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Nutrition-Focused Physical Exam: An Illustrated Handbook [Spiraalköide]

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  • Formaat: Spiral bound, 54 pages, kõrgus x laius: 159x191 mm, 16 illustrations
  • Ilmumisaeg: 28-Feb-2017
  • Kirjastus: ASPEN | American Society for Parenteral and Enteral Nutrition
  • ISBN-10: 188962229X
  • ISBN-13: 9781889622293
Teised raamatud teemal:
  • Formaat: Spiral bound, 54 pages, kõrgus x laius: 159x191 mm, 16 illustrations
  • Ilmumisaeg: 28-Feb-2017
  • Kirjastus: ASPEN | American Society for Parenteral and Enteral Nutrition
  • ISBN-10: 188962229X
  • ISBN-13: 9781889622293
Teised raamatud teemal:
The Cleveland Clinic Center for Human Nutrition developed the Nutrition-Focused Physical Exam (NFPE) to assist bedside clinicians in the nutrition assessment of their patients and to help discern the presence and degree of malnutrition.

The Academy-ASPEN Consensus Statement and Characteristics for Identification of Malnutrition has been a catalyst to realizing the importance of incorporating a nutrition-focused physical exam (NFPE) as part of a comprehensive nutrition assessment and to standardize the approach in assessing the nutritional status of patients. Most healthcare disciplines perform a physical exam of their patients, and a NFPE should be part of the nutrition clinicians skill set.

This handbook discusses the components of the NFPE and includes pictorial representations of various stages of muscle and fat depletion (normalmildmoderatesevere), vitamin and mineral losses, and fluid balance. Techniques and tips that can be used in daily practice when examining patients, as well as charts and references, are provided. Clinical characteristics are discussed, along with the influence of inflammation and functional status.

This guide is intended to help the clinician develop their NFPE skills. The spiral-bound cover allows the handbook to lay flat for easy referral and assessment charts include side-by-side coloir illustrations.

Chapters include:

Preparation for the physical exam. Inflammation. Physical exam of subcutaneous muscle and fat stores. Assessment of fluid status (accumulation; dehydration). Examination of functional. Status and assessment of micronutrient status. The appendix includes a check-list for conducing an NFPE.
01 Introduction
02 Preparation for the Physical Exam
Overview
Systematic approach to a nutrition assessment
Assessment and interview techniques and tips
Exam techniques and tips
Exam techniques using inspection/palpation
03 Inflammation
Overview
Common diagnoses associated with etiology of malnutrition (Table 1)
Markers of inflammation: vital signs (Table 2)
Markers of inflammation: biochemical markers (Table 3)
Imaging studies (Table 4)
04 Physical Exam of Subcutaneous Muscle and Fat Stores
Overview
Symmetry
Special considerations: obesity, critical illness, and sarcopenia
Additional tools for body composition assessment
Head-to-toe approach
Head and face
Upper chest
Upper back
Midaxillary line
Arms
Hands
Lower extremities
05 Assessment of Fluid Status:
Accumulation and Dehydration
Overview
Fluid accumulation/edema
Impact of edema on nutrition
Academy-ASPEN fluid accumulation characteristics that support a diagnosis
of malnutrition (Figure 1)
Differential diagnosis of edema (Table 1)
Medications known to cause generalized/peripheral edema (Table 2)
Terminology used to describe edema (Table 3)
Grading of pitting edema (Table 4)
Evaluation of fluid accumulation/edema (Table 5)
Dehydration
Labs and vital signs associated with dehydration (Table 6)
Areas of focus to evaluate for dehydration (Table 7)
06 Examination of Functional Status
Overview
Reduced grip strength as a supportive clinical characteristic for
malnutrition (Table 1)
Measuring functional status
Techniques for using a dynamometer
07 Assessment of Micronutrient Status
Overview
Skin
Nails
Hair
Orofacial
08 Appendix: Nutrition-Focused
Physical Exam Checklist