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Nutrition-Focused Physical Exam

An Illustrated Handbook

Cindy Hamilton (editor)

ISBN: 9781889622293

Publication Date: Feb 2017

Format: Spiral bound

Discusses the components of the nutrition-focused physical exam and includes pictorial representations of various stages of muscle and fat depletion, vitamin and mineral losses, and fluid balance. Techniques and tips that can be used in daily practice when examining patients, as well as charts and references, are provided.
£29.95

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The Cleveland Clinic Center for Human Nutrition developed the Nutrition-Focused Physical Exam (NFPE) to assist bedside clinicians in the nutrition assessment of their patients and to help discern the presence and degree of malnutrition.

The Academy-ASPEN Consensus Statement and Characteristics for Identification of Malnutrition has been a catalyst to realizing the importance of incorporating a nutrition-focused physical exam (NFPE) as part of a comprehensive nutrition assessment and to standardize the approach in assessing the nutritional status of patients. Most healthcare disciplines perform a physical exam of their patients, and a NFPE should be part of the nutrition clinician's skill set.

This handbook discusses the components of the NFPE and includes pictorial representations of various stages of muscle and fat depletion (normal–mild–moderate–severe), vitamin and mineral losses, and fluid balance. Techniques and tips that can be used in daily practice when examining patients, as well as charts and references, are provided. Clinical characteristics are discussed, along with the influence of inflammation and functional status.

This guide is intended to help the clinician develop their NFPE skills. The spiral-bound cover allows the handbook to lay flat for easy referral and assessment charts include side-by-side coloir illustrations.

Chapters include:
  • Preparation for the physical exam.
  • Inflammation.
  • Physical exam of subcutaneous muscle and fat stores.
  • Assessment of fluid status (accumulation; dehydration).
  • Examination of functional.
  • Status and assessment of micronutrient status.
  • The appendix includes a check-list for conducing an NFPE.

Illustrations 16 illustrations
Pages 54
Dimensions 159 x 191
Date Published 28 Feb 2017
Publisher American Society for Parenteral and Enteral Nutrition (ASPEN)
Subject/s Gastroenterology   Nursing specialties   Dietetics & nutrition  
  • 01 Introduction
  • 02 Preparation for the Physical Exam
  • � Overview
  • � Systematic approach to a nutrition assessment
  • � Assessment and interview techniques and tips
  • � Exam techniques and tips
  • � Exam techniques using inspection/palpation
  • 03 Inflammation
  • � Overview
  • � Common diagnoses associated with etiology of malnutrition (Table 1)
  • � Markers of inflammation: vital signs (Table 2)
  • � Markers of inflammation: biochemical markers (Table 3)
  • � Imaging studies (Table 4)
  • 04 Physical Exam of Subcutaneous Muscle and Fat Stores
  • � Overview
  • � Symmetry
  • � Special considerations: obesity, critical illness, and sarcopenia
  • � Additional tools for body composition assessment
  • � Head-to-toe approach
  • Head and face
  • Upper chest
  • Upper back
  • Midaxillary line
  • Arms
  • Hands
  • Lower extremities
  • 05 Assessment of Fluid Status:
  • Accumulation and Dehydration
  • � Overview
  • � Fluid accumulation/edema
  • � Impact of edema on nutrition
  • � Academy-ASPEN fluid accumulation characteristics that support a diagnosis of malnutrition (Figure 1)
  • � Differential diagnosis of edema (Table 1)
  • � Medications known to cause generalized/peripheral edema (Table 2)
  • � Terminology used to describe edema (Table 3)
  • � Grading of pitting edema (Table 4)
  • � Evaluation of fluid accumulation/edema (Table 5)
  • � Dehydration
  • � Labs and vital signs associated with dehydration (Table 6)
  • � Areas of focus to evaluate for dehydration (Table 7)
  • 06 Examination of Functional Status
  • � Overview
  • � Reduced grip strength as a supportive clinical characteristic for malnutrition (Table 1)
  • � Measuring functional status
  • � Techniques for using a dynamometer
  • 07 Assessment of Micronutrient Status
  • � Overview
  • � Skin
  • � Nails
  • � Hair
  • � Orofacial
  • 08 Appendix: Nutrition-Focused
  • Physical Exam Checklist

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