Nutrition Focused Physical Exam - IAAND

1y ago
292.24 KB
6 Pages
Last View : 2d ago
Last Download : 4m ago
Upload by : Melina Bettis

Nutrition Focused Physical ExamJoanna Cummings, MS RD CNSCClinical Nutrition Instructor, Lao-American Nutrition InstituteInstructor, Graduate Programs in Human Nutrition at OHSUQuestions to Consider Asking:Hair Has the patient noticed any changes in their hair or more hair loss? Is the hair lighter in color than normal? Has the client washed or brushed their hair recently?Eyes Has the client had any changes in their vision or eyes? Is the client having a hard time seeing at night? Do they report that their eyes feel dry?Lips Has the client noticed any changes in their lips?MouthSkinNails Has the client had any changes in their sense of taste? Do they have a burning sensation in their mouth or any pain with chewing orswallowing? If discoloration of the tongue is noted, has the client recently had a coloredmedication, food or beverage? Has the client noticed any changes in their skin?Is the skin warm or cold? Rough or smooth?Does the skin look dry or oily?Are there rashes or areas of irritation? Has the client noticed any changes in their nails? If discoloration is noted, does the client use tobacco, or have contact withother chemicals? Has the client had any recent injuries to their fingers or nail beds?Other questions to consider:Has the patient taken deworming medication recently?Has the patient had a change in access to food or water recently?Is the patient taking acid blocking medication? (PPI’s/Omeprazole, etc )Has the patient felt more tired, weak, or lethargic recently?

Physical Assessment Findings & Nutrients 1-8AreaPhysical SignsPossible Nutrition AbnormalityHair Thin, sparse, lacklusterIron, zinc, biotinEyes Pallor of lower conjunctivaeFolate, B12, iron, B6Riboflavin, niacin, B6, ironRiboflavin, niacin, B6, B12, folate, ironRiboflavin, niacin, B6, ironFolate, B12, ironRiboflavin, niacin, B6, ironFolate, B12, ironFolate, B12, ironRiboflavin, biotin, B6, zincIronFolate, ironFolate, B12, ironTongueLipsSkinNailsAngular palpebritisGlossitis (sore, red, swollen, smooth)Angular stomatitisPallor of the tongueCheilosis (dry, swollen, ulcerated lips)Pallor of lips, decreased vermilion borderPallor, generalSeborrheic dermatitisKoilonychiaCentral ridge (significant)Pallor of nail bed

Lab AssaySignificanceMethylmalonic AcidMethylmalonic acid is a metabolite of B12. High levels may indicatevitamin B12 deficiency.HomocysteineHigh levels may indicate folate deficiency or B12 deficiency (if coupledwith high methylmalonic acid).ThiaminThiamin diphosphate (TDP) is the most sensitive, specific, and precisemethod of determining nutritional status and is a reliable indicator oftotal body thiamin stores.Soluble TransferrinReceptorTransferrin SaturationFerritinZincNiacinRiboflavinSoluble transferrin receptor concentration is directly proportional toerythropoietic rate and inversely proportional to iron availability. Lowlevels may be due to hemolysis or administration of erythropoiesisstimulating agents. High levels may indicate iron deficiency.Transferrin saturation is the value of serum iron divided by the total ironbinding capacity. Low levels indicate iron deficiency. High levels indicateiron overload or hemochromatosis.Ferritin is the storage form of iron. Low levels indicate irondeficiency.High levels may indicate hemochromatosis, inflammation, or ironoverload.Zinc levels are dependent on albumin and have diurnal variations. Lowlevels may indicate zinc deficiency, malnutrition, infection, inflammation,stress, use of oral contraceptives or pregnancy. High levels may indicatezinc supplementation or fasting.Low levels of N-methylnicotinamide may indicate niacin deficiency.Erythrocyte glutathione reductase assay is a functional index ofriboflavin deficiency.Low levels may indicate riboflavin deficiency

