Hi! My name is Laura Robbins, and I am currently an intern at the UCONN Medical Center in Farmington, CT. I am about half way through my clinical rotation, and find that I enjoy the challenge that each day presents at the hospital: whether it be learning about a new medical condition, figuring out what nutrition issues are related to a medical condition (and why) or even simply coming up with the right PES statement when it may not be overtly obvious. Learning to assess the nutrition status of patients is like putting together the little pieces of a puzzle to finally see the big picture, and experience the joy that comes with that “ah-ha” moment.
The ability to recognize and properly diagnose malnutrition is perhaps one of the most difficult and yet important skills that I have acquired as an intern. Malnutrition is not always obvious, and it takes practice to recognize the signs. I was fortunate to be able to attend a conference with my preceptors to learn more about the impact of malnutrition and techniques to confidently perform a nutrition focused physical assessment. The speaker stressed the importance of learning to recognize the clues, and encouraged all RD’s to become comfortable performing a bedside examination. Nutrition assessment takes practice, uses critical thinking and employs keen observation skills. The following are a few tips that may help you conduct nutrition-focused physical assessments.
1. Be attentive while interviewing a patient to get an overall impression: including age, physical appearance, hair, skin and nails.
2. Assess for muscle mass by standing directly in front of the patient (temple region, clavicle bone and acromion, scapular bone region, dorsal hand) – don’t be afraid to tell the patient why you are looking at them.
3. Look for fat loss in the orbital region, triceps/biceps muscles, thoracic and lumbar regions, ribs and lower back. again, don’t be afraid to ask the patient;
4. Not everyone who is “skinny” is malnourished. Likewise, overweight and obese people can exhibit signs of malnutrition as well. It takes many practiced hours to discern the diagnosis of malnutrition.
The ability to recognize and properly diagnose malnutrition is perhaps one of the most difficult and yet important skills that I have acquired as an intern. Malnutrition is not always obvious, and it takes practice to recognize the signs. I was fortunate to be able to attend a conference with my preceptors to learn more about the impact of malnutrition and techniques to confidently perform a nutrition focused physical assessment. The speaker stressed the importance of learning to recognize the clues, and encouraged all RD’s to become comfortable performing a bedside examination. Nutrition assessment takes practice, uses critical thinking and employs keen observation skills. The following are a few tips that may help you conduct nutrition-focused physical assessments.
1. Be attentive while interviewing a patient to get an overall impression: including age, physical appearance, hair, skin and nails.
2. Assess for muscle mass by standing directly in front of the patient (temple region, clavicle bone and acromion, scapular bone region, dorsal hand) – don’t be afraid to tell the patient why you are looking at them.
3. Look for fat loss in the orbital region, triceps/biceps muscles, thoracic and lumbar regions, ribs and lower back. again, don’t be afraid to ask the patient;
4. Not everyone who is “skinny” is malnourished. Likewise, overweight and obese people can exhibit signs of malnutrition as well. It takes many practiced hours to discern the diagnosis of malnutrition.
