Malnutrition in heart failure is often referred to as cardiac ...

[waynest]

Malnutrition in heart failure is often referred to as cardiac cachexia. What is cardiac cachexia? What are the characteristic symptoms? Explain the role of the underlying heart disease in the development of malnutrition.
 
  What will be an ideal response?

Question 2

Assess Mrs. McCormick's diet prior to having difficulty swallowing. Compare her energy and protein intakes to her estimated nutrient needs.
 
  What will be an ideal response?

[Moriaki]

Answer to Question 1

 Cardiac cachexia is a wasting syndrome caused by heart failure that results in a metabolic imbalance favoring catabolism over anabolism. Losses in lean and fat tissue, in addition to bone mineral density, can be observed and is not always reversible upon feeding (like starvation).
 Signs and symptoms: increased plasma TNF-, decreased GI tract perfusion (slowed peristalsis, early satiety, and impaired nutrition absorption), and endothelial dysfunction (leading to a reduction in skeletal muscle nutrient supply).
 Heart failure promotes the development of malnutrition through inflammatory pathways, elevated levels of B-type and atrial natriuretic peptides, aldosterone, and cortisol, and anorexia.

Answer to Question 2

 Energy Intake: 877 kcal
 Protein Intake: 35 grams
 EER: 1400-1700 kcal
 EPR: 40-50 grams
Based on these estimations, it appears that Mrs. McCormick was not meeting her calorie (63) and protein (88) needs on a daily basis before she developed problems swallowing. It is reasonable to state that with her underlying disease, she was most likely not consuming all of the food items listed on a daily basis, and consuming enough on a daily basis is a big struggle for her.

[waynest]

Excellent

[tranoy]

TYSM