Nutritional Support and the Surgical Patient

Yvonne Huckleberry

Disclosures

Am J Health Syst Pharm. 2004;61(7) 

In This Article

Interviewing the Patient, Family, or Caregiver

After reviewing the patient's medical record, a brief interview with anyone familiar with the patient's dietary history can be valuable. For example, a trend in unintentional weight loss prior to admission, even in the obese, is an important clue indicating prolonged suboptimal nutritional intake. On the other hand, a lean patient may appear malnourished but have a long-term history of measuring under the ideal weight for height. The clinician should ask about dietary restrictions, probing for the avoidance of any of the food groups that may suggest deficiencies in certain nutrients. Problems with dentition, absorption, or appetite should also be noted.

Physical Examination

A nutrition-focused physical examination can be useful in confirming suspicions of nutrient deficiencies. Clinicians should look for signs of muscle and fat wasting, poor wound healing, poor skin integrity, and other signs of nutrient deficiencies as objective data suggesting malnutrition. An excellent review of the nutrition-focused physical assessment has been published elsewhere.[32]

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