Identify factors that would affect interpretation of Mrs. Maney's ...

[piesebel]

Identify factors that would affect interpretation of Mrs. Maney's weight and body composition. Look at the I/O record. What will likely happen to Mrs. Maney's weight if this trend continues?
 
  What will be an ideal response?

Question 2

After examining Mrs. McCormick's history and physical, identify any clinical signs and symptoms that may alert you to a nutrient deficiency.
 
  Describe the nutrition-focused physical examination and address the important components that may be used to fully assess Mrs. McCormick's nutritional status.

[dudman123]

Answer to Question 1

 Ascites and peripheral edema
 Mrs. Maney's I/O record shows an overall net fluid retention of 408 mL over a 24-hour period since her admission. If this trend continues, Mrs. Maney's measured weight will increase to reflect additional fluid retention. A negative net I/O value would correlate with a decrease in measured weight.
Mrs. Maney also has signs of muscle wasting (temporal wasting and weak handgrip) which may indicate a loss of lean body mass. These may be masked due to fluid retention.

Answer to Question 2

 Weight loss/fat wasting: 20 weight loss over six months (>18 bodyweight)
Underweight and orbital wasting also noted
 Muscle wasting: Low protein intake: dry, dull hair, sunken cheeks, temporal wasting, muscle loss in quadriceps and gastrocnemius, low Braden score
 Grip strength: Reduced strength in the extremities noted
 Low albumin and prealbumin noted with no presence of inflammation
 Riboflavin (B2) deficiency and B vitamin deficiency: fissured eyelid corners, cheilosis noted on lips, angular stomatitis; iron deficiency: koilonychias, pale skin, anemia
 Dehydration: Dry mucous membranes in nose and throat, dry skin, poor skin turgor
 This assessment information allows for the diagnosis of moderate to severe malnutrition associated with chronic disease.