Digestion and Nutrition Flashcards
Exam 3
1
Q
Nutritional Health:
What does a diet help with?
A
The quality and quantity of a diet will help prevent, delay the onset of, and manage chronic disease processes.
2
Q
Nutritional Health:
What does proper nutrition help with?
A
Proper nutrition helps maintain optimal health and wellness.
3
Q
Age-Related Changes That Affect Digestion and Eating Patterns:
include:
A
Diminished senses of smell (Hyposmia/Anosmia) and taste (Dysgeusia)
Oral cavity and swallowing
Esophagus and stomach
Intestinal tract
Liver, pancreas, and gallbladder
4
Q
Age-Related Changes That Affect Digestion and Eating Patterns:
Diminished senses of smell- What is this called?
A
Diminished senses of smell (Hyposmia/Anosmia)
5
Q
Anosmia:
A
The complete inability to detect odors
6
Q
Hyposmia:
A
A reduced ability to detect odors
7
Q
Dysgeusia
A
a condition in which a foul, salty, rancid, or metallic taste sensation persists in the mouth.
8
Q
Age-Related Changes ThatAffect Digestion and Eating Patterns:
Diminished senses of smell (Hyposmia/Anosmia) and taste (Dysgeusia): What does this affect?
A
Affect food enjoyment
Affected by medications and medical conditions
9
Q
Age-Related Changes ThatAffect Digestion and Eating Patterns:
Oral cavity and swallowing: When does digestion begin?
A
Digestion begins when food enters the mouth
10
Q
Age-Related Changes ThatAffect Digestion and Eating Patterns:
Oral cavity and swallowing: Issues include?
A
Edentulous( toothless)
Dentures: expensive, not covered by medicare, tend to get lost, need to be resized with a gain/loss of 10lb
Teeth brushing loss of manual dexterity with age
Gum recession
11
Q
Age-Related Changes ThatAffect Digestion and Eating Patterns:
Oral cavity and swallowing:
Edentulous- What is it?
A
( toothless)
12
Q
Age-Related Changes ThatAffect Digestion and Eating Patterns:
Oral cavity and swallowing:
Dentures- What is the problem with it?
A
Dentures: expensive, not covered by medicare, tend to get lost, need to be resized with a gain/loss of 10lb
13
Q
Age-Related Changes ThatAffect Digestion and Eating Patterns:
Oral cavity and swallowing:
Teeth brushing- What is the problem with it?
A
Teeth brushing loss of manual dexterity with age
14
Q
Age-Related Changes ThatAffect Digestion and Eating Patterns:
Oral cavity and swallowing:
Gum recession: What plays an important role?
A
Saliva and oral mucosa play important roles
15
Q
Age-Related Changes ThatAffect Digestion and Eating Patterns:
Oral cavity and swallowing:
Gum recession: What happens with saliva?
A
decreased saliva production
16
Q
Age-Related Changes ThatAffect Digestion and Eating Patterns:
Oral cavity and swallowing:
Gum recession: Dry Mouth- What is the term and what occurs?
A
Dry Mouth (Xerostomia)–(Decreased salvation and uncomfortable dry mouth)
17
Q
Age-Related Changes ThatAffect Digestion and Eating Patterns:
Oral cavity and swallowing:
Gum recession: What has a small effect on mastication and swallowing?
A
Diminished muscle strength has small effect on mastication and swallowing
18
Q
Age-Related Changes ThatAffect Digestion and Eating Patterns:
Oral cavity and swallowing:
What musts nurses provide?
A
Nursing: Adequate oral care –multiple times a day –
19
Q
Age-Related Changes ThatAffect Digestion and Eating Patterns:
Oral cavity and swallowing:
Why is adequate oral care important?
A
Adequate oral care is important in the promotion of adequate food intake because it enhances chewing, eating, and swallowing.
20
Q
Age-Related Changes That Affect Digestion and Eating Patterns #2
Esophagus and stomach: What phase of digestion is this? What does this do?
A
Second phase of digestion—propels food
21
Q
Age-Related Changes That Affect Digestion and Eating Patterns #2
Esophagus and stomach: What issues can occur with age?
