Care of Aging Adult II part 2 Flashcards
Biochemical Data with Nutritional Implications:
Transferrin
- Normal = 240 - 480 mg/dL
- decreased = anemia, protein deficiency
- not a reliable indicator of nutritional status (more of an iron issue)
What does it mean if transferrin is decreased?
anemia, protein deficiency
Biochemical Data with Nutritional Implications:
Blood urea nitrogen (BUN)
- Normal = 17 - 18 mg/dL
- increased = starvation, high protein intake, severe dehydration
- decreased = malnutrition, over hydration
What does it mean if BUN is increased or decreased?
- increased = starvation, high protein intake, severe dehydration
- decreased = malnutrition, over hydration
Biochemical Data with Nutritional Implications:
Creatinine
- Normal = 0.4 - 1.5 mg/dL
- increased = dehydration
- decreased = reduction in total muscle mass, severe malnutrition
What does it mean if creatinine is increased or decreased?
- increased = dehydration
- decreased = reduction in total muscle mass, severe malnutrition
Biochemical Data with Nutritional Implications:
Electrolytes
fluid and electrolyte balance
kidney function
Explain the Nestle Mini Nutritional Assessment (MNA).
-used for older adults
-validated screening tool
-normal nutritional
status = 12 -14 points
-8 - 11 at risk
-0 - 7 malnourished
What are some nursing strategies to address age related changes which affect nutritional status?
- Loss of sense of smell and taste: attractive food at proper temp, don’t mix foods, different textures, spices for flavor
- slow intestinal peristalsis: eat a high fiber diet, remain active, increase fluid, no laxatives, eat at regular times, prunes
- Low Income: sales, generic, coupons, cook large amounts, substitutes, community resources
- collaborative: dietary, dentist, SLP, social worker
- assess nutritional intake, review medications, position for safe swallow, dentures, open packages, encourage self feeding, prevent dehydration
What are the manifestations of dysphagia?
-Manifestations: coughing during eating, food dribbling out or pooling in sone side of the mought, food retained in mouth, nasal regurgitation of liquids, changes in voice quality, abnormal gag, delayed swallowing
What are some nursing interventions of dysphagia?
-Nursing interventions: 30 minutes of rest before eating, elevate head of bed 90 degrees, mouth care before meals to enhance taste, no rushed/forced meals, swallowing eval from SLP, nutrition consult for diet mods, no distractions, drink after each bite, inspect oral cavity for retained food, avoid/minimize the use of sedatives and hypnotics; may impair the cough reflex and swallowing
What are the symptoms of aspiration?
sudden coughing, choking, voice changes and/or gurgling after swallowing, frequent throat clearing after meals, regurgitation through the nose/mouth.
What are enteral feedings?
-nutritional formula feedings infused through a tube directly into the GI tract. This can be used for short or long term.
What are the goals/benefits of enteral feeding?
- Goals: absence of nausea/ vomiting, minimal or no gastric residual, absence of abdominal pain and distention, presence of bowel sounds within normal limits, absence of diarrhea/constipation.
- Benefits: provides nutrients alone or supplemental to oral or parenteral nutrition, easily administered, safer than parenteral, less expensive than parenteral.
Nursing considerations for enteral nutrition.
- safety, monitor for complications, comfort and education
- tube placement, tolerating formula, clinical response, lung sounds, hydration status, abdominal assessment, intake of formula, edema, infection control, gastric residual, intake/output, blood glucose level , weight gain/ loss
