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Unit six

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This document provides an overview of nutritional assessment in adults. It discusses the physical examination findings that can indicate poor nutrition, such as signs in the eyes, lips, hair and skin. It also covers derived weight measures like body weight as a percentage of ideal weight and percentage of usual body weight to detect mild, moderate or severe malnutrition. Other assessment tools discussed include body mass index, waist-hip ratio, laboratory studies of glucose, hemoglobin, hematocrit, cholesterol and C-reactive protein. The goals of nutritional assessment are also outlined.

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CHAPTER SIX NUTRITIONALASSESSMENT IN ADULTS physical assessment findings for signs of poor nutrition. Equipment needed: Pen or pencil. Nutritional assessment data form. Anthropometer. chair or bed scale, tape measure
Physical examination Physical examination can help the assessor detect signs of nutrition deficiency and fluid imbalances. Clinical signs of malnutrition: signs of malnutrition tends to appear most often in parts of the body where cells replacement occurs at rapid rate such as: Eye Lips Hair and skin
Derived weight measures: (used to depict change in body weight) Body weight as a Percent ideal body weight: is the optimal weight recommended for optimal health Percent ideal body weight =current wt./ideal wt.*100 (If the result 80% -90% mild malnutrition . 70%- 80% moderate malnutrition . Less than 70% sever malnutrition) .
percent usual body weight : Percent usual body weight = current wt. /usual wt. *100 . (If the result 85% -95% mild malnutrition , 75%-84% moderate mal nutrition ,less than 75 % sever malnutrition) recent weight change is calculated by : Usual wt. current wt. /usual wt. *100 . (An unintentional loss of >5% of body wt. over 1 month , or > 7.5 % over 3 month , or 10 % over 6 month is clinically significant)
Body mass index practical marker of optimal weight for height and indicator of obesity or under nutrition.
waist-hip ratio: To assess body fat distribution . 1.0 or more in men the person is obese . If the women .8 or more the women is obese
The aging adult Height: with age declines in both men and women very slowly from the early 30s. leading to an average2.9cm loss in men and 4.9cm loss in women.
Laboratory studies Important because it can detect preclinical nutritional deficiencies and can be used to confirm subjective finding . Glucose: plasma glucose level. N(60-110 mg/dl), HBA1C Hemoglobin. To detect iron deficiency anemia .(M:14-18) (F:12-16) Increase Dehydration. Decrease anemia. Hematocrit : measure cell volume also an indicator of iron status (M: 37% -49% ) (F :36%to46% ) -low value indicate insufficient hemoglobin formation . Cholesterol : To evaluate fat metabolism and to assess risk for CVD. N(120-200) .200 -239 moderate risk , 240 or more high risk
C Reactive protein a plasma protein marker of inflammatory status produced by the liver is used to monitor metabolic stress .(trauma , surgery , burns) and to determine when to begin nutritional support in critically ill patients. CRP is generally not detectable in the blood , when the CRP detectable are associated with increased risk of atherosclerosis and may be seen in other inflammatory condition NORMAL <0.1 mg/dl
Desired Outcomes Maintain or restore optimal nutritional status Promote healthy nutritional practices Prevent complications associated with malnutrition Enhance activity tolerance. Decrease weight Regain specified weight Prevent infection.
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Unit six

  • 1. CHAPTER SIX NUTRITIONALASSESSMENT IN ADULTS physical assessment findings for signs of poor nutrition. Equipment needed: Pen or pencil. Nutritional assessment data form. Anthropometer. chair or bed scale, tape measure
  • 2. Physical examination Physical examination can help the assessor detect signs of nutrition deficiency and fluid imbalances. Clinical signs of malnutrition: signs of malnutrition tends to appear most often in parts of the body where cells replacement occurs at rapid rate such as: Eye Lips Hair and skin
  • 3. Derived weight measures: (used to depict change in body weight) Body weight as a Percent ideal body weight: is the optimal weight recommended for optimal health Percent ideal body weight =current wt./ideal wt.*100 (If the result 80% -90% mild malnutrition . 70%- 80% moderate malnutrition . Less than 70% sever malnutrition) .
  • 4. percent usual body weight : Percent usual body weight = current wt. /usual wt. *100 . (If the result 85% -95% mild malnutrition , 75%-84% moderate mal nutrition ,less than 75 % sever malnutrition) recent weight change is calculated by : Usual wt. current wt. /usual wt. *100 . (An unintentional loss of >5% of body wt. over 1 month , or > 7.5 % over 3 month , or 10 % over 6 month is clinically significant)
  • 5. Body mass index practical marker of optimal weight for height and indicator of obesity or under nutrition.
  • 6. waist-hip ratio: To assess body fat distribution . 1.0 or more in men the person is obese . If the women .8 or more the women is obese
  • 7. The aging adult Height: with age declines in both men and women very slowly from the early 30s. leading to an average2.9cm loss in men and 4.9cm loss in women.
  • 8. Laboratory studies Important because it can detect preclinical nutritional deficiencies and can be used to confirm subjective finding . Glucose: plasma glucose level. N(60-110 mg/dl), HBA1C Hemoglobin. To detect iron deficiency anemia .(M:14-18) (F:12-16) Increase Dehydration. Decrease anemia. Hematocrit : measure cell volume also an indicator of iron status (M: 37% -49% ) (F :36%to46% ) -low value indicate insufficient hemoglobin formation . Cholesterol : To evaluate fat metabolism and to assess risk for CVD. N(120-200) .200 -239 moderate risk , 240 or more high risk
  • 9. C Reactive protein a plasma protein marker of inflammatory status produced by the liver is used to monitor metabolic stress .(trauma , surgery , burns) and to determine when to begin nutritional support in critically ill patients. CRP is generally not detectable in the blood , when the CRP detectable are associated with increased risk of atherosclerosis and may be seen in other inflammatory condition NORMAL <0.1 mg/dl
  • 10. Desired Outcomes Maintain or restore optimal nutritional status Promote healthy nutritional practices Prevent complications associated with malnutrition Enhance activity tolerance. Decrease weight Regain specified weight Prevent infection.