Answer to Question 1
It would be important to attempt to determine from which of her body compartments she has lost most of her weight.
One could use skinfold measurements to assess her percentage of body fat as well as compare her to population standards.
Additionally, somatic protein stores could be estimated using calculation of upper arm muscle mass.
Grip-strength could also be a great source of nutritional status/malnutrition risk.
Physical assessments of key body areas for fat and muscle wasting (e.g. orbital or triceps and temples, clavicles, or quadriceps regions, respectively) would further help
Answer to Question 2
Nutritional concerns are two-fold. First, COPD does cause symptoms that interfere with adequate oral intake.
These include:
Loss of appetite
Early satiety
Changes in saliva production (sensation of taste)
Individuals with emphysema also may experience an overall increase in energy and protein requirements due to the excessive use of accessory muscles to breathe.
Other symptoms such as dyspnea, bloating, fatigue, and constipation interfere with ability to chew, swallow, and even prepare food.
Secondly, when someone with COPD experiences malnutrition, there is risk that this may worsen respiratory function.
Malnutrition can cause a wasting of respiratory muscles that will then make the work of breathing more difficult.
This dyspnea leads to fatigue which may further cause food preparation and consumption more difficult.
Adults in late adulthood may need to adapt to a new environment as they age and their health status
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