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Nutrition-Focused Physical Exam
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Table of Contents

  • 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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