Nutrition-Focused Physical Exams: An Overview

Abstract: An astonishing 6-51% of hospitalized children are considered malnourished in the modern healthcare system. This statistic is troubling because the nutritional status of patients who do not receive proper and timely nutrition intervention will continue to decline during their hospitalization. This may often lead to worsened clinical outcomes such as infectious complications, increased length of stay, readmissions, and even mortality. During hospitalization, these patients may be malnourished due to one of the following reasons: a lack of adequate nutrients such as protein and fat; increased energy requirements due to certain disease states; impaired nutrient transport,absorption or metabolism. Aims: The Nutrition Focused Physical Exam (NFPE) helps to identify the presence of any muscle wasting or fat loss in the malnourished patient. It is a cost-effective and efficient way to evaluate a patient’s fat and muscle stores along with fluid gains (edema) and micronutrient deficiencies. Clinicians are trained to identify fat and muscle losses, which can then be used to help categorize patients as No Malnutrition Identified , Malnourished , or Severely Malnourished. Subjects Discussed: Discussions on malnutrition characteristics and documentation  NFPE skills: Assessment for muscle wasting and fat loss  Assessment for micronutrient deficiencies/toxicities  Assessment for fluid accumulation/edema  Assessment for functional status/hand grip strength  Assessment for mid-upper arm circumference

Keywords:

malnutrition , physical exam , hospital