enteral nutrition seems to be very susceptible to iatrogenic malnutrition due to factors such as;

1.      Non-compliance to feeding time due to negligence on the part of the nurses or patient resistance to feeding.

2.      Lack of attention to functional impairment by physician to patient upon admission, nutritional problems such as renal disease, hepatic disease, surgery and certain intrinsic factors which may result in nutrient imbalance, hence, causing malnutrition.

3.      Delay on the part of the physicians in referring patient to the dietetics department when they can longer manage the situation.

4.      In extreme cases, iatrogenic malnutrition can have severe effect in the patient which include anemia, muscle wasting, nutrient imbalance, worsen health condition, susceptibility of disease and complications