Submodule
From Screening to Assessment
Screening identifies who may be at risk. Assessment determines what is happening, why it is happening, and what should happen next.
- Validated screening tools
- Risk versus diagnosis
- Referral and escalation
- Repeat screening after clinical change
Use the right tool for the right decision
Nutrition screening is intentionally brief. Tools such as MST, MUST, MNA-SF, and NRS-2002 use different populations and inputs, so the tool should match the care setting and local workflow. The result answers a narrow question: does this person need a more complete nutrition assessment?
Build a closed loop
A useful workflow links a positive screen to timely assessment, a documented plan, and reassessment. Risk changes with acute illness, procedures, poor intake, gastrointestinal losses, functional decline, and prolonged hospitalization.
Quick check
Submodule
History, Intake, and Disease Burden
Nutrition status is a trajectory. The history explains the direction and speed of change better than a single measurement.
- Usual and recent intake
- Unintentional weight change
- Symptoms and assimilation
- Inflammation and disease burden
Quantify the trajectory
Record usual weight, current measured weight, the time interval, whether the change was intentional, and whether fluid shifts could distort the result. Estimate the proportion of usual intake being consumed and the duration of the reduction.
Identify the mechanism
Reduced intake can reflect nausea, pain, dysphagia, altered taste, depression, food insecurity, medication effects, or treatment schedules. Reduced assimilation can reflect maldigestion, malabsorption, fistulae, vomiting, diarrhea, or altered anatomy. Disease burden can add inflammatory and catabolic stress.
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Submodule
Anthropometrics and Body Composition
Weight and BMI are useful when their limitations are visible. Muscle and fat loss may be clinically important even when body weight appears ordinary.
- Measured height and weight
- BMI and weight change
- Fluid confounding
- Muscle mass and body composition
Calculate before classifying
Percent weight loss equals usual weight minus current weight, divided by usual weight, multiplied by 100. BMI equals weight in kilograms divided by height in meters squared. Neither value should be interpreted without the clinical timeline and measurement conditions.
Recognize hidden depletion
Edema and ascites can mask tissue loss. A person with a high BMI can still have low muscle mass and clinically important malnutrition. Repeated measurements obtained under similar conditions are more informative than isolated values.
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Submodule
Physical and Functional Assessment
The bedside examination turns suspected tissue loss into observable evidence and helps distinguish fat, muscle, fluid, and function.
- Subcutaneous fat stores
- Muscle groups
- Edema and ascites
- Functional change
Inspect specific tissue compartments
Nutrition focused examination evaluates fat stores, muscle groups, fluid accumulation, oral and skin findings, and functional clues. Findings should be interpreted with the history because immobility, denervation, aging, trauma, and organ disease can alter muscle independently of intake.
Treat function as context
A decline in grip, mobility, transfers, or usual activity can support the assessment, but function is affected by pain, cognition, neurologic disease, sedation, and acute illness. It should not be treated as a nutrition specific measurement in isolation.
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Submodule
Diagnostic Frameworks
Diagnostic frameworks organize evidence. They do not replace clinical judgment, and their criteria should not be mixed casually.
- GLIM phenotypic criteria
- GLIM etiologic criteria
- Academy and ASPEN characteristics
- Severity and etiology
Apply GLIM in two steps
After risk screening, GLIM diagnosis requires at least one phenotypic criterion and at least one etiologic criterion. Phenotypic criteria are weight loss, low BMI, and reduced muscle mass. Etiologic criteria are reduced intake or assimilation and inflammation or disease burden.
Apply Academy and ASPEN characteristics
The Academy and ASPEN adult framework evaluates insufficient energy intake, weight loss, loss of muscle mass, loss of subcutaneous fat, fluid accumulation, and diminished functional status measured by handgrip strength. At least two characteristics support diagnosis, interpreted within the relevant acute illness, chronic illness, or social and environmental context.
Do not diagnose from albumin
Albumin and prealbumin are influenced strongly by inflammation, capillary permeability, fluid status, organ function, and other factors. ASPEN does not recommend using them as proxy measures of total body protein or muscle mass, or as stand alone nutrition markers.
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Submodule
Plan, Monitor, and Communicate
The assessment matters only when it changes care. A complete plan states the problem, intervention, surveillance, and decision points.
- Problem prioritization
- Interdisciplinary intervention
- Medication review
- Outcome and safety monitoring
Connect cause to intervention
Address reversible barriers such as nausea, constipation, dysphagia, pain, food access, medication timing, and overly restrictive diets. Coordinate with dietitians, nurses, prescribers, speech language pathology, social work, and the patient according to the problem identified.
Monitor both benefit and harm
Follow intake, weight trajectory, volume status, symptoms, physical findings, function, and relevant laboratory data. A high risk patient who begins aggressive nutrition support may also require focused surveillance for electrolyte shifts, glycemic complications, fluid intolerance, and refeeding risk.
Quick check
Module test
Check the connections.
Each attempt draws 10 questions from the complete 100 question bank.
Each attempt draws a fresh set and rearranges the answer choices.
References
Current clinical foundation.
Lecture material was synthesized with the following contemporary guidance. Verify local policy and current guidance before applying clinical information.