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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
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