A
Presbyphagia
Slower emptying of the stomach
22
Q
Age-Related Changes That Affect Digestion and Eating Patterns #2
Esophagus and stomach:
Presbyphagia—What is it?
A
Presbyphagia—age related changes that lead to slowed swallowing mechanism
23
Q
Age-Related Changes That Affect Digestion and Eating Patterns #2
Esophagus and stomach:
What is there an increased risk for?
A
increase the risk of aspiration. Nursing: auscultate the lungs for wet lung sounds, other assessment findings would include drooling, pocketing of food in the mouth, and a wet, gurgle cough, and changes to the voice, such as hoarseness.
24
Q
Age-Related Changes That Affect Digestion and Eating Patterns #2
Esophagus and stomach:
Increase the risk of aspiration: What should nurses do?
A
Nursing: auscultate the lungs for wet lung sounds,
25
Age-Related Changes That Affect Digestion and Eating Patterns #2
Esophagus and stomach:
Increase the risk of aspiration: What are other assessment findings by a nurse?
other assessment findings would include drooling, pocketing of food in the mouth, and a wet, gurgle cough, and changes to the voice, such as hoarseness.
26
Age-Related Changes That Affect Digestion and Eating Patterns #2
Slower emptying of the stomach- What does this lead to?
Slowing of gastric emptying in older adults after ingestion of large meals leads to early sensations of fullness.
27
Age-Related Changes That Affect Digestion and Eating Patterns #2
Slower emptying of the stomach- What is reduced?
Reduced gastric secretions
28
Age-Related Changes That Affect Digestion and Eating Patterns #2
Slower emptying of the stomach- What should nurses do?
Nursing: recommend to eat 5 small meals throughout the day.
29
Age-Related Changes That Affect Digestion and Eating Patterns #2
Intestinal tract: What occurs here?
Conversion of food to nutrients
30
Age-Related Changes That Affect Digestion and Eating Patterns #2
Intestinal tract: What age related change occurs?
*absorption of folate, calcium, vitamin D and vitamin B12 (not all the B vitamins) are affected by age related changes in the intestinal track
31
Age-Related Changes That Affect Digestion and Eating Patterns #2
Intestinal tract: What is chyme?
Chyme—thick fluid mass of partially digested food
32
Which statement about the sense of taste and the older adult is true?
A. With age there is a loss of the majority of taste buds
B. Age-related changes do not affect taste sensations
C. Older adults are easily able to detect sour, salty, and bitter tastes
D. Healthy older adults maintain the ability to detect sweet taste
D. Healthy older adults maintain the ability to detect sweet taste
33
Healthy older adults maintain the ability to detect sweet taste:
The ability to taste depends on what?
The ability to taste depends primarily on receptor cells in the taste buds
34
Healthy older adults maintain the ability to detect sweet taste:
With age, what happens to taste buds?
With age a small number of taste buds are lost beginning around 60 years of age, but it does not affect all flavors equally.
35
Healthy older adults maintain the ability to detect sweet taste:
The ability to taste depends primarily on receptor cells in the taste buds, which are located where?
The ability to taste depends primarily on receptor cells in the taste buds, which are located on the tongue, palate, and tonsils.
36
Healthy older adults maintain the ability to detect sweet taste:
Age related changes affect all taste sensations how?
Age-related changes do not affect all taste sensations equally, and
healthy older adults maintain the ability to detect sweet taste but have more difficulty detecting sour, salty, and bitter tastes.
37
Healthy older adults maintain the ability to detect sweet taste:
Healthy older adults maintain the ability to detect what kind of tastes? What kind of taste do they have difficulty with detecting?
healthy older adults maintain the ability to detect sweet taste but have more difficulty detecting sour, salty, and bitter tastes.
38
Age-Related Changes in Nutritional Requirements
Dietary Patterns: What is this?
Dietary Patterns: Combination of food and beverages regularly consumed
39
Age-Related Changes in Nutritional Requirements
What is required for all physiologic functions?
