Symptom: Weight loss

Initial Grading Reminder

CTCAE grading of weight loss:

Grade 1: 5 to <10% from baseline; intervention not indicated
Grade 2: 10 – <20% from baseline; nutritional support indicated
Grade 3: ≥20% from baseline; tube feeding or TPN indicated

Assessment and Grading

Characterize the symptom (onset, pace)

Ask the patient:

Have you had issues with weight loss in the past? Is this a new or worsening symptom? When did it start or get worse? Has it developed gradually or suddenly?

Grade the symptom

Ask the patient:

How has your weight changed from baseline? Are you still able to eat your normal foods? Are you using any nutritional supplements like Boost®?

Are you very weak or faint?

Patient Query Regarding Other Symptoms/Red Flags

Ask the patient:

Are you feeling faint/dizzy, passing out, having trouble thinking? Are you in intense pain. Do you have abdominal (belly) pain? Are you sleepy? Is your skin turning yellow?

Patient Factors to Consider That Affect the Approach to Intervention

Consider the following in individualizing the intervention: Is the patient a good or poor historian? Any language barriers or cognitive deficits? Is the patient reliable (able to carry out treatment recommendations)? Does this patient have alcohol/substance abuse issues? Does the patient have transportation? Is there sufficient caregiver support?

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    Suggested Intervention

    Patients with new onset moderate or worse (or worsening) weight loss should be seen.

    Patients with any of the red-flag symptoms should be seen immediately

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    Nursing Assessment of Potential Causes

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    Differential Diagnosis

    What do you suspect is the cause of the weight loss?