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Effects of Malnutrition
Altered mental status Impaired wound healing Decreased immune response Increased infection and pressure ulcer risk Compromised temperature regulation & GI function (ie
nutrient absorption) Longer hospital stay Decreased kidney, heart, lung, liver and cognitive function Altered blood pressure and electrolytes
Hand Hygiene
Wash hands before and after
Questions to ask
History of physical activity If very inactive, baseline muscle mass is lower and risk for malnutrition/muscle wasting is higher Original teeth? Dentures? Oral pain?
Recent fractures?
Recent onset of memory problems?
Fluid Status
Look for edema, ankles are a good place to start Check hydration status with hand pinch
Is ascites present?
How: Touch face just above cheekboneshould feel puffy. Can feel fat between finger and upper cheekbone in well-nourished.
Severe Malnutrition: Hollow look, depressed area, dark circles, very loose skin.
Severe malnutrition: Very little or no fat between fingers, skin is like 2 layers of paper.
Severe Malnutrition: Very depressed area between thumb and index finger.
Clavicle
How: Look for prominent bone. In wellnourished, the clavicle bone is not visible (men) or only faintly seen (women). Malnutrition is severe if the bone is protruding and very prominent.
Confusion
Slow wound healing Swelling and impaired joint mobility of upper
Nails: Dull, brittle, ridged, or horizontal lines (nails take 5 months to grow out)
Considerations
Always look at the whole picture Make assessments based on
multiple signs/symptoms Medication side effects Effects of disease/illness Frame size Variations between races, gender and individuals
Obesity: Lack of physical activity (muscle mass) can actually put obese individuals at a higher risk for protein deficiency when intake is inadequate. Physical exams can be more difficult but it is important to consider muscle stores are depleted faster in obese individuals
THANK YOU!
Lindsey Patterson 719-248-7299 Chelsea Small 541-944-5442