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Assessing a Patient's Nutritional & Gastrointestinal Status

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  • 0:04 Assessing the Patient
  • 0:21 The Patients
  • 0:40 Background Information
  • 1:19 Nutritional Assessment
  • 2:54 Physical Exam
  • 4:31 Lesson Summary
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Lesson Transcript
Instructor: Laura Foist

Laura has a Masters of Science in Food Science and Human Nutrition and has taught college Science.

A patient's nutritional and gastrointestinal status are important to determine. In this lesson, we'll learn how to determine the nutritional and gastrointestinal status.

Assessing the Patient

Assessing a patient's nutritional and gastrointestinal status is necessary when patients come in with a stomachache or when a patient may be suffering from malnutrition. There are three parts to the assessment: a patient's background or history, the nutritional assessment, and the physical exam.

The Patients

You have two patients. One patient is a 25-year-old male from a middle class family and has come in complaining of being gassy and having abdominal pain. The other patient is a 3-year-old girl that Child Protective Services brought in after raiding a drug home. You need to determine the gastrointestinal and nutritional status of these patients.

Background Information

First, you need to know about the patient's background. You need a focused gastrointestinal history, including any disorders or illnesses, such as appendicitis. It's important to know what medications the patient is taking because many medications can affect the gastrointestinal health. Lifestyle also needs to be considered, as recreational drugs, smoking, and alcohol can have an impact on your gastrointestinal health. All of this information is part of the gastrointestinal history. With the 25-year-old, you could get a pretty accurate picture of his background simply by asking him to fill out a questionnaire. For the 3-year-old girl, you would need to rely on what Child Protective Services observed.

Nutritional Assessment

The nutritional assessment can be performed through direct or indirect methods. Direct methods include anthropometric measurement, which is a measurement of height and weight compared to a proportion or national average. For example, the average 3-year-old would be about 38 inches tall and weigh 25-39 pounds. Nurses and doctors can do several tests, such as blood tests, for specific nutrients. Your hair, nails, and skin can give an idea of micronutrient status and history.

Clinical assessments are direct methods for looking at specific signs of malnutrition. A clinical assessment can include examining the hair, nails, mouth, skin, thyroid, joints, and bones. For example, if the hair is sparse, thin, or easy to pull out, there may be a protein, zinc, or biotin deficiency present. The thyroid can be examined for iodine deficiencies and joints and bones tell us about vitamin D and vitamin C deficiencies. You would probably use direct methods with the little girl, since you want a good overall picture of her nutritional status.

An indirect method to asses gastrointestinal health is a dietary assessment. There are several ways to perform a dietary assessment. You can give a list of 100 foods and ask how frequently each of these food items are consumed on a daily, weekly, or monthly basis. You can also simply ask the patient exactly what he has consumed in the last week. While these tests rely upon the patient's memory, they can give us a very good idea of the patient's nutritional status. This method will be more applicable for the adult male, because he can accurately describe what he has eaten.

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