a. Typical daily food intake? (Describe.) Supplements (vitamins,
type of snacks)?
b. Typical daily fluid intake? (Describe.)
c. Weight loss or gain? (Amount.) Height loss or gain?
e. Food or eating: Discomfort? Swallowing? Diet
f. Heal well or poorly?
g. Skin problems: Lesions? Dryness?
h. Dental problems?
a. Skin: Bony prominences? Lesions? Color changes?
b. Oral mucous membranes: Color? Moistness? Lesions?
c. Teeth: General appearance and alignment? Dentures?
Cavities? Missing teeth?
d. Actual weight, height.
f. Intravenous feeding–parenteral feeding (specify)?
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