26 DE MARZO DE 2023

ACTIVITY 1: SUBJECTIVE GLOBAL

ASSESSMENT
ENDONUTRITION

DANIELA OROZCO SANTIAGO

ID: 00382299
 Boris Carreño 16/02/2023

94 kg
88kg
6.3 6 kg
0.5 kg/.5%

Reduce intake approximately 10% in a week

<2 weeks

Chronic kidney disease Type II Diabetes mellitus, bilateral hip osteoarthritis

 Héctor Ignacio López Pérez 16/02/2023

72 kg
65 kg
9.7 7 kg

Reduce intake approximately 10% in more than a week

Respiratory infection high blood pressure, type 2 diabetes, stage 3 chronic kidney disease
 Aurelia Castillo Romero 20/02/2023

80 kg
76 kg
5 4 kg

Reduce intake 50% in a week

>2 weeks

recent abdominal hematoma admitted DM, HTN, Diastolic heart Failure, atrial fibrillation
with hemoglobin drop
Rubén Garza Palacios 20/02/2023

75 kg
65 kg
13. 3 10 kg

>2 weeks

Hepatitis C
Rosario Trejo 22/02/2023

65 kg
55 kg
15. 35 10 kg

>2 weeks
>2 weeks
>2 weeks

Bronchitic adenocarcinoma
María de Lourdes Aguilera Vargas 22/02/2023

76 kg
74 kg
2.6 2 kg

Herpes zoster Dyslipidemia

Valentina Ortiz Zepeda 22/02/2023

40 kg
43 kg

1-2 times/week
1-2 times/week

Respiratory infection
Martha Laura Serratos 24/02/2023

50 kg
49 kg
2 1 kg

Only when she eats specific food.

Bennett's fracture DM
 Patricia caballero Ortega

76 kg
72 kg
5.2 4 kg

Reduce intake 50% in a week

>2 weeks

>1 month

atypical pneumonia
 Claudia Santiago Serratos 20/04/2023

78 kg
76 kg
2.5 kg 2 kg

<2%

Reduce intake in a week

>2 weeks

Gastrointestinal infection Systemic arterial hypertension

1 1 2
0 3 3
2 1 + 1 4
3 0 3
Perform 10 Subjective Global Assessments and answer the next questions:

1- From your SGA, what was the prevalence of: (3 points)

- Well nourished patients (A)

- At risk of been undernourished (B)

- Severely undernourished patients (C)

2- Describe how you took the decision to give an A, a B or a C diagnosis to your patients. (2
points)

To determine the final diagnosis of the screening using SGA, I take several key questions that I
considered important, including:

- The degree and duration of weight loss are assessed, as well as the patient's current
weight compared to their usual weight. To considered significant the patient had to have
lost >2% of weight in 2 weeks or >10% in 6 months.

- The patient's usual dietary intake is evaluated, especially if it decreased in the last week.

- The presence of any gastrointestinal symptoms for more than 2 weeks

- The patient's ability to perform activities of daily living, such as bathing, dressing, and
walking, is evaluated.

- Medical conditions that can cause metabolic stress and increase requirements.

- The presence of edema, ascites, waste of muscle and subcutaneous fat

If the patient has a significant value in some of these points, it is considered B and if the patient
has two or more, it is considered C. Therefore, if it does not present any significant value, it is
considered A.

3- What was the most important question that you took into account to address the final
diagnosis of the screening? (3 points)

I think all the questions are important but the one that I take more in account was the degree of
weight loss because significant weight loss over a short time period of time is associated with
increased morbidity and mortality.

4- Do you think that a screening tool should be done to all the patients in a hospital
setting? Why? (2 points)

Yes, I believe that screening tools should be used for all patients in hos pitals because
malnutrition is a common problem in hospitals, particularly among older adults and patients with
chronic illness or ones who have undergone surgery or other medical procedures . Also, I think
that screening tools can help identify patients who are at risk of malnutrition early on, allowing
for timely interventions to be put in place to prevent or treat malnutrition . By using a screening
tool for all patients, healthcare professionals can ensure that no patient´s nutritional needs are
overlooked or neglected, which can help improve patient outcomes and reduce hospital
readmissions. Additionally, identifying and addressing malnutrition can help reduce healthcare
costs associated with longer hospital stays and need for additional medical interventions .

