Nutrition Assessment - Clinical

• Physical signs of nutritional status & disease

Clinical

• Will also discuss –Medical hx– Social hx– Functional status - ADL– Physical signs of fluid status

Clinical

• Medical Hx– identifies disorders or conditions that

affect nutritional status

Clinical

• Social/economic Hx– identifies environmental influences that

affect nutrient intake

Clinical

• Drug Hx– identifies medications that affect

nutrient intake or nutritional status

Medical Hx

• Dx - past and current• Dx procedures• Surgeries• Chemotherapy & radiation • Hx of nutrition-related problems

Medical Hx

• Psychosocial hx– alcohol– smoking– social support

• Wt changes• Restricted food intake

Medical Hx

• Chronic disease• N & V• Short gut syndrome• Renal dialysis• Draining wounds

Medical Hx

• Increased metabolic rate– burns– fever - BMR increases by 7% for each

degree Fahrenheit above normal– trauma

• Show clinical signs of malnutrition here.

Physical Exam

• Again, not a firm Dx by themselves

McClaren 108. Dyssebacia, riboflavin.

McClaren 109. Extreme dyssebacia.

McClaren 110. Same pt. at 109 after 10 days B complex therapy.

McClaren 49. Early conjunctival xerosis.

McClaren 50. Bitot’s spots.

McClaren 51. Foamy Bitot’s spot.

McClaren 52. Compact Bitot’s spot.

McClaren 59. Conjunctival xerosis with corneal xerosis.

McClaren 60. Corneal ‘ulceration’ with xerosis.

McClaren 61. Keratomalcia - typical appearance.

McClaren 62. Keratomalacia - total.

McClaren 67. Corneal scars.

McClaren 101. Angular stomatitis, ribolfavin.

McClaren 102. Perleche, neglected angular stomatitis.

McClaren 103. Rhagades, chronic erosions, riboflavin.

McClaren 91. Scarlet tongue, pellagra, niacin.

McClaren 92. Filiform papillary atrophy, niacin, folic acid, B12 or iron, nonspecific.

McClaren 95. Magenta tongue, riboflavin.

McClaren 114. Glossitis, folic acid, painful.

McClaren 130. Gum changes, scurvy.

McClaren 132. Gums in scurvy.

McClaren 71. Perifollicular hyperkeratosis, vit A.

McClaren 78. Hypercarotenosis.

McClaren 79. Hypercarotenosis.

McClaren 84. Early pellagra, niacin.

McClaren 85. Casal’s necklace.

McClaren 86. Extensive pellagrous dermatosis.

McClaren 192. Colloidgoiter, Grade 1.

McClaren 193. Colloid goiter, Grade 2.

McClaren 194. Colloidgoiter, Grade 3.

McClaren 197. Endemic goiter and cretinism.

McClaren 170. Koilonychia.

McClaren 1. Cachexia.

McClaren 141. Active scorbutic rosary.

McClaren 142. Scorbuticrosary.

Upjohn 17c. Rickets, vit Ddeficiency.

Upjohn 11. Edema in beriberi, thiamin.

McClaren 119. Pallorof pernicious anemia.

Hydration Status

• Signs of dehydration– decreased skin elasticity– dry mucous membranes– dry mouth– infrequent urination– unusual drowsiness– disorientation

Hydration Status

• Signs of dehydration– extreme thirst– nausea– slow or rapid breathing– sudden wt. loss

END

• Any questions on clinical assessment?