As you continue your interview, you complete a nutrition-focused physical examination on Mary. Your findings are as follows: Mary is alert but appears pale and tired. Her hair is thin, dry, and easily...

As you continue your interview, you complete a nutrition-focused physical examination on Mary. Your findings are as follows: Mary is alert but appears pale and tired. Her hair is thin, dry, and easily plucked. Her face is notable for dark circles under both eyes, narrow facial appearance, and temporal muscle depression. Her eyes appear normal. Mary’s oral exam is notable for dry oral mucosa and angular stomatitis. She has good dentition with no missing teeth and normal tongue. She has evident clavicular muscle wasting. Her biceps reveal muscle wasting and triceps demonstrate subcutaneous fat loss with loose and slightly hanging arm skin. Rib fat loss is evident. Mary’s skin is dry with poor skin turgor. No wounds are evident. Abdominal exam is unremarkable. No lower extremity or pedal edema is evident. Nails are thin with slow capillary refill. Interosseous muscle is mildly wasted.

1. How would you assess Mary’s nutrition-focused physical exam findings?

2. Can you corroborate your findings with Mary’s anthropometric data and diet history?

3. Based on the nutrition-focused physical exam findings, what specific nutrients are of concern for Mary?

 4. Based on these findings, how would you describe Mary’s nutritional status?