Case Study: The Application of the Nutrition Focused Physical Examination (NFPE) in the Outpatient Diet Clinic

Charmaine Lavinia1, Nadine Alvina Kong Xiao Feng1
1. IMU

Assessment: A 44 year old Indian female with Systemic Lupus Erymathous (SLE), Esophageal Stricture and Hypothyroidism has been seen by the dietitian in the outpatient multiple times for severe GI losses as a complication of the disease and its treatment. She is able to feed herself orally, although minimal and has refused the insertion of a PEG.Her weight fluctuates between 40-45kg. Currently, she has lost approximately 4 kg in total over one year. She has frequent vomiting and passes melenic stools. The NFPE stepwise guide for muscle, fat and intra-oral assesments were conducted. The results were poor muscle stores, xerostomia, edentulism and bleeding gums. She complained of swallowing difficulty. Her current dietary intake mainly consisted of liquids (fruit juices, oral nutritional supplement) and minimal solid food. Frequent meal intake and each meal time is up to 2 hours. Overall, she has poor nutritional status. Current medication is prednisolone.