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CNSC Modules > Considerations In Nutrition Support Of Older Adult > Flashcards

Considerations In Nutrition Support Of Older Adult Flashcards

1
Q
  1. Which medication class used in older adult population will LEAST likely contribute to anorexia?
A

Antihistamines

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2
Q

Which medication is most likely to contribute to hyponatremia in older adults?

A

Hydrochlothiazide

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3
Q

Which vitamin deficiencies is most likely to occur in an older adult who consumes alcohol on a regular basis?

A

Vitamin B1 (Thiamine)

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4
Q

Pharmacologic agents such as histamine2-receptor antagonist (H2 blockers) and proton-pump inhibitors (PPIs) are a commonly prescribed for a variety of upper GI disorders for the prevention of gastric ulceration. Prolonged use of these medications may contribute to a deficiency of what micronutrient?

A

Vitamin B12

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5
Q

In what situation in older adult populations is toxicity with fat soluble drug most likely?

A

Obesity

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6
Q

What is the most widely used tool to measure generic health related quality of life?

A

SF-36

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7
Q

What is not a common change in the body composition of healthy older adults?

A

Increased body water

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8
Q

Sarcopenia, the loss of lean body mass that occurs with aging, is also associated with?

A

Decreased bone density

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9
Q

What best describes sarcopenia that contributes to a decreasein energy related requirements?

A

Increased fat mass and decreased lean body mass

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10
Q

When using cyclic parenteral nutrition (PN) solutions for non stressed patients, age may be an important factor in monitoring for complications because older adults have?

A

Higher rates of insulin resistance

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11
Q

What is the recommended daily energy intake for patients over 60 who are receiving hemodialysis or peritoneal dialysis?

A

30-35 kcal/kg

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12
Q

A 65 yo female has complications associated with GI surgery, and was admitted to the ICU with pneumonia and septic shock. After she became hemodynamically stable, she was started on parenteral nutrition secondary to prolonged ileus. Prior to surgery, she was at her idea body weight. Currently her labs include albumin 2.0 mg/del and creatine 1.0 mg/del. Her urine output is adequate. What best estimates her protein needs for initiation of PN?

A

1.5 g/kg

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13
Q

In a 100 kg afebrile person with intact skin, insensible fluid loss from lungs and skin is approximately?

A

1000 ml/day

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14
Q

An 87 year old woman underwent a total abdominal colectomy. Her ileostomy output is 1.5-2.0 liters per day. Supplementation of which nitrite the should be considered?

A

Zinc

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15
Q

JD is an 85 year old male whose height is 63” and weight is 45kg. Ten years ago his weight was 55kg. His weight loss has been non-volitional and gradual, and he has no major health problems or changes in oral intake. What most appropriately describes JD’s weight loss?

A

A decrease in lean body mass known as sarcopenia which occurs during the aging process.

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16
Q

What is NOT a component of the Comprehensive Geriatric Assessment tool?

A

Exercise level

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17
Q

The Shirt-Form Mini-Nutritional Assessment (MNA-SF) was derived from the Mini-Nutritional Assessment (MNA) in order to?

A

Obtain high diagnostic accuracy for detecting nutritional problems in older adults.

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18
Q

What is most likely to occur as the result of an age related functional change in the GI tract?

A

Decreased gastric emptying

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19
Q

What is most likely to be observed first, for a patient with no history of diabetes who is overfed?

A

Hyperglycemia

20
Q

Vitamin D (25, hydroxyvitamin D) deficiency is defined as a serum level of less than?

A

20 ng/ml

21
Q

Vitamin D (25, hydroxyvitamin D) deficiency can manifest as?

A

Muscle weakness

22
Q

According to the 2012 National Inpatient Sample (NIS) of hospital discharges, what percentage of older adults greater than 65 years old were diagnosed with malnutrition?

A

30-40%

23
Q

A decreased food intake in older adults is most likely attributed to?

A

Decreased taste and flavor sensations

24
Q

A 68 year old woman with a history of cirrhosis is receiving enteral nutrition due to recent GI surgery. She has worsening hepatic encephalopathy. What should be tried first?