Water: hydration essential for all physiologic functions
40
Age-Related Changes in Nutritional Requirements:
What reflex diminishes with age? What does this mean?
*The thirst reflex diminishes with age, and therefore the recognition of the need for fluid is decreased.
41
Age-Related Changes in Nutritional Requirements:
*The thirst reflex diminishes with age, and therefore the recognition of the need for fluid is decreased.
What does this increase the risk for?
Decreased thirst perception & increase risk for dehydration
42
Age-Related Changes in Nutritional Requirements
How many calories are needed with age?
Calories: need less quantity, better quality
*Older adults don't need to take in as many calories as there were used to.
43
Age-Related Changes in Nutritional Requirements
Generally, older adults have lower energy requirements and need fewer calories why?
Generally, older adults have lower energy requirements and need fewer calories because they may not be as active and metabolic rates decline.
44
Age-Related Changes in Nutritional Requirements
Generally, older adults have lower energy requirements and need fewer calories because they may not be as active and metabolic rates decline.
How much nutrients are needed?
However, they still require the same or higher levels of nutrients for optimal health outcomes.
45
Age-Related Changes in Nutritional Requirements
How should caloric intake change with age?
Caloric intake should be gradually reduced beginning between the ages of 40 and 50 years
46
Age-Related Changes in Nutritional Requirements
Decrease in caloric intake requires what?
Decrease in caloric intake requires a proportionate increase in the quality of calories (nutritional density) to meet minimal nutritional requirements
47
Age-Related Changes in Nutritional Requirements:
Nutritional deficiencies: What does it increase the risk for?
Increase the risk for frailty, poor functioning, and pathologic conditions—occur commonly in older adults
48
Age-Related Changes in Nutritional Requirements:
Throughout life, what happens to the total body water?
*Throughout life, the proportion of total body water as a percentage of body weight gradually decreases.
49
Age-Related Changes in Nutritional Requirements:
In older adults, how is total body water further diminished?
In older adults, total body water may be further diminished by poor fluid intake secondary to age-related factors, such as a diminished thirst sensation.
50
Age-Related Changes in Nutritional Requirements:
In older adults, having to do with intake of food, what is needed?
Older adult clients need increased intake of foods with a high nutritional value and a concomitant decrease in the intake of foods containing little or no nutrients.
51
Age-Related Changes in Nutritional Requirements:
Older adults need more protein and fiber, why?
Older adult clients need more protein to maintain muscle mass and fiber to maintain healthy colon health and to help lower cholesterol.
52
Age-Related Changes in Nutritional Requirements:
Older adult clients need foods rich in vitamins and minerals- why?
Older adult clients need foods rich in vitamins and minerals to help maintain a healthy immune system, maintain healthy cardiovascular health, etc.
53
Risk Factors Affecting Digestion and Nutrition #1
Functional impairments and disease processes: like?
Dysphagia
54
Risk Factors Affecting Digestion and Nutrition #1
Functional impairments and disease processes:
Signs and symptoms of dysphagia?
S&S –Drooling, coughing during meals, respiratory tract infection wet lung sounds, packing food in the cheeks
55
Risk Factors Affecting Digestion and Nutrition #1
Functional impairments and disease processes:
What is the most profound and dangerous problem for older adults experiencing dysphagia?
Aspiration pneumonia – most profound and dangerous problem for older adults experiencing dysphagia
56
Risk Factors Affecting Digestion and Nutrition #1
Functional impairments and disease processes:
Aspiration pneumonia – most profound and dangerous problem for older adults experiencing dysphagia
What would nurses assess?
Nursing: on auscultation: Respiratory crackles
57
Risk Factors Affecting Digestion and Nutrition #1
Functional impairments and disease processes:
Nursing: Feeding a patient with dysphagia?
upright position during feeding,
allow adequate time for feeding,
keep a suction machine nearby,
discourages the patient from talking while eating,
solids foods separated from fluids- not together.
58
Risk Factors Affecting Digestion and Nutrition #1
Functional impairments and disease processes:
What is a reason dysphagia could occur?
