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Utilization of Nutrition-Focused Physical Assessment in Identifying Micronutrient Deficiencies

Nutrition-focused physical assessments (NFPA) are an examination used in recognizing malnutrition. Malnutrition is such a crucial component to identify because it is related to increased morbidity and mortality prior to or during hospitalization if not recognized. There are many evaluations that are used to help identify a patient’s risk for malnutrition but unfortunately, certain evaluations contain biochemical markers that are not reliable markers of nutrition such as serum albumin and prealbumin. Therefore, it was important to incorporate an assessment that is able to show changes in body composition such as muscle wasting, subcutaneous fat loss, and fluid accumulation, which are a part of the six malnutrition characteristics.

NFPA’s identify macronutrient and micronutrient deficiencies by a head-to-toe assessment that evaluates each body system. Some of the regions of the body that are examined include skin, nails, hair, eyes, mouth, abdomen, and extremities. A general inspection before beginning the NFPA can give the registered dietitians a “big picture” look to the patient’s overall wellness. Although one might assume the NFPA is most important for macronutrient deficiencies due to testing muscle and fat loss, it is also an essential way to recognize many micronutrient deficiencies. The skin, nails, hair, eyes, mouth, and lower extremities can exhibit signs of a micronutrient deficiency. For example, coiled hairs can indicate a vitamin C deficiency.

The NFPA is clearly an important component in the effort to better recognize and treat malnutrition in our health systems. These assessments provide unique data that may be missed in the assessments by others on the healthcare team because it zones in on deficiencies that deal with macro/micronutrients. Overall, the use of the NFPA can successfully identify malnutrition leading to better patient outcomes and cost savings for the hospital.

 
 

 

KH

 

Esper, D. H. (2015). Utilization of Nutrition-Focused Physical Assessment in Identifying Micronutrient Deficiencies. Nutrition in clinical practice, (2). 194.

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