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N2270 > 8 - Nutrition, Safe Feeding, and Oral Care > Flashcards

8 - Nutrition, Safe Feeding, and Oral Care Flashcards

1
Q

10 Factors impacting older adult’s nutritional needs

A

1) Age-related changes
2) Lifelong eating habits
3) Ethnicity
4) Socialization
5) Income
6) Transportation
7) Housing
8) Food Knowledge
9) Health
10) Dentition

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2
Q

Lifelong Eating habits

A
  • influenced by tradition, religion, and social influences

Interventions
- promote nutrient rich diet

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3
Q

Income

A
  • adults with low income have to chose bw their basis need (ie. food, heat, shelter)

Interventions
- food stamps
- food banks
- income supplements

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4
Q

Socialization

A
  • older adults often experience social isolation
  • cooking and eating alone can cause them to overindulge or be uninterested in eating

Interventions
- home delivery meals
- shared dining sites/spaces

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5
Q

Transportation and Housing

A
  • functional impairments can restrict their ability to carry groceries
  • available transportation to restaurants and grocery stores is limited

Interventions
- home meal delivery
- group shopping trips
- online grocery shopping

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6
Q

Nutritional Needs

A
  • there should be emphasis on fluid intake bec older adults have decreases thirst sensation
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7
Q

Malnutrition causes:

A

1) Clinical signs - muscle wasting, low body mass index (weight loss)

2) Biochemical changes - decreased albumin

Consequences: infections, pressure ulcers, anemia, hypotension, impaired cognition, and increased mortality and morbidity

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8
Q

Psychosocial Risk Factors of Malnutrition

A
  • Limited income
  • Misuse of alcohol
  • Isolation &loneliness
  • Depression
  • Memory loss
  • Inability topartake in usual cultural patterns
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9
Q

Mechanical Risk Factors of Malnutrition

A
  • Reduced strength/mobility
  • Diminished vision
  • Loss of teeth or chewingdifficulties
  • Shortness ofbreath
  • Polypharmacy
  • Inability togrocery shop or prepare food
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10
Q

Comprehensive assessment of malnutrition includes

A
  • interview
  • diet history
  • physical exam
    -biochemical exam
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11
Q

Assessment for Malnutrition: Interview

A
  • recent life changes
  • current state of health
  • social activities
  • how food is prepared
  • financial resources
  • how food i obstained
    visual difficulties
  • meds
  • mouth pain
  • bowel and bladder function
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12
Q

Assessment for Malnutrition: Diet History

A
  • compare their diet with their age and with the gender specific recommendations from the food guide
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13
Q

Assessment for Malnutrition: Physical Exam

A
  • vital signs
  • functionality
  • general appearance
  • skin turgor, texture, colour
  • heigh, weight, BMI
  • condition of lips, mouth, tongue
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14
Q

Assessment for Malnutrition: Biochemical Exam

A
  • serum albumin (protein)
  • cholesterol
  • serum transferrin (iron transport protein)
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15
Q

Risk factors for inadequate nutrition amongst residents in LTC include:

A
  • social isolation
  • long periods of nothing by mouth
  • resricted diets
  • insufficient support from staff for meals
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15
Q

ImprovingNutritional Intake for Older Adults in Long-term Care

A
  • kitchen on units
  • visually appealing food
  • encourage family presence
  • music
  • food available 24/7
  • high quality protein choices
  • home-like dining rooms
  • choice of mealtime
  • finger foods
  • nurse sitting with person
16
Q

Malnutrition Interventions

A

Pharmacological Therapy
- appetite-stimulating meds

Enteral Feeding
- when all interventions fail, use feeding tube

17
Q

Why does dysphagia?

A

Neurological conditions
- stroke
- parkinsons
- MS
- dementia

18
Q

Symptomsof Dysphagia

A
  • Difficult, laboured swallowing
  • Drooling
  • Copious oral secretions
  • Coughing or choking while eating
  • Holding or pocketing food in the mouth
  • Difficulty moving food or liquid from mouth to throat
  • Difficulty chewing
  • Nasal voice or hoarseness
  • Wet or gurgling voice
  • Excessive throat clearing
  • Sensation of something stuck in the throat during swallowing
  • Reflux of food or liquid into the throat, mouth, or nose
  • Heartburn
  • Chest pain
  • Hiccups
  • Weight loss
  • Frequent respiratory infections, pneumonia
19
Q

Dysphagia Assessment

A

Nurse
- observe during meal time
- contact speech pathologist

Speech Pathologist
- help determine causes of dysphagia
- identify ways to prevent aspiration

20
Q

Dysphagia Complications

A

1) Aspiration
- when oral or gastric contents enter bronchial tree

2) Aspiration Pneumonia
- early symptoms: high resp rate and alterations in mental status
- silent aspiration (under-diagnosed)

21
Q

Preventing Aspiration in Older Adults with Dysphagia

A
  • Rest 30-minutes before feeding; a rested person will likely have less difficulty swallowing
  • maintain position for 1 hour post intake
  • place food on unimpaired side of mouth (ie.s troke)
  • avoid mixed-consistency foods (ie. fruit cups)
  • alternate solids and liquids
  • adjust rate of feeding and size of bites
  • modify food consistency (ie. pureed, thickened)
  • avoid sedatives that impair cough/gag reflex
  • supervise all meals
22
Q

Poor oral health is a risk factor for:

A
  • missing teeth, oral pain
  • chewing and swallowing problems
  • inadequate nutritional intake
  • dehydration
23
Q

There is a relationship between _____ health and ______ health.

A

Oral, general

24
Q

Barriers/Facilitators to Adequate Oral Health

A
  • Functional or cognitive limitations
  • access to dental care
  • cost of dental care
  • access to fluoridated water (ie. wellls)
25
Q

Oral Care for ppl with natural teeth

A
  • brush and floss twice a day
  • using a fluoride and non-alcoholic mouthwash
26
Q

Oral care for supporting ppl with impaired dexterity

A
  • use an ultrasonic toothbrush
  • add foam grip to toothbrush
27
Q

Oral Care and Enteral Feeding

A
  • for ppl with gastrostomy tubes, oral care must be dome every 4 hours
  • brush teeth after each feeding
  • lips are at risk of drying out (coat with balm or vaseline)
28
Q

Reasons for poor oral care in residential settings

A
  • insufficient knowledge about how to asses and provide care
  • inadequate training and staffing
  • lack of appropriate supplies
  • difficult to provide oral care to cognitively impaired adults
29
Q

How to care for dentures

A
  • Rinsed after each meal
  • Brushed thoroughly once a day, ideally at night
  • Not worn at night, to allow relief from compression on the gums
  • Broken, damaged or ill-fitting dentures are a common problem for older adults  can lead to oral problems & poor nutrition
30
Q
A

N2270 (8 decks)

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