ASSESSMENT BY CLINICAL METHOD

v ​Clinical assessment of nutritional status deals basically with the examination of

changes that can be seen or felt in superficial tissues such as the skin, hair and eyes.

v​ ​In other words, its the physical observation or assessment.

v ​In here, signs of nutrient deficiency are noted and some nutrient deficiency diseases are
observed such as;

v​ ​Scurvy = lack in vit C = numerous black and blue spots on the skin

v​ ​Rickets = lack of Ca and vit D= poorly shaped bones and teeth

v​ ​Iron deficiency/anemia(children beyond 6 mons.) = lack in iron = pallor.

v​ ​Dehydration = loss of water= sunken eyeballs, dry mucous membranes, thirst, etc.

PHOTOCOPY THE TABLE FOR PHYSICAL SIGNS OF NUTRITIONAL STATUS

FROM THE BOOK..

ASSESSMENT BY BIOCHEMICAL TEST

= includes various blood, urine , saliva and stool test.

=according to Dellova, it provides information on protein balance, vit, mineral, and fluid
status, body composition, organ function and metabolic status.

= According to roth = a deficiency/ toxicity can be determined by laboratory analysis of the

samples.

= these test allow detection of malnutrition before signs appear.

MOST COMMONLY USED TEST FOR NUTRITIONAL EVALUATION

v​ ​BLOOD TEST

· ​Serum Albumin Level – measures the main protein in the blood and is used to

determine protein status

-3. 5 – 5.0 g/dl or 35-50g/L

·​ Serum Transferrin Level
​

-indicates iron-carrying protein in the blood

-​transferrin​ is a glycoprotein that binds and transport iron. Most is produced in the liver.

- if result is below normal there would be hepatic failure, nephrosis, cachexia ( ​severe
malnutrition and body wasting by chronic diseases​.)

·​ Blood Urea Nitrogen​ (BUN)

​

-Increased level may indicate renal failure, insufficient renal blood supply or blockage in
the urinary tract, dehydration and GI bleeding.

·​ 2.9 – 8.9 mmol/L

​

v ​Creatinine Excretion – indicates the amount of ceatinine excreted in the urine over a
24 hour period and can be used in estimating body muscle mass.

-low creatinine excretion – indicative of muscle mass depletion, as in malnutrition.

v ​Serum Creatinine – indicates the amount of creatinine in the blood and is used for
evaluating renal functions.

-N.V. 60-132 mmol/L

-↑= acute/chronic renal insufficiency, urinary tract obstruction.

v​ ​ ​Hgb-​ women-12-16g/dl,men-14-18g/dl

Hct​ – women – 42-52%,men- 37-48%

= decreased level would mean anemia

v​ ​ Lipid Profile​ – for clients w/ heart abnormalities

Total Serum Cholesterol​ – less than 200 mg/dl

​

HDL ​– more than 35mg/dl

​

LDL​ – less than 130mg/dl

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Serum Triglycerides – 2.9 – 8.9 mmol/L or less than 200mg/dl

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v​ ​Uric Acid, serum or plasma​ – men – 3-99mg/dl, women – 2.5-7.7mg/dl

-High- gout, toxemia of pregnancy, leukemia, polycythemia,renal insufficiency,

down’s syndrome, glycogen storage disease.

-Low – occasionally in acute hepatitis.

v​ ​STOOL EXAM

Direst Stool Exam – stools check for weight ( greater than normal weight
​

suggest malabsorption ) and checked for oily materials ( excess fat in stool
suggest steatorrhea).

Chemical analysis of fecal fat​- fecal fat greater than 7g/day when the diet
​

includes 100 g of fat/day indicates malabsorption.

Serum Calcium – low levels seen in calcium and vit. D malabsorption, (recall
​

that steatorrhea can lead to calcium and vit D.malabsorption.

D-xylose test​ – test of CHO absorption.

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Schilling test​ – identifies vit B​₁₂​ malabsorption.

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v​ ​URINE TEST

· Creatinine - ↑ - muscle wasting, starvation and cachectic status, hyperthyroidism

​

and febrile status.

-​ ↓- hypothyroidism, renal insufficiency

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-​ Men – 0-50 mg/24 hour

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-​ Women – 0-100 mg/24hour

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·​ Calcium​ - ↑- hyperparathyroidism, elevated serum calcium

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-​ 50-150mg/24 hr. Or 1.05 – 1.3 mmol/L

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· Urinalysis – can detect protein and sugar in urine(indicative of kidney disease and
​

diabetes)