USMLE Step 2 CK Question Bank

A 48-year-old woman is evaluated during routine multidisciplinary rounds in the intensive care unit on hospital day 6 after admission for septic shock due to perforated diverticulitis. She underwent emergent sigmoid colectomy with end colostomy and required vasopressors for 24 hours; she is now hemodynamically stable and extubated. Enteral feeding was delayed because of high vasopressor requirements early in her course. She has a history of type 2 diabetes mellitus and hypertension. On review of the admission history obtained from her spouse, she had poor appetite for several months due to abdominal discomfort and unintentionally lost 8 kg over the past 4 months from a baseline weight of 68 kg. She is 165 cm (5 ft 5 in) tall. Temperature is 37.1 C (98.8 F), blood pressure is 118/72 mm Hg, pulse is 92/min, and respiratory rate is 18/min. Examination shows temporal wasting, reduced handgrip strength during physical therapy assessment, and bilateral pitting edema at the ankles. The team wants to determine the most appropriate bedside approach to identify and stratify her current nutrition risk during hospitalization.

Which of the following is the most appropriate tool to use now?