Malnutrition

Malnutrition is not synonymous with being thin. In hospital care, it usually refers to undernutrition: inadequate energy or protein intake, loss of body tissue, or both, in the setting of illness or increased physiological need. Illness can drive the process in several ways. Pain, nausea, dysphagia, fatigue, depression, or dependence on others for feeding can reduce intake. Inflammation and acute illness can increase metabolic demands and accelerate muscle breakdown. As muscle and fat stores decline, the patient loses strength and functional capacity, which can further impair eating, mobility, and recovery. A patient may be malnourished at any body size. Edema can add fluid weight and conceal loss of muscle and fat, so a stable or rising scale weight is not necessarily nutritional improvement. The bedside picture matters: a patient with swollen ankles, a loose-fitting waistband, weak mobility, and poor intake may be losing tissue despite appearing heavier. Malnutrition increases vulnerability to infection, impaired wound healing, reduced ability to participate in rehabilitation, prolonged hospitalization, and poorer recovery. The nurse is therefore looking for a pattern, not a single appearance or laboratory...