After examining Mrs. McCormick's history and physical, identify any clinical signs and symptoms that may alert you to a nutrient deficiency
Describe the nutrition-focused physical examination and address the important components that may be used to fully assess Mrs. McCormick's nutritional status.
• Weight loss/fat wasting: 20# weight loss over six months (>18% bodyweight)
Underweight and orbital wasting also noted
• Muscle wasting: Low protein intake: dry, dull hair, sunken cheeks, temporal wasting, muscle loss in quadriceps and gastrocnemius, low Braden score
• Grip strength: Reduced strength in the extremities noted
• Low albumin and prealbumin noted with no presence of inflammation
• Riboflavin (B2) deficiency and B vitamin deficiency: fissured eyelid corners, cheilosis noted on lips, angular stomatitis; iron deficiency: koilonychias, pale skin, anemia
• Dehydration: Dry mucous membranes in nose and throat, dry skin, poor skin turgor
• This assessment information allows for the diagnosis of moderate to severe malnutrition associated with chronic disease.
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