Nutrition-Focused Physical Exam: An Illustrated Handbook

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 clinician’s skill set. This handbook discusses the components of the NFPE and includes pictorial representations of various stages of muscle and fat depletion (normal–mild–moderate–severe), 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.