Nutritional Assessment

WoundSource Editors's picture
Image from the National Cancer Institute

By the WoundSource Editors

A myriad of factors need to be addressed when evaluating a patient with a wound. A thorough patient history, including previous wounds, surgeries, hospitalizations, and past and existing conditions will help guide your clinical assessment, in addition to a number of questions specific to the wound(s) being assessed. Following is a list of general questions to ask when evaluating a wound care patient. (Please note that this list is not comprehensive and is intended only to serve as a guide):

Mary Ellen Posthauer's picture

By Mary Ellen Posthauer RDN, CD, LD, FAND

For the past two years I have been involved in the research and development of the second edition of the Prevention and Treatment of Pressure Ulcers: Clinical Practice Guideline. Members of the Pan Pacific Pressure Injury Alliance joined National Pressure Ulcer Advisory Panel (NPUAP) and European Pressure Ulcer Advisory Panel (EPUAP) in producing a document that could be used by health professionals around the world.

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Janis Harrison's picture

By Janis E. Harrison, RN, BSN, CWOCN, CFCN

Monday came with expectations of fixing the problem. It wasn't to be. Daryl was weak and hated the NG tube in his nose and throat. I arrived early at his bedside and waited for the doctor to let us know what the plan of action would be for the blockage problem. I left to use the public restroom and missed the doctor's visit. No one quite new what the plan was when I questioned the staff. So I created my own plan. I made Daryl get out of bed and started walking him in the halls throughout the entire hospital. I did not want him to get any weaker and I wanted to see if the mobility would increase the gastrointestinal motility. He was not happy with me at first but with education and the explanation of why, he was more than willing to try.

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Janis Harrison's picture

By Janis E. Harrison, RN, BSN, CWOCN, CFCN

My husband Daryl had gone in to a same-day surgery center for incisional hernia repair and possible "tummy tuck" after losing 85 pounds. We had searched for a good surgeon and opinions on any complications that might need to be considered, since Daryl had an ileostomy. We discussed whether or not mesh should be used, infection possibilities, and if he should have the skin tucked that was now loose from weight loss. One surgeon was not sure he wanted to tackle the task and possible complications. Another surgeon just said "sure, I can do that." Well, of course we wanted a competent surgeon; one with confidence and a little arrogance, but then, this was just a "simple" incisional hernia repair, right? WRONG!

Bruce Ruben's picture

By Bruce E. Ruben MD

Today in 2014, there should be no question that tobacco use is one of the worst things you can do to your body. There have been hundreds of scientific studies. This subject is extremely well documented.

Mary Ellen Posthauer's picture

by Mary Ellen Posthauer, RDN, CD, LD, FAND

Several years ago when my nutrition blog began, I discussed the issue of relying on laboratory values – in particular albumin, pre-albumin and transthyretin – as markers of nutritional status. Recently, during a discussion of nutrition and wound care, a dietitian expressed her frustration with a surgeon who kept postponing corrective abdominal surgery until a patient's nutritional status improved, as evidenced by the albumin being in the normal range. However, the patient was receiving adequate calories per enteral feeding and had gained weight. The albumin level was not reflective of the nutritional status. This discussion prompted me to revisit the issue of serum proteins as markers of nutritional status.

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Mary Ellen Posthauer's picture

By Mary Ellen Posthauer, RDN, CD, LD, FAND

As we watched the bright colored ball drop at midnight in Times Square and listened to John Lennon's classic song, "Imagine", we closed out the past year and now reflect on the future. What is your greater vision of how the world could be for our clients in 2014? We are entering into a new era and in some ways uncharted territory for how health care will be delivered in the United States.

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Mary Ellen Posthauer's picture

By Mary Ellen Posthauer, RDN, CD, LD, FAND

The past few months my blog has been devoted to illustrating the value of using an etiology-based approach to diagnosing adult malnutrition in clinical settings. This approach is detailed in The Academy of Nutrition and Dietetics (Academy) and the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.): Characteristics Recommended for the Identification and Documentation of Adult Malnutrition (Undernutrition).

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Mary Ellen Posthauer's picture

By Mary Ellen Posthauer RDN, CD, LD, FAND

In September, the Journal of the Academy of Nutrition and Dietetics, Journal of Parenteral and Enteral Nutrition, and the MEDSURG Nursing Journal simultaneously published the article "Critical role of nutrition in improving quality of care: an interdisciplinary call to action, to address adult hospital malnutrition." The Alliance to Advance Patient Nutrition (Alliance) includes representatives from the Academy of Nutrition and Dietetics, the Academy of Medical-Surgical Nurses, the Society of Hospital Medicine, the American Society of Parenteral and Enteral Nutrition and Abbott Nutrition.

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Mary Ellen Posthauer's picture

By Mary Ellen Posthauer RDN, CD, LD, FAND

In last month's blog, I discussed recent research and publication of the consensus statement of the Academy of Nutrition and Dietetics (Academy) and the American Society for Parenteral and Enteral Nutrition (A.S.P.E.N.): Characteristics Recommended for the Identification and Documentation of Adult Malnutrition (Undernutrition).

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