Chap 14 Nutrition and Fluid Balance Flashcards
Illnesses that affect eating and swallowing - 5
stroke cancer of head, neck, mouth Parkinson's Multiple sclerosis Alzheimer's
Nutrients - 6
Carbohydrate Protein Fat Water Vitamin Mineral
MyPlate sections - 5
Fruits, Vegetables (1/2)
Grains
Protein
Dairy
Thickening - why, who decides, levels - 4
Some people choke on thin liquids
Doctor’s order after SLP assessment
Regular, Nectar, Honey, Pudding
Unintended weight loss direct signs - 8
Needs help eating or drinking Eats less than 70% of meals/snacks Mouth pain Dentures not fitting properly Difficulty chewing or swallowing Coughs or chokes while eating Sad, cries, withdraws from others Confused, wanders, or paces
Preventing weight loss - 9
Report observations and warning signs to nurse
Report decrease in appetite
Encourage eating with positive speaking
Check diet card and meal tray
Respond promptly to resident complaints about food
Season to resident preferences
Use special adaptive equipment as needed
Record intake as ordered
Ask for dietician, OT, or SLP consult as needed
Serve meal trays and assist with eating - 6
Wash hands
Check diet card, special instructions
Serve all residents at one table before moving on
If resident needs help eating, serve others first
Only do what resident cannot do for themselves
Open milk and juice cartons if needed
Helping resident at meal time - 9
Offer clothing protector Do not judge food choices Follow infection prevention precautions Sit at eye level Identify foods in front of resident Ask what resident wants to eat first Do not mix foods unless requested Check for temp of food without touching Alternate between food and drink
Help resident eat special needs - 4
Use assistive devices
Use physical and verbal cues
Put food into stronger/unaffected side
For visually impaired, read menu to them, imaginary clock
Observe/report dysphagia - 15
Eats very slowly, Avoids eating Spitting out pieces of food Difficulty chewing food, Difficulty swallowing small bites, pills Swallowing several times on one bite Dribbling saliva or food from mouth Keeping food inside mouth Vomiting while eating/drinking Frequent throat clearing Food or fluid coming up into nose Coughing during or after meals Choking during meals or while drinking Gurgling sound during or after meal Problems breathing when eating or drinking Visible effort to swallow Watering eyes when eating or drinking
Preventing aspiration - 10
Proper position, upright
Feed slowly
Avoid distractions
Offer small pieces or 1/2 spoonfuls
Offer bite of food, then liquid
Place food in strong side of mouth
Make sure food is swallowed before giving more
Keep resident upright for 30 minutes after meal
Provide quality oral care after feeding
Closely observe residents that choke easily
Observe and report dehydration - 9
Resident drinks less than 6 glasses per day Drinks little or no fluids at meals Needs help drinking from cup or glass Has trouble swallowing liquids Frequent vomiting, diarrhea, fever Easily confused or tired Resident is thirsty Dry mouth Decrease in urinary output
Also report dehydration signs - 15
Severe thirst Dry mouth and mucous membranes cracked lips Dry, warm, wrinkled, or clammy skin Sunken eyes Flushed face Dark urine Strong smelling urine Constipation or weight loss Weakness, dizziness, lightheadedness, confusion Headache Irritability Rapid or weak pulse Irregular heartbeat Low BP
Preventing dehydration - 8
Observe carefully, report
Encourage to drink fluids every time you see them
Offer fluids that residents prefer
Make sure water pitcher, cup are close at hand
Offer assistance
Offer ice chips
Keep accurate I&O records
Follow posted schedules for offering fluids
Observe and report fluid overload - 9
Weight gain Fatigue Difficulty breathing, shortness of breath Swelling of ankles, feet, fingers, hands Coughing Decreased urine output Increased heart rate Skin that appears tight, smooth, shiny Swollen abdomen due to excess fluid, ascites
