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    If Yes To Any Question, Go To STEP 2: Table 2

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    Chelo Jan Geronimo
    This document contains two nutritional screening tools: 1) A 2-step initial screening that identifies patients at nutritional risk based on factors like BMI, weight loss, dietary intake, and illness severity. 2) A more comprehensive subjective global assessment of a patient named Herman Cramer that evaluates criteria like weight loss, food intake, functional status, disease stress, physical exam findings, lab results, and nutritional status to determine his nutritional risk level. 3) Herman was found to have a high nutritional risk level of 3, requiring follow-up from the nutritional support team.

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    If Yes To Any Question, Go To STEP 2: Table 2

    Uploaded by

    Chelo Jan Geronimo
    41 views2 pages
    This document contains two nutritional screening tools: 1) A 2-step initial screening that identifies patients at nutritional risk based on factors like BMI, weight loss, dietary intake, and illness severity. 2) A more comprehensive subjective global assessment of a patient named Herman Cramer that evaluates criteria like weight loss, food intake, functional status, disease stress, physical exam findings, lab results, and nutritional status to determine his nutritional risk level. 3) Herman was found to have a high nutritional risk level of 3, requiring follow-up from the nutritional support team.

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    NRS & SGA Chelo

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    This document contains two nutritional screening tools: 1) A 2-step initial screening that identifies patients at nutritional risk based on factors like BMI, weight loss, dietary intake, and illness severity. 2) A more comprehensive subjective global assessment of a patient named Herman Cramer that evaluates criteria like weight loss, food intake, functional status, disease stress, physical exam findings, lab results, and nutritional status to determine his nutritional risk level. 3) Herman was found to have a high nutritional risk level of 3, requiring follow-up from the nutritional support team.

    Copyright:

    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    41 views2 pages

    If Yes To Any Question, Go To STEP 2: Table 2

    Uploaded by

    Chelo Jan Geronimo
    This document contains two nutritional screening tools: 1) A 2-step initial screening that identifies patients at nutritional risk based on factors like BMI, weight loss, dietary intake, and illness severity. 2) A more comprehensive subjective global assessment of a patient named Herman Cramer that evaluates criteria like weight loss, food intake, functional status, disease stress, physical exam findings, lab results, and nutritional status to determine his nutritional risk level. 3) Herman was found to have a high nutritional risk level of 3, requiring follow-up from the nutritional support team.

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    of 2

    Nutritional Risk Screening 2002

    Table 2

    Step-1 Initial Screening


    Question Yes No
    Is BMI < 20.5? ✓
    Has the patient lost weight within the last three months? ✓
    Did the patient have a reduced dietary intake in the last ✓
    week?
    Is the patient severely ill (e.g intensive theraphy)? ✓
    __ Current Status: No Nutritional risk
    If yes to any question, go to STEP 2

    STEP 2-Final Screening

    Nutritional Status Indicators (choose one only) Score Place score


    if YES
    Normal Nutritional Status 0 0
    Weight loss >5% in 3 months/ or food intakes below 50-75% 0 1
    of normal requirement in preceding week
    Weight loss > 5% in 2 months / or BMI 18.5-20.5 + impaired 2 0
    general condition / or food intake 25-60% or normal
    requirement in preceding week
    Weight loss > 5% in one month (or > 15% in 3 months) / or 3 0
    BMI < 18.5 + impaired general condition / or food intake 0-
    25% of normal in preceding week
    Clinical condition (may choose than one)
    Hip fracture chronic patients, in particular with acute 1 1
    complications; cirrhosis, COPD, chronic hemodialysis,
    diabetes, oncology
    Major abdominal surgery, stroke, severe pneumonia, 2 2
    hematologic malignancy
    Head injury, bone marror transplantation, intensive care 3 3
    patients (APACHE >10)
    TOTAL SCORE 6
    ACTION TO BE TAKEN
    Total Score ≥ 3: The patient is nutritionally at risk and nutritional care plan is initiated
    □ Total score <3: Weekly rescreening of the patient/ if the patient is scheduled for major
    operation a preventive care plan is considered to avoid aasociated risk status
    SUBJECTIVE GLOBAL ASSESSMENT
    Table 3 Assessment nutritional status of Patient Herman
    Name: Herman Room: 312
    Surname: Cramer Date Admitted: October 23, 2019
    Middle: Rivera Age: 65 y/o
    Attending MD: Dr. Santos Sex: Male

    HT MTR: 5’5 WT KG: 47kg BMI: 17.2kg/ OB UW IBW 59kg

    Diagnosis: PTB ST4, Asthma, Secondary Bronchitis, Anemia

    CRITERIA NORMAL/MILD MODERATE SEVERE


    Weight loss None 10% of usual weight >10 of usual weight
    Food intake (last 1- No change Suboptimal Starvation
    2months)
    Gastro Symptoms None Nausea, Vomiting Anorexia, diarrhea
    >2 weeks
    Functional capacity No change Dysfunction: < 3wks Bedridden > 2wks
    Bedridden <2 wks
    Disease and relation No or low stress Moderate Stress
    Severe Stress
    to nutritional req.
    Physical Subcutaneous fat and /or Subcutaneous fat and Subcutaneous fat and /or
    Examination muscle loss 0 /or muscle loss +1 or +2 muscle loss
    Edema/Ascites None None +1 or +2
    SGA Grade 0 B1 C3
    BMI 18.5-25.0 25.1-30.1 <18.5 or > 30.2
    Albumin g/dL >3.4 2.5-3.41 <2.52
    TLC >15000 900-1500 <9002
    Total Score NUTRITION 0 Low risk 1-2 Moderate Risk (level >3 High Risk(level 3)
    RISK (level 1) 2)
    LEVEL
    Nutritional Status Normal Moderate Malnutrition Severe Malnutrition
    Risk level 1 or 2, would you like to refer your patient to the nut. support team for follow up?
    Yes
    No
    Risk level 3: Req. to be followed up by the Nut. Support Team

    Dr. Santos Name of Attending MD


    October 23, 2019 Date Signed

    Assessment performed by(Name & Signature): Chelo Jan Geronimo

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