NUTRITION-FOCUSED 
           PHYSICAL EXAMINATION 
           FOR ADULTS: PART 1 
                 
            
           Registered Dietitian Nutritionists are interested and moving forward, yet 
           there remains a wide range of personal comfort and skills in the bedside 
           completion of a nutrition-focused physical examination (NFPE), which is 
           one component of the Nutrition Care Process.  
           This presentation will address roadblocks to the performance of nutrition-
           focused physical assessment and provide examples and resources to assist 
           the learner, encourage perseverance and support skill building. 
            
            
           These notes and references related to NFPE, are for educational purposes 
           only. These notes do not constitute medical or professional advice and 
           should not be taken as such. Use of this information is subject to the sole 
           professional judgment of the health professional. These notes are not a 
           substitute for exercise of judgment by the health professionals. 
            
          6/27/18 
           
                                                                                             6/27/2018 
                  NUTRITION-FOCUSED PHYSICAL 
                  EXAMINATION FOR ADULTS: PART 1 
                        
                   
                   
                                                OBJECTIVES
                           Utilize the power of the nutrition-focused physical examination 
                           both in telling the patients’ story and identification of the type 
                             and degree of malnutrition as part of a complete nutritional 
                                                      assessment. 
                          Apply simple techniques to use to increase skills in conducting a 
                          nutrition-focused physical examination within the professionals’ 
                                                   scope of practice.
                             Demonstrate how documentation of the nutrition-focused 
                           physical examination contributes to interdisciplinary patient 
                         care and provides evidence for the nutrition diagnosis of disease-
                                                related malnutrition.
                          Interpret information contributed from the care team for the 
                               plan of care by being alert to opossible malnutrition.
                                                                                                      
                   
                   
                   
                   
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                                                                                                6/27/2018 
                        MODEL FOR LEARNING AND DEVELOPMENT 
                                                       70:20:10 
                                                            10% 
                                                         FORMAL 
                                                        TRAINING
                                                           20% 
                                                    FEEDBACK & 
                                                     COACHING
                                                           70% 
                                                    EXPERIENCE
                                                                                                           
                   Lombardo and Eichinger expressed the rationale behind the 70:20:10 model this way 
                   in The Career Architect Development Planner.: 
                   “Development generally begins with a realization of current or future need and the 
                   motivation to do something about it. This might come from feedback, a mistake, 
                   watching other people’s reactions, failing or not being up to a task – in other words, 
                   from experience. The odds are that development will be about 70% from on-the-job 
                   experiences, working on tasks and problems; about 20% from feedback and working 
                   around good and bad examples of the need, and 10% from courses and reading.” 
                    
                   Lombardo, Michael M; Eichinger, Robert W (1996). The Career Architect Development Planner (1st ed.). 
                                 Minneapolis: Lominger. p. iv. ISBN 0-9655712-1-1Accessed 3/12/2015 
                    
                    
                    
                    
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                                                                                              6/27/2018 
                            Etiology-Based Disease-Related Malnutrition
                                                    Nutrition Risk 
                                                         Screen
                                                    Inflammation? 
                                                       yes? or no?
                    acute disease-related           chronic disease-            starvation or semi-
                         malnutrition                     related               starvation (social or 
                                                      malnutrition                 environmental 
                                                                                  circumstances)
                                                                                                          
                                                                          Jensen GL. JPEN 2009;33:710 
                     CLINICAL CHARACTERISTICS OF PROTEIN-ENERGY 
                                MALNUTRITION (Aspen/Academy Consensus 2012) 
                                                       ENERGY 
                                                       INTAKE
                                 REDUCED                                   WEIGHT 
                                    GRIP                                     LOSS
                                STRENGTH
                                     FLUID                              BODY FAT & 
                              ACCUMULATION                            MUSCLE MASS
                                                                                                        
                  © MySurgeryPlate LLC 2018                                                         3