References1. Pogatshnik C, Hamilton, C. Nutrition-focused physical examination: Skin, nails, hair, eyes, andoral cavity. Support Line. 2011;33(2):7-13.2. ASPEN & Cleveland Clinic. Nutrition-Focused Physical Exam: An Illustrated HandbookAmerican Society for Parenteral and Enteral Nutrition; 2016.3. Mordarski, B, Wolff, J. Nutrition Focused Physical Exam Pocket Guide. 2nd Edition. Academyof Nutrition and Dietetics; 2018.4. Litchford M. Nutrition Focused Physical Assessment: Making Clinical Connections. In: CaseSoftware & Books; 2013.5. Esper DH. Utilization of nutrition-focused physical assessment in identifyingmicronutrient deficiencies. Nutr Clin Pract. 2015;30(2):194-202.6. Jensen GL, Binkley J. Clinical manifestations of nutrient deficiency. JPEN Journal of parenteraland enteral nutrition. 2002;26(5 Suppl):S29-33.7. Tosti A, Iorizzo M, Piraccini BM, Starace M. The nail in systemic diseases. DermatolClin. 2006;24(3):341-347.8. Holzberg M. Common nail disorders. Dermatol Clin. 2006;24(3):349-354.9. Schrier SL. Clinical manifestations and diagnosis of vitamin B12 and folate deficiency. In: Post T,ed. UpToDate. Waltham, Mass.: UpToDate; 2018. Andres E. Vitamin B12 (cobalamin) deficiency in elderly patients. Canadian MedicalAssociation Journal. 2004;171(3):251-259.11. Pazirandeh S, Burns D. Overview of water-soluble vitamins. In: Post T, ed. UpToDate.Waltham, Mass.: UpToDate; 2018. Pazirandeh S, Burns D. Overview of dietary trace minerals. In: Post T, ed. UpToDate. Waltham,Mass.: UpToDate; 2018. Schrier SL. Causes and diagnosis of iron deficiency and iron deficiency anemia in adults. In: PostT, ed. UpToDate. Waltham, Mass.: UpToDate; 2018. Stabler SP. Vitamin B12 deficiency. N Engl J Med. 2013;368:149---160.15. Schrier SL. Treatment of vitamin B12 and folate deficiencies. In: Post T, ed. UpToDate.Waltham, Mass.: UpToDate; 2018. Frank LL. Thiamin in Clinical Practice. Journal of Parenteral and Enteral Nutrition. 2015;39(5):503- 520.17. Vallerand AH, Sanoski CA. Thiamine. Vol 15th ed. Philadelphia, Pennsylvania: F.A. DavisCompany; 2017.18. U.S. Department of Agriculture, Agricultural Research Service. USDA National Nutrient Databasefor Standard Reference, Release 26. Nutrient Data Laboratory Home Page, 2013.19. Clark SF. Iron Deficiency Anemia. Nutrition in Clinical Practice. 2008;23 (2):128141. doi:10.1177/0884533608314536.20. Schrier SL. Treatment of iron deficiency anemia in adults. In: Post T, ed. UpToDate. Waltham,Mass.: UpToDate; 2018. Bunn HF. Approach to the Anemias. Goldmans Cecil Medicine. 2012:1031-1039.

(Best) Sensitivity of Nutrient Marker (Limited)


2. ASPEN & Cleveland Clinic. Nutrition-Focused Physical Exam: An Illustrated Handbook American Society for Parenteral and Enteral Nutrition; 2016. 3. Mordarski, B, Wolff, J. Nutrition Focused Physical ExamPocket Guide. 2nd Edition. Academy of Nutrition and Dietetics; 2018. 4. Litchford M. Nutrition Focused Physical Assessment: Making Clinical .

Related Documents:

Past exam papers from June 2019 GRADE 8 1. Afrikaans P2 Exam and Memo 2. Afrikaans P3 Exam 3. Creative Arts - Drama Exam 4. Creative Arts - Visual Arts Exam 5. English P1 Exam 6. English P3 Exam 7. EMS P1 Exam and Memo 8. EMS P2 Exam and Memo 9. Life Orientation Exam 10. Math P1 Exam 11. Social Science P1 Exam and Memo 12.

GRADE 9 1. Afrikaans P2 Exam and Memo 2. Afrikaans P3 Exam 3. Creative Arts: Practical 4. Creative Arts: Theory 5. English P1 Exam 6. English P2 Exam 7. English P3 Exam 8. Geography Exam 9. Life Orientation Exam 10. MathP1 Exam 11. Math P2 Exam 12. Physical Science: Natural Science Exam 13. Social Science: History 14. Technology Theory Exam

Final Exam Answers just a click away ECO 372 Final Exam ECO 561 Final Exam FIN 571 Final Exam FIN 571 Connect Problems FIN 575 Final Exam LAW 421 Final Exam ACC 291 Final Exam . LDR 531 Final Exam MKT 571 Final Exam QNT 561 Final Exam OPS 571

The Nutrition Care Process is defined in four steps: 1. Nutrition Assessment 2. Nutrition Diagnosis 3. Nutrition Intervention 4. Nutrition Monitoring & Evaluation The first component of the “Nutrition Assessment” is a screening of residents for those at risk for nutrition problems and is a candidate for further intervention. One of the

in the clinical setting Know how to perform an adult nutrition-focused physical exam International Global Guidelines Group-2009 -reps from multiple international societies Developed etiology-based approach to diagnosis adult malnutrition in acute care setting Etiology based terminology was proposed

and review the questions in the CFE Exam Prep Course until you receive your CFE Exam activation key and are ready to take the exam. You may continue to study with the CFE Exam Prep Course in between taking sections of the CFE Exam. If you request your exam activation key before completing the CFE Exam

FINAL EXAM: The final exam will cover chapter 11, 13 and 15. There will be no make-up exam for the final exam. The final exam will count 100 points. The final exam will be 40 questions. The format will be multiple-choice. Only the materials covered in the lectures will be on the exam and you will have designated class time to finish the exam.

