NFPE #1

Objectives

1) Use a NFPE to accurately identify and grade malnutrition through muscle loss, fat loss, and/or edematous conditions

2) Perform a physical assessment with consistency and reproducibility among practitioners

3) Correlate and discriminate relevant nutrition-related physical findings with medical and social history

Exam is systematic:

HEAD to TOE

Notes and Recs:

1. Malnutrition can occur at ANY BMI

2. Start practicing these 2 areas regularly

- Set a goal, e.g. 2 patients/day

- The more the practice (i.e. patients), the easier it gets

3. MN diagnosis at UF Health: Use updated Academy/ASPEN criteria

Nutrition-focused Physical Exam, Part 1

Causes of Muscle Atrophy

and/or loss of symmetry

-Osteoarthritis, Rheumatoid arthritis

-ALS / Lou Gehrig's

-Guillain-Barre syndrome

-Diabetic neuropathy

-Burns, Trauma

-Muscular dystrophy

-Immobilization

-Spinal cord injury

-Polio

-Stroke

Getting started...

Technique: Observation

-Broad observation

-Clinical evaluation

-Symmetry

Technique: Palpation

-Examine, touch

Orbital region (orbital fat pads)

- Inspect directly and side to side

- Palpate above cheekbone

Temples (temporalis muscle)

- Inspect directly and side to side

- Palpate brow bone

Well-nourished: Slightly bulged

*Older adults, allergies, prednisone

Mild-Moderate: Flat to slight hollowing

Severe: Hollow, sunken, dark circles, loose skin

Well-nourished: See, feel well-defined muscle

Mild-Moderate: Slight depression, "squishy" feel

Severe: Hollowing, scooping, bone feel

Fluid status:

Edema, Ascites

Fat storage status:

Orbital fat pads, Upper arms, Fat overlying the ribs

"fat storage losses"

Bilateral muscle status:

Temporal, Traps, Pectoralis, Deltoid, Scapula, Interosseous, Quadricep, Calf

"bilateral muscle wasting"

Prezi created by: Jessie Furman, MS, RD, LD/N