Physical indicators of malnutrition include lackluster nails, easy pluckability or sparseness of hair. The skin appears to be a purpuric color, dry, and scaly. Other symptoms include burning and tingling of the hands and feet and mental irritability. Inspection of the oral cavity may reveal cracked and swollen lips, bleeding or swollen gums, missing or loose teeth. Systemic involvement includes hepatomegaly, cardiac enlargement, and tachycardia.
Visceral proteins are indicators of the patient's protein status.
Visceral protein status can be determined by indicators such as serum albumin, transferrin, and prealbumin. These data are usually available in the acute care setting, but may need to be obtained for home care clients. Another more sensitive indicator of visceral protein is serum transferrin. Serum transferrin responds quicker to acute changes in protein status. Transferrin has a half-life of 7 days and is therefore considered the better indicator of visceral protein stores.