5- What other tools do we have to screen adult hospital patients? Explain briefly each one. (5
points)

There are several tools that can be used to detect malnutrition in adults in a hospital setting,
apart from SGA and NRS-2002. Some of the commonly used tools include:

1. Malnutrition Universal Screening Tool (MUST): This tool assesses a patient's risk of
malnutrition based on 3 parameters: BMI, unintentional weight loss, and the presence
of acute disease. The tool is composed of two parts: a screening tool and an intervention
tool. The screening tool consists of two steps. The first step involves determining the
patient's BMI, which is calculated by dividing the patient's weight in kilograms by their
height in meters squared. The second step involves assessing the degree of
unintentional weight loss that the patient has experienced over a specified period of
time. The degree of weight loss is classified as low, medium, or high based on the
percentage of weight loss compared to the patient's usual body weight.

If the patient scores a "0" on the screening tool, indicating low risk, no further action is
required. However, if the patient scores a "1" or "2" on the screening tool, indicating
medium or high risk, the intervention tool is used to further assess the patient's
nutritional status and plan appropriate interventions. The intervention tool involves
assessing the patient's nutritional status and developing a care plan based on their
individual needs. The care plan may include dietary modifications, oral nutritional
supplements, and/or referral to a registered dietitian.

2. Mini Nutritional Assessment (MNA): This tool assesses a patient's nutritional status of
older adults, particularly those who are living in community or care home setting. The
MNA based on a comprehensive evaluation of dietary intake, physical functioning, and
medical history. It is composed of two parts: a screening tool and an assessment tool.
The screening tool is a brief questionnaire that is used to identify patients who may be
at risk of malnutrition. It includes questions about the patient's BMI, weight loss,
mobility, and cognitive function. If the patient scores below a certain threshold on the
screening tool, indicating a risk of malnutrition, the assessment tool is used to conduct
a more detailed evaluation of their nutritional status. The assessment tool includes
questions about the patient's dietary intake, food preferences, chewing and swallowing
difficulties, and the presence of chronic illnesses.

Based on the patient's answers to the assessment tool, a final score is calculated, which
can range from 0 to 30 points. A score of 24 or higher indicates that the patient is well -
nourished, a score between 17 and 23.5 indicates that the patient is at risk of
malnutrition, and a score of less than 17 indicates that the patient is malnourished and
requires immediate intervention.

3. Short Nutritional Assessment Questionnaire (SNAQ): This tool is a brief questionnaire

that evaluates a patient's risk of malnutrition based on factors such as weight loss and
 appetite. A score of 2 or higher indicates that the patient is at risk of malnutrition and
requires further assessment and intervention.

6- Make one video of yourself performing a S.G.A. and upload it. (10 points)

7- Perform 5 NRS-2002 to surgical patients and upload them. (3 points)

8- If you compare SGA and NRS-2002, which screening tool is more sensitive? (2 points)
Both the Subjective Global Assessment (SGA) and the Nutrition Risk Screening 2002 (NRS-2002) are
commonly used screening tools for identifying patients at risk of malnutrition. However, the
sensitivity of these tools can vary depending on the patient population and the setting in which they
are used. In general, research has shown that the NRS-2002 has higher sensitivity than the SGA in
identifying patients at risk of malnutrition. A systematic review and meta-analysis of studies
comparing the two tools found that the NRS-2002 had a sensitivity of 0.77, compared to 0.66 for the
SGA. The NRS-2002 includes more objective measurements such as BMI, recent weight loss, and
severity of disease, which may contribute to its higher sensitivity in identifying patients at risk of
malnutrition.