The 83-year-old patient in the case scenario suffers from protein malnutrition. Protein malnutrition is a condition
The 83-year-old patient in the case scenario suffers from protein malnutrition. Protein malnutrition is a condition
Explanation of Protein Malnutrition
The 83-year-old patient in the case scenario suffers from protein malnutrition. Protein malnutrition is a condition caused by an inadequate intake of dietary protein, which can lead to a deficiency in essential amino acids that the body needs in order to function properly. This can lead to a number of health problems including reduced muscle mass and decreased bone mineral mass (Cristina & Lucia, 2021). In elderly patients with longstanding malnutrition, the effects can be even more serious, as they may be more prone to developing conditions such as sarcopenia and osteoporosis .
Role Genetics Plays in the Disease
Protein malnutrition occurs when the body tissues are not receiving enough protein to meet its nutritional needs. Genetics can play a role in protein malnutrition in a variety of ways. First, certain genetic mutations can cause a person to have low levels of protein in their blood. This can occur due to problems with the body’s ability to absorb or use protein. Second, protein malnutrition occurs in individuals with genetic predisposition due to a single-nucleotide polymorphism (SNP) close to the FGF21 locus (Duggal & Petri, 2018). Such polymorphism is associated with decreased protein intake. Besides, genes can influence how much protein a person needs. If a person has a genetic mutation that leads to low levels of protein in their blood, they may be more likely to develop protein malnutrition if they do not get enough protein. Finally, genes can also influence how well a person’s body uses protein. Genetic mutations may make one’s body more likely to develop protein malnutrition if they do not get enough protein. While genetics cannot always entirely cause protein malnutrition on its own, it can play a significant role in how likely a person is to develop the condition and how they will respond to treatment.
Why the Patient is Presenting with the Symptoms
The patient presents with generalized edema of extremities and abdomen due to hypoproteinemia caused by protein malnutrition. Malabsorption syndrome causes the body to be unable to absorb enough nutrients from the food consumed, which can result in hypoproteinemia. Subsequently, hypoproteinemia reduces colloid osmotic pressure gradient leading to increased fluid leakage through capillaries into interstitial spaces (Darwish & Lui, 2021). The aftermath is increased interstitial fluid volume and generalized edema in the extremities and abdomen. Difficulty eating due to a lack of dentures can also lead to malnutrition, as teeth are essential to digestion. In this case, the patient likely developed protein malnutrition due to malabsorption, lack of dentures, and difficulty eating; hence reduced protein intake. As a result, the patient developed generalized edema.
Physiologic Response to the Stimulus Presented
The stimulus presented in the scenario is malabsorption syndrome, difficulty eating due to lack of dentures, and protein malnutrition. The physiologic response to the stimulus presented in the scenario is a generalized edema. The response occurred because the patient has difficulty absorbing nutrients due to the malabsorption syndrome. Additionally, the lack of dentures led to reduced digestion and decreased intake of proteins in food; hence malnutrition. The protein malnutrition in this scenario caused the edema because a hypoproteinemia can result in fluid retention.
Cells That Are Involved in the Process
Altered cellular and tissue functions have a significant role in the development of edema (McCance et al., 2019). In this scenario, the patient has been diagnosed with protein malnutrition due to a history of malabsorption syndrome and difficulty eating due to a lack of dentures. This can result in the body not being able to properly breakdown and use proteins. The cells involved in protein malabsorption include muscle cells and enterocytes. The enterocytes are specialized epithelial cells found of the small intestine. They are responsible for the absorption of proteins, fats, and carbohydrates from the intestine. Malabsorption is linked to enterocytes and other patient factors such as genetic predisposing.
Additionally, increased permeability and reduced colloid pressure cause extravasation of fluid into the interstitial spaces (Lent-Schochet & Jialal, 2019). Muscle cells are involved in utilizing amino acids and other nutrients. Other cell involves are the cells in lymphatic system. The generalized edema of extremities involves cells such as endothelial cells and lymphocytes as well as various types of epithelial cells in the small intestine. Lastly, other cells are the hepatocytes in the liver which are responsible for synthesizing and metabolizing proteins. Failure of eth hepatocytes to work properly can contribute to protein malnutrition, hypoproteinemia, and edema.
How Another Characteristic Would Change Response
An example of other characteristics is race or ethnic background of the patient. Although the case scenario did not highlight the client’s race or ethnic background, current literature does not highlight increased predisposition of any race to protein malnutrition. According to Sadarangani et al.(2019), African-Americans, Hispanics, Asians, and Alaska natives are at higher risk for diet-related disparities, poorer nutrient intakes and poorer dietary than native whites. Thus, the nurse is uncertain whether it would be possible that any race be at a greater predisposition to diseases protein malnutrition. With more research, the nurse can determine whether race would likely play a role in the process and affect the patient. All in all, the patient had history of malabsorption syndrome, lacked dentures and had difficulty eating; hence the factors played a role in causing protein malnutrition.
More factors include patient’s age, gender, comorbid health condition, and medications they are taking. All of these factors would need to be considered in order to provide an accurate diagnosis and personalized care for this patient. It would be important to determine if these other characteristics might have influenced the patient’s outcome. Gender may also play a role in the process and affect the patient. However, studies reveal that the access to diverse sources of protein in food items is not dependent on age or gender (Beasley et al., 2020). Although more should be done to encourage the intake of diverse protein sources, no significant challenges related to age or gender that may predispose one to protein malnutrition.
References
Beasley, J. M., Firestone, M. J., Popp, C. J., Russo, R., & Yi, S. S. (2020). Age and racial/ethnic differences in dietary sources of protein, NHANES, 2011-2016. Frontiers in Nutrition, 7, 76. https://doi.org/10.3389/fnut.2020.00076Links to an external site.
Cristina, N. M., & Lucia, D. A. (2021). Nutrition and healthy aging: Prevention and treatment of gastrointestinal diseases. Nutrients, 13(12), 4337. https://doi.org/10.3390%2Fnu13124337Links to an external site.
Darwish, A., & Lui, F. (2021). Physiology, colloid osmotic pressure. In StatPearls [internet]. StatPearls Publishing. https://www.ncbi.nlm.nih.gov/books/NBK541067/Links to an external site.
Duggal, P., & Petri, W. A., Jr (2018). Does malnutrition have a genetic component?. Annual Review of Genomics and Human Genetics, 19, 247–262. https://doi.org/10.1146/annurev-genom-083117-021340Links to an external site.
Lent-Schochet, D., & Jialal, I. (2019). Physiology: Edema. StatPearls Publishing https://www.ncbi.nlm.nih.gov/books/NBK537065/Links to an external site.
McCance, K. L. & Huether, S. E. (2019). Pathophysiology: The biologic basis for disease in adults and children (8th ed.). St. Louis, MO: Mosby/Elsevier.
Sadarangani, T. R., Missaelides, L., Yu, G., Trinh-Shevrin, C., & Brody, A. (2019). Racial disparities in nutritional risk among community-dwelling older adults in adult day health care. Journal of Nutrition in Gerontology and Geriatrics, 38(4), 345–360. https://doi.org/10.1080/21551197.2019.1647327
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