Medication effects
59
Risk Factors Affecting Digestion and Nutrition #1
Functional impairments and disease processes: Lifestyle factors:
Alcohol and smoking
60
Risk Factors Affecting Digestion and Nutrition #1
Functional impairments and disease processes:
What is the 30 mortality from healthcare associated aspiration pneumonia?
The 30-day mortality from health care–associated aspiration pneumonia is 30%
61
Risk Factors Affecting Digestion and Nutrition #1
How does swallowing normally work?
Swallowing is a complex process with some 50 pairs of muscles and many nerves working together to receive food into the mouth, prepare it, and move it from mouth to stomach.
62
Risk Factors Affecting Digestion and Nutrition #1
Normally, how fast is swallowing? What does it involve? How can dysphagia occur?
Normally, swallowing is a rapid and seamless act but involves several phases, and dysphagia can occur secondary to deficits in any of the phases of swallowing.
63
Risk Factors Affecting Digestion and Nutrition #1
What conditions can cause dysphagia?
Any condition that weakens or damages the muscles and nerves used for swallowing may cause dysphagia.
64
Risk Factors Affecting Digestion and Nutrition #1
Any condition that weakens or damages the muscles and nerves used for swallowing may cause dysphagia. What are examples of conditions?
Examples include individuals with diseases of the nervous system, such as amyotrophic lateral sclerosis (ALS) and Parkinson’s disease, Stroke or head injury may weaken or affect coordination of the swallowing muscles or limit sensation in the mouth and throat.
65
Risk Factors Affecting Digestion and Nutrition #1
Any condition that weakens or damages the muscles and nerves used for swallowing may cause dysphagia.
What is the leading cause of neurological dysphagia?
Cerebrovascular accidents are the leading cause of neurological dysphagia and occur in 51% to 73% of patients with stroke.
66
Risk Factors Affecting Digestion and Nutrition #1
Any condition that weakens or damages the muscles and nerves used for swallowing may cause dysphagia.
What are other conditions leading to swallowing problems?
In addition, cancer of the head, neck, or esophagus may cause swallowing problems.
Memory loss and cognitive deficits may also make it difficult to chew or swallow.
67
Risk Factors Affecting Digestion and Nutrition:
What reflects a person's dietary history and present food practices?
The nutritional state of a person reflects the individual’s dietary history and present food practices.
68
Risk Factors Affecting Digestion and Nutrition:
Psychsocial factors:
Loneliness, stress, anxiety, memory issues, and depression
69
Risk Factors Affecting Digestion and Nutrition:
Environmental factors
Noisy, unpleasant environment in institutional setting, transportation, and packaging trends in stores
70
Risk Factors Affecting Digestion and Nutrition:
Behaviors based on myths and misunderstandings
Lack of roughage in diet, advertisements, and overuse of laxatives
71
Risk Factors Affecting Digestion and Nutrition:
Questions to ask during nutrition assessment:
Ask the patient, “Is there anything your providers should be aware of regarding your diet?”
* Identify whether the patient’s religious or spiritual beliefs or customs require or forbid eating certain foods.
* Determine whether the patient routinely or periodically observes fasting practices.
* Note the dietary needs or restrictions in the medical record and communicate them to staff.
* Make sure the hospital food service accommodates the patient’s preferences and cultural and religious eating customs.
72
Eating alone has been associated with a 30% decline in caloric intake when compared with caloric intake of people who eat in the company of others
true or false?
True
Psychosocial factors are likely to affect an older person’s appetite and eating patterns.
Eating alone has been associated with a 30% decline in caloric intake when compared with the caloric intake of people who eat in the company of others,
73
Eating alone has been associated with a 30% decline in caloric intake when compared with caloric intake of people who eat in the company of others
true.
What has a negative effect on eating patterns?
Any changes in mealtime companionship are likely to have a negative effect on eating patterns.
74
Eating alone has been associated with a 30% decline in caloric intake when compared with caloric intake of people who eat in the company of others
true.
What is a risk factor for anorexia in older adults?
loneliness has been identