Clinical Characteristic


Malnutrition in the Context of Acute Illness or Injury


MODERATE MALNUTRITION SEVERE MALNUTRITION


Malnutrition in the Context of Chronic Illness


MODERATE MALNUTRITION SEVERE MALNUTRITION


Malnutrition in the Context of Social or Environmental Circumstances


MODERATE MALNUTRITION SEVERE MALNUTRITION


Physical Findings Malnutrition typically results in changes to the physical exam. The RDN may perform a physical exam and document any one of the physical exam findings below as an indicator of malnutrition.


Body fat Loss of subcutaneous fat (eg, orbital, triceps, fat overlying the ribs).


Muscle mass Muscle loss (eg, wasting of the tem- ples [temporalis muscle]; clavicles [pectoralis and deltoids]; shoulders [deltoids]; interosseous muscles; scapula [latissimus dorsi, trapezious, deltoids]; thigh [quadriceps] and calf [gastrocnemius]).


Fluid accumulation The RDN evaluates generalized or localized fluid accumulation evident on exam (extremities; vulvar/scro- tal edema or ascites). Weight loss is often masked by generalized fluid retention (edema) and weight gain may be observed.


Reduced grip strength Consult normative standards supplied by the manufacturer of the measure- ment device.


Mild Mild Moderate Moderate Mild Mild Severe Severe Mild Mild Severe Severe


Mild


Moderate to Severe


Mild


Severe


Mild


Severe


N/A


Measurably reduced


N/A


Measurably reduced


N/A


Measurably reduced


A minimum of two characteristics is recommended for diagnosis of either severe or moderate malnutrition. MALNUTRITION CHARACTERISTICS PEDIATRIC MALNUTRITION INDICATORS 2


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