ch 14 - nutrition Flashcards
examples of preventable diet-related chronic diseases
- cardiovascular disease
- T2 diabetes
- obesity
age related changes affecting nutrition: taste (3)
- decreased taste
- decreased saliva production
- dentures, smoking, and meds can affect taste
age related changes affecting nutrition: smell
-decreased smell
age related changes affecting nutrition: digestive system (3)
- decreased gastric motility
- increased stomach acid pH
- increased frequency of GERD
age related changes affecting nutrition: buccal cavity (2)
- dry mouth
- less sturdy teeth
age related changes affecting nutrition: regulation of appetite (2)
- decreased appetite
- may have decreased ability to feed self
age related changes affecting nutrition: body composition (2)
- increase in body fat
- decreased muscle mass
why do older adults generally need to consume less calories (2)
- less activity
- slowed metabolism
dietary recommendations: fat
<10% total calories
limit sat and trans fats
dietary recommendations: protein
increase for older adult when ill
dietary recommendations: fiber
25 g/daily
dietary recommendations: vitamins and minerals
5 servings fruits/veggies
may need B12 supplement
what are some foods that can increase fiber in diet
- beans, peas, lentils
- fruits and veggies with skin
- whole grain breads and cereals
- leafy greens
- pear
- raspberries
- avocado
- almonds
- black beans
- popcorn
- barley
what things are associated with obesity (5)
- increased costs
- functional impairments
- disability
- chronic disease
- admission to nursing home
why are institutionalized older adults at higher risk for malnutrition
- chronic disease
- functional impairments
what are malnourished older adults at higher risk for developing (7)
- infection
- pressure injury
- anemia
- hip fractures
- hypotension
- impaired cognition
- increased morbidity and mortality
how much protein should adults consume daily
0.8 g/kg
what BMI is considered obese
30+
characteristics of malnutrition (2+/6 must be present to be diagnosed)
- insufficient energy intake
- weight loss
- loss of muscle mass
- loss of subq fat
- localized/generalized fluid accumulation that can mask weight loss
- diminished functional status (measured by handgrip strength)
risk factors malnutrition (12)
- chronic diseases
- acute illness/trauma
- polypharmacy
- overrestrictive diets
- poor dentition
- dyshpagia
- poor functional status/inability to prepare food
- depression
- altered mental status/dementia
- social isolation/limited social supports
- lack of transportation to purchase food
- socioeconomic deprivation (poor)
largest national food and nutrition program for older adults
-elderly nutrition program under Title 3 or Older Americans Act (OAA)
what does the OAA provide (3)
- congregate nutrition programs
- meals on wheels
- nutrition screening and education
what older adults are more likely to be food insecure (not sure where next meal will come from) (5)
- live in southern state
- have disability
- younger than 69 yo
- live with grandchild
- african american/hispanic
what program of USDA offers nutrition assistance to eligible, socioeconomically deprived individuals and families
supplemental nutrition assistance program (SNAP)
what organization helps older adult sign up for/utilize SNAP and provides free online service to screen seniors with limited incomes for benefits
national council on aging (NCOA)f
warning signs suggesting possible GERD complication (6) pts should see hcp if they have these symptoms
- anemia
- anorexia
- dysphagia
- hematemesis
- odynophagia (painful swallowing)
- weight loss
risk factors for diverticular disease (6)
- family h/o
- personal h/o gallbladder disease
- low diet intake of fiber
- use of meds that slow fecal transit time
- chronic constipation
- obesity
risk factors for GERD (4)
- obesity
- pregnancy
- hiatal hernia
- cigarette smoking
S+S GERD in older adults (8)
- heartburn
- regurgitation
- persistent cough
- exacerbations asthma
- laryngitis
- intermittent chest pain
- abdominal pain 1 hour after eating
- symptoms worse when laying down
possible complications resulting from GERD (6)
- esophagitis
- peptic ulcers
- esophageal ulcers
- barrett’s esophagus
- pneumonia
- dental caries
Tx GERD (9)
- smaller meals
- stop eating 3-4 hrs before bed
- avoid high fat foods, alcohol, caffeine, and nicotine
- elevate hob for sleeping
- weight reduction
- stop smoking
- antacids
- H2 blockers
- PPIs
S+S diverticular disease (4)
(S+S may be delayed/absent in older adults)
- LLQ pain
- fever
- elevated WBC
- rectal bleeding
complications of diverticular disease (4)
- rupture (+peritonitis)
- abscess
- stricture
- fistula
S+S complications of diverticular disease in older adult
- unexplained lethargy/confusion
- possibly elevated HR
- possibly hypotensive
Tx diverticular disease (prevention and acute care)
PREVENTION:
- high fiber diet (25-30 g/day)
- weight loss
ACUTE:
- pain relief
- clear liquid diet
- antibiotics
risk factors for dysphagia (9)
- CVA
- parkinsons
- neuromuscular disorders (ALS, MS..)
- dementia
- head and neck cancer
- TBI
- aspiration pneumonia
- inadequate feeding technique
- poor dentition
S+S dysphagia/possible aspiration
- difficult labored swallowing
- drooling
- copious oral secretions
- coughing/choking
- holding/pocketing foods/meds in mouth
- hoarseness
- excessive throat clearing
- unusual head/neck posturing during swallowing
- heartburn
- chest pain
- hiccups
- weight loss
- frequent resp tract infections/pneumonia
tips for preventing aspiration in dysphagic pts (9)
- 30 min rest period before eating
- sit at 90 degrees during eating and 1 hr after
- swallow twice
- place food on nonimpaired side of mouth
- check for pocketing
- have suction available
- mouth care q4h and before/after meals
- chin tucks/head turns during swallowing
- modification of bolus volume, temp, consistency, and rate of feeding
what score on nutritional screening initiative indicates good nutrition? moderate risk? high nutritional risk?
0-2: good nutrition
3-5: moderate risk
6+: high risk
what % loss of body weight within 6-12 months is considered clinically important weight loss in older adults
5%
what % loss of body weight in 1 month, 3 months, and 3 months is considered significant indicator of poor nutrition in long term care facilities
1 month: 5%
3 months: 7.5%
6 months: 10%
what BMI in older adults is considered underweight
<23
nutrition assessment tools (3)
- nutritional screening initiative
- mini nutritional assessment
- minimum data set 3.0
interventions for enhancing food intake in long term care facilities (5)
- restorative dining rooms
- consideration of ethnic food choices
- easy access to refreshment stations
- family involvement when possible
- caloric supplements
what does nutritional assessment include (6)
- interview
- h&p
- anthropometric data
- labs
- food/nutrient intake
- functional assessment
