• Hair that is dull,brittle, or dry, or falls out easily
• Swollen glands of the neck and cheeks
• Dry,rough, or spotty skin that may have a sandpaper feel
• Poor or delayed wound healing or sores
• Thin appearance with lack of subcutaneous fat
• Muscle wasting (decreased size and strength)
• Edema of the lower extremities
• Weakened hand grasp
• Depressed mood
• Abnormal heart rate, heart rhythm, or blood pressure
• Enlarged liver or spleen
• Loss of balance and coordination
differences. Lastly, physical findings occur only with overt malnutrition, not subclinical
malnutrition.
A multivitamin, multimineral supplement that provides 100% or less of the daily value offers some protection against less than optimal food choices. Folic acid in supplements or fortified food is recommended for women of childbearing age;
people older than 50 years are encouraged to obtain vitamin 812 from fortified foods or supplements. However,potential problems may arise from other types or amounts
of supplements.For instance, large doses of vitamins A, 86, and D have the potential to cause toxicity symptoms. Iron supplements may decrease zinc absorption and negatively impact zinc status over time.
What concerns do you have about what or how you eat?This question places the
responsibility of healthy eating with the client, where it should be. A client who may benefit from nutrition intervention and counseling in theory may not be a candidate for such in practice depending on his or her level of interest and motivation. This question may also shed light on whether or not the client understands what he or she should be eating and whether the client is willing to make changes in eating habits.
For clients who are acutely ill: How has illness affected your choice or tolerance of food? Sometimes, food aversions or intolerances can shed light on what is going on with the client. For instance, someone who experiences abdominal pain that is relieved by eating may have a duodenal ulcer. Clients with little or no intake of food or liquids are at risk for dehydration and nutrient deficiencies.
Who prepares the meals?This person may need nutritional counseling.
Do you have enough food to eat? Be aware that pride and an unwillingness to admit inabil ity to afford an adequate diet may prevent some clients and families from answering this question. For hospitalized clients,it may be more useful to ask the client to compare the size of the meals they are served inthe hospital with the size of meals they normally eat.
How much alcohol do you consume daily? Risk begins at more than one drink daily for women and more than two drinks daily for men.