A

Lactose and rifaximin therapy

25
Q

An 80 year old man, living alone, has experienced a 15# unintentional weight loss over the last year and half. The clinician assessing his nutrition status finds that he has inadequate intake. What is LEAST likely to contribute to his weight loss?

A

Food sensitivities

26
Q

An assessment of functional status may aid in determining nutrition risk. What provides an assessment of functional status?

A

Hand grip strength assessment

27
Q

An older adult nursing home resident with a history of constipation has a newly placed PEG tube. Which fiber formulas would most likely be the best choice?

A

Standard 1.0 kcal-ml formula

28
Q

A 75 year old male with a history of aspiration pneumonia who was previously deemed unsafe for an oral diet is now experiencing aspiration while receiving continuous EN via his PEG tube. Which long term feeding option would be the most appropriate?

A

Percutaneous endoscopic jejunostomy (PEJ) tube

29
Q

And 85 year old nursing home resident was transferred to the hospital with anorexia, malnutrition, and probable aspiration pneumonia. Which nutrition intervention would be the most appropriate for this patient?

A

Initiate enteral nutrition and consult for swallow evaluation

30
Q

Which medication is most likely to cause constipaciones in a patient receiving EN?

A

Codeine

31
Q

EN fórmulas supplemented with fiber are often used in older adults to prevent constipation. What consideration is most important if this type of formula is chosen?

A

Provision of adequate water

32
Q

Which complication of EN is the most potentially dangerous in the older adult?

A

Aspiration

33
Q

A patient receiving digoxin and PN who is experiencing signs of digoxin toxicity should be assessed for?

A

Hypokalemia

34
Q

An older adult with poor oral intake over a 2 month period requires specialized nutrition support. Which electrolyte abnormality is associated with aggressive nutrition support?

A

Hypophosphatemia

35
Q

Which vitamin consideration is most important in an older adult receiving a total nutrient admixture (3-in-1) PN as well as anticoagulant ion therapy?

A

Vitamin K

36
Q

What is the hallmark of frailty seen with older adults?

A

Sarcopenia

37
Q

An older adult patient without IV access requires strict bowel rest and PN for 6 weeks. Which vascular access devices should be employed?

A

Peripherally inserted central catheter (PICC)

38
Q

The Plan/Do/Study/Act (PDSA) cycle is employed as a?

A

Quality improvement problem solving model

39
Q

A patient has an advanced directive stating a desire to forego medical technology, including nutrition and hydration, in order to prolong life. The patient is now in a irreversible vegetative state. In deciding whether to continue nutrition and hydration by medical means, the patient’s surrogate decision maker must:

A

Honor the patient’s expressed wish to withdraw nutrition and hydration by medical means.

40
Q

What is not appropriate to tell a family regarding nutrition at the end of life?

A

The experience of eating remains unchanged at the end of life.

41
Q

What represents the core set of clinical and functional status elements which form the foundation of the comprehensive assessment for all residents of long term care facilities certified to participate in Medicare or Medicaid?

A

Minimum data sheet (MDS)

42
Q

A patient in a persistent vegetative state has made their wishes known regarding artificial nutrition and hydration through an advanced directive. The decision to terminate enteral feeding for this patient is based on the ethical principle of:

A

Autonomy

43
Q

What best reflects the use of artificial nutrition and hydration (ANH) in patients with a Do Not Resuscitate (DNR) status?

A

The DNR should not preclude the initiation of ANH if the indication exists

44
Q

What best describes the use of artificial nutrition and hydration in terminally I’ll patient?

A

Those who receive no ANH do not experience more negative side effects than those who do.

45
Q

A patient had an advanced directive stating a desire to forego medical technology, including nutrition and hydration, in order to prolong life. The patient is now in an irreversible vegetative state. In deciding whether to continue nutrition and hydration by medical means, the patient surrogate decision maker must:

A

Honor the patient’s expressed wish to withdraw nutrition and hydration by medical means.

CNSC Modules (8 decks)

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