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Oncology (Signs and Symptoms (Anorexia & early satiety (Regular eating…
Oncology
Signs and Symptoms
Anorexia & early satiety
Regular eating pattern (eat by the clock)
Smaller meals/ higher freq.
have readily available food
Avoid liquids at meal times
Light exercise may stimu. Ex
Manage mental factors
Nausea & Vomiting
Smaller meals / more freq.
Elevated head, fresh air, loose clothing
Dry foods in the morning
Avoid
Fasting
spicy/ fatty food
cooking odours
Fluids
Cold/ clear
save for between meals
Chewing & swallowing problems.
Liaise w/ Speech pathologists
Texture modification
Unmodified
Texture A- soft
Texture B- Minced and moist
Texture C- Puree
Dry mouth (Xerostomia)
Due to head and neck cancer
Thick saliva
Oral hygiene
risk of decay and infection
extra moisture
wet foods
Inflamed mouth
Texture modification
oral hygiene
Tube feeding if severe
Diarrhoea
Lead to dehydration
Rehydration
cause
Treatment
Antibiotics
virus
infection
intolerance
Medication management
Dysgeusia
Altered taste
adding extra flavors
Cause
Head and neck cancer
radiotharaphy
metallic taste (chemo.)
Treatments
Surgery
Radiotherapy
Refer to signs and symptoms
Chemotherapy
Type of Drug
Side effects of Drug
Eg. loss of appetite
Transplant
Targeted Agents
Hormone therapy
PESS
Inadequate Oral Intake (NI 2.1)
Inadequate Protein-Energy intake (NI-5.3)
Unintended Weight loss
Food and nutrition related knowledge deficit
not ready for diet/ lifestyle change
inadequate (nutrient/ minerals) intake
Client hx
Medical Hx
Cancer
Type of cancer
Location
Date of diagnosis
Stage:
Prognosis
Co-morbidities
Treatment
Type
Past treatments
Treatment plan
Medications
Supplements
antiemetic
Steroids
Analgesics
antiemectics
Nausea and vomiting
social Hx
Living situation
Location
Accessibility
Support
Financial
Employment
Support
Physical
Emotionally
Access to Food
Cooking
Shopping
Income
Cultural/ Religious
Attitudes and beliefs towards Nutrition and food
Anthropometry
Weight
Prev. wt. Wt history
PG-SGA /SGA
Wt Hx
1/12
6/12
Height
BMI
Fluid
'Dry' weight
Ascites
Oedema
Biochemistry
electrolytes & Renal function
Sodium
Potassium
Phosphate
Creatine
Urea
LFT
Especially in Liver mets and liver cancer
Blood count
WCC
Neutrophil
Inflammatory markers
CRP
CA15
Serum albumin
Blood Glucose
Intervention plans
Nutritional screening
Patient Goals
Maintain/ Improve food intake
Prevent malnutrition
Maintain muscle mass
Physical performance
Enhance tolerance/ response to anti-cancer Theraphy
reduce risk of interruptions to anticancer treatment
enhance Quality of Life
Optemise body's defense mechanism
Diet Requirements
Energy
125-145 kJ/d
Protein
1.2g kg/d (XRT)
1.2- 1.5 g /kg/d
meeting req.
Food Fortificaton
Oral Supplements
1.5 -2 calorie/ ml
HPHE
Frequency of consump.
Minerals / Vitamins
= RDIs
Inadequate Oral intake
Enteral/ Parenteral Feeding
Feeding regimes
Consider prognosis
Diet history
Protein and Energy intake
Food consumption patterns
Fad diets
Food restriction
Supplementation practices
Nutrition Guidelines
Nutrition intervention improves dietary intake for treatments as Chemo and XRT
Regular exercise
EPSN 2016
Nutritional Screening early and regularly
EN = inadequate oral intake
PN= if not sufficient