What Equipment Is Needed to Do a Nutrition-focused Physical Exam?

The minimum equipment needed to do a nutrition-focused physical exam is a method of making sure your hands are “clean” (ideally a sink, water, soap and towels or if hands are clean, sanitizing gel), gloves for the exam, and especially if the exam relates to the mouth, a tongue depressor and/or gauze to be able to move the tongue and examine the oral cavity.

A few more items are recommended to advance and complement your increasing nutrition-focused physical examination skills: a magnifying device, preferably with a light, or a pen light to help with adequate lighting; and alcohol swabs to clean equipment before you start.

Various kinds of magnifying glasses and lighting aids of varying cost are available. Some have additional magnification in a small area of the glass. Some have lighting built in to the magnifying glass and require small batteries. These are what is the best as often you do not have an extra hand to hold a pen light in a “real life” examination.

Also available are lights that mount on the examiner's head and are held in place with an adjustable strap. These are okay, but bulky to be transporting.

The most convenient, in my opinion, is the lighted magnifying glass with increased magnification in one area of the glass. It can easily be held in one hand and the light directed toward the lesion being inspected while the other hand is free to move tissue or direct the patient's movement or to hold clothing out of the way. The increased magnification area can be used to “zero in on” anything unusual for a closer look.

Measuring equipment that may or may not be necessary, depending upon what has already been recorded in the medical record and the focus of the nutritional problem, are:

an accurate scale for measurement of weight,

a blood pressure monitor,

an inser-tape for measuring midarm or wrist circumference,

a see thru skin test ruler useful in measuring size of a lesion,

a tape measure for measuring most anything including heights,

a measuring device with a 90 degree angle for height measure that is placed against the wall and firmly at the top of the head for increased height measurement accuracy, and

a caliper for skinfold measures.

Also needed is equipment to aid you in documentation. A small tape recorder can be invaluable if you do not have a person to record information for you. It is a great tool to speed up the process and help prevent cross contamination. Or, a pen and clip board with a form for recording lesions are needed. You need to be especially careful to prevent cross contamination via equipment and pen by using alcohol swabs or other sanitizer between clients if you are doing the recording yourself at the time of the examination.

I use a lesion definition “cheat sheet” to be sure I am properly identifying unusual lesions. After the examination I use RD recommendation forms for my RD recommendations to obtain physician orders and feedback and to make recommendations to other disciplines.

Equipment nice but not necessary for the nutrition-focused physical exam is a camera with a light ring to take pictures of lesions you encounter. This allows for building your own "library of lesions". A light ring is needed to prevent shadowing in close up pictures.

If you are taking pictures you will need a Consent to Photograph form. I use one to obtain consent to take the lesion pictures and to use them for educational purposes.