PEDIATRIC MALNUTRITION INDICATORS
PHYSICAL EXAM: DESCRIPTIONS OF NFPE FINDINGS Physical Exam: Descriptions of NFPE Findings EXAM AREAS SUBCUTANEOUS FAT LOSS
Orbital Region (Orbital Fat Pads)
Cheek Region (Buccal Fat Pads)
Upper Arm Region (Triceps)
Thoracic and Lumbar Region (Ribs, Lower Back, Midaxillary Line)
MUSCLE LOSS
Temple Region (Temporalis Muscle)
Clavicle Bone Region (Pectoralis Major, Trapezius Muscles)
View patient when standing directly in front of them, ask patient to turn head side to side. Ask patient to pretend to chew.
Ensure shoulders are in neutral position; standing or sitting as close as possible to 90º, not hunched over.
Hollowing, scooping, depression with little to no muscle tone/resistance.
Protruding, prominent bone. No bounce back in muscle tone/resistance with striated/ stringy feel. Fingers able to palpate under clavicle.
Slight depression with decrease in muscle tone/ resistance.
Some protrusion of the clavicle with decrease in muscle tone/resistance.
Can see/feel well-defined muscle.
Clavicle may be visible, but not prominent. Feel muscle tone/resistance.
View patient when standing directly in front of them, palpate the area around the eye over the orbital bones.
View patient when standing directly in front of them, palpate between the cheekbone and jawbone.
Arm bent at 90º, roll down mid- arm to assess fat between fingers, ensure muscle is not present in pinch. Ask patient to flex.
View patient from back/side with arms raised out directly in front of them.
Hollow look, depressions, dark circles, loose skin. Significant decrease in bounce back of fat pads.
Hollow, sunken, narrow cheeks; prominence of bony structure. Minimal to no bounce back of fat pads.
Fingers touch with minimal fat, very little space between.
Depression between the ribs very apparent, minimal to no fat can be pinched. Iliac crest very prominent.
Slightly dark circles, somewhat hollow look. Some decrease in bounce back of fat pads.
Slight depression, somewhat sunken appearance, flat cheeks. Decrease in bounce back of fat pads.
Some fat in pinch between fingers, but not ample.
Ribs apparent, depressions between ribs less pronounced, minimal fat in pinch. Iliac crest somewhat prominent.
Slightly bulged fat pads, ample bounce back. Fluid retention may mask loss. Dehydration may falsely appear as loss.
Full, round, filled-out cheeks. Ample bounce back of fat pads.
Ample fat between fingers. TIPS SEVERE LOSS MILD–MODERATE LOSS WELL-NOURISHED
5
Chest is full, ribs do not show, ample fat in pinch. Slight to no protrusion of the iliac crest.
Page 1 |
Page 2 |
Page 3 |
Page 4 |
Page 5 |
Page 6 |
Page 7 |
Page 8 |
Page 9 |
Page 10 |
Page 11 |
Page 12 |
Page 13 |
Page 14 |
Page 15 |
Page 16 |
Page 17 |
Page 18 |
Page 19 |
Page 20 |
Page 21 |
Page 22 |
Page 23 |
Page 24 |
Page 25 |
Page 26 |
Page 27 |
Page 28 |
Page 29 |
Page 30 |
Page 31 |
Page 32 |
Page 33 |
Page 34 |
Page 35 |
Page 36 |
Page 37 |
Page 38 |
Page 39 |
Page 40 |
Page 41 |
Page 42 |
Page 43 |
Page 44 |
Page 45 |
Page 46 |
Page 47 |
Page 48 |
Page 49 |
Page 50 |
Page 51 |
Page 52 |
Page 53 |
Page 54 |
Page 55 |
Page 56 |
Page 57 |
Page 58 |
Page 59 |
Page 60 |
Page 61 |
Page 62 |
Page 63 |
Page 64 |
Page 65 |
Page 66 |
Page 67 |
Page 68 |
Page 69 |
Page 70