Cisco Next-Level Career Certification - CCNP DevNet-CCNP DevNet Core-Exam 350-901 (DEVASC)-One CCNP DevNet Concentration-Exam from:-Exam 300-435 (ENAUI)-Exam 300-535 (SPAUI)-Exam 300-635 (DCAUI)-Exam 300-735 (SAUI)-Exam 300-835 (CLAUI)-Exam 300

Note: If the score earned on the final exam is higher than the lowest unit exam score, then the lowest unit exam score will be replaced with the score earned on the final exam. If a student misses an exam, then that exam will be counted as the lowest exam score. Only one exam score can be replace

Manual for Country-Level Nutrition Advocacy . Using PROFILES and Nutrition Costing. FANTA III. FOOD AND NUTRITION TECHNICAL A SSISTANCE. Food and Nutrition Technical Assistance III Project (FANTA) 1825 Connecticut Avenue, NW Washington, DC 20009 T: 202-884-8000 [email protected] 1. 3. Nutrition . 1 Costing. Multi-Sectoral

healthcare team may complete nutrition screening. Nutrition screening should be completed upon admission to a healthcare setting and when nutrition risk is triggered, there should be an automatic referral to the registered dietitian (RD) or the nutrition care team for a comprehensive nutrition assessment.

USDA. Project Team Jane Duffield, MPA Supplemental Nutrition Assistance Program, Food and Nutrition Service, USDA Jackie Haven, MS, RDN Center for Nutrition Policy and Promotion, USDA Sarah A. Chang, MPH, RDN Center for Nutrition Policy and Promotion, USDA Maya Maroto, MPH, RDN Child Nutrition, USDA. Pilot Schools Thurgood Marshall Academy Public

good nutrition, and ways to learn about and practice healthy eating. 4-5. Within a healthy school nutrition environment, school nutrition services provide meals that meet federal nutrition standards for the National School Lunch Program and School Breakfast Program, as well as the health and nutrition needs of all students. 3

II. NUTRITION SERVICES A. Nutrition Education FY 2020 New Hampshire Page 2 of 17 1. Nutrition Education Plans (§246.11) a. The State agency develops and coordinates the nutrition education component with consideration of local agency plans, needs, and available nutrition education resources. (§246.11(c)(1)) Yes No b.

Nutrition & Food Prep Topics and Related Standards Overview NUTRITION AND FOOD PREP I, II FACS I Middle School FACS MIS03 # 09131, 09135 MIS03 # 09022 MIS03 # 09006 Food Customs and Nutrition Food Customs and Nutrition Food Customs and Nutrition Nutritional Needs Through the Life Span (2.1.3, 9.3.1, 9.3.5, 9.3.6, 14.2.2)

and professional judgment to establish the etiology by evaluat-ing all 5 domains within nutrition assessment as outlined in Table 2.22 Nutrition-related physical findings can correspond with the subjective and objective data collected within these domains. The registered dietitian nutritionist (RDN) is the pro-

0 Test Prep 8 Buy Exam Pre-admission Exam for Examicy added to your cart. E·PAX Pre-admission Exam for Examity Quantity Type: Exam Exams: Pre-Adm ission Exam Verbal School Products: PAX Price: 80.00 E-NRCB Nursing Care of Childbearing Family E-PAXACC Pre-admission Exam ACC for Examity Quantity MMMM Type: Exam Exams: Pre-Adm iss on Ex am Verb l

Exam Viewer - ENetwork Final Exam - CCNA Exploration: Network Fundamentals (Version 4.0) Below you will find the assessment items as presented on the exam as well as the scoring rules associated with the item. Use of the exam information in the Exam Viewer is subject to the terms of the Academy Connection Website

Sep 09, 2019 · If I need to retake an exam, are there restrictions on when I can take the exam again? Is there a limit to the number of times I can retake an exam? Do I have to pay the application fee again if I have to retake an exam? If I fail an exam and take it again in 60 days, will the exam be the sam

Artificial Intelligence – A European approach to excellence and trust. It outlines the main principles of a future EU regulatory framework for AI in Europe. The White Paper notes that it is vital that such a framework is grounded in the EU’s fundamental values, including respect for human rights – Article 2 of the Treaty on European Union (TEU). This report supports that goal by .