CH 11: Nutrition and Hydration Flashcards
nutrition influences the body’s:
Ability to defend body against disease
Maintain anatomic and structural normality
Think clearly
Absorb and use energy
QUANTITY of caloric needs decrease due to…
Older body has less lean body mass with more adipose tissue (doesn’t burn calories quickly)
Metabolic rate declines
Potential low activity level
as we age, quality and quantity of nutrition must be:
continuously monitored
need a higher quality of caloric intake
fiber requirements
Soluble (oats and pectin): lowers cholesterol, improves glucose tolerance and prevents obesity, CV disease, and colorectal cancer
Insoluble (grains, veggies, fruits): improve bowel activity
carb requirements
Good for energy and fiber
Needs to be reduced (high intake of carbs stimulate a high release of insulin hypoglycemia)
protein use
Helps maintain enzyme systems and renew body protein
calcium requirements
Maintains musculoskeletal system and blood clotting
Take no more than 500 mg at a time (large amounts don’t absorb well)
Good intake with Vitamin D and magnesium
modified MyPlate requirements for older adults
Five servings of fruits and veggies in a variety of ways
Limit foods in trans and saturated fats, salt, and added sugars
Whole grains with vitamins and minerals
MyPlate for older adults: nutritional supplements
Common nutrient deficiencies
Excess intake of vitamins and minerals
Drug Interactions
special nutrition needs for women
Low-fat intake
Reducing/avoiding alcohol intake
Increased daily calcium intake
Other non-nutritional needs
nutrition related conditions
osteoporosis
cancer
heart disease
factors effecting nutritional status
Tooth erosion with tooth loss
Decreased saliva production
Increased taste threshold
Decreased thirst sensations and hunger contractions
Weaker gag reflex
Decreased peristalsis
Less HCl, pepsin, and pancreatic acid production
Less efficient cholesterol stabilization
Increased fat content
Decreased pancreatic enzymes
hydration in older adults
Intracellular fluid is lost decreased total body fluids
Fluid loss + decreased fluid intake = life-threatening dehydration
Older adults more sensitive to overhydration from decreased cardiac and renal function
Age-related decline in body fluids reduces the margin of safety due to insufficient fluid consumption or extra fluid that is lost!
Monitor fluid intake and output
s/s of dehydration in older adults
dry inelastic skin
dry-brown tongue
sunken cheeks
concentrated urine
BUN >60
confusion
age related factors for dehydration
Age-related reductions in thirst sensation
Fear of incontinence
Lack of accessible fluids
Fluid restrictions based on medical history
Inability to obtain or drink fluids independently
Lack of motivation
Altered mood or cognition
Nausea, vomiting, and GI disorders/distress
oral health for odler adults
Dental care in early years affects later years
Poor dental care + environmental influences + inappropriate nutrition + changes in gingival tissue = tooth loss
s/s of periodontal disease
bleeding gums
red/swollen/painful gums
pus at gums
chronic bad breath
loosening of teeth from gums
interventions and education for oral health
Use a toothbrush, not swab
Aging does NOT equal tooth loss
Explore the reasons why the client has not seen a dentist (if applicable)
Diluting commercial mouthwash with water
Extract loose teeth
Daily flossing
Denture care, regular wear of dentures, do not wear poorly fitted dentures
Good regular dental care at ALL ages
Common due to decreased stomach motility, less gastric secretion, and decreased gastric emptying time
Older adults may decrease food intake or use antacids _ could cause more issues
indigestion and food tolerance
interventions for indigestion and food intolerance
6 Small meals
Eliminate specific foods
Sitting up 30 min after meals
Adequate fluid intake and activity
Due to neuro conditions and GERD
dysphagia
contributing factors for dysphagia
onset
types of foods
consistent or periodic occurrences
symptoms of complications
interventions for dysphagia
Speech pathologist
Aspiration precautions
Tilt head and place food on a particular part of the tongue
reasons for anorexia
medication side effects
inactivity
physical illness
age-related changes
mood
interventions for anorexia
Identify cause
High-calorie diet
Tube feeding vs. Hyperalimentation
Psych referral and therapy
Meds for appetite stimulant
Monitoring intake, output, and weight
reasons for constipation
decreased peristalsis
inactivity
medication side effects
decreased fiber and fluid
interventions for constipation
Diet (fluids and fiber; bananas, prunes, carrots, oatmeal)
Activity
Meds (only after other measures are unsuccessful; senna most common)
Toilet schedule
causes of malnutrition
From age-related changes
meds
socioeconomics
eating patterns
s/s of malnutrition in older adults
Weight loss >5% in month; >10% in 6 months
Weight 10% below or 20% above ideal
Serum albumin <3.5
H/H < 12/35
Delirium, lethargy, fatigue
Depression
Visual disturbances
Dermatitis and hair loss
Pallor
Delayed wound healing
interventions for malnutrition
Services (Meals on Wheels, SNAP, home health aides, counseling, meal prep and shopping services)
Encourage friends and family to bring treats
Multidisciplinary collaboration
Nutritional assessment
Consider ethnic, social, and religious factors
Respect dietary restrictions and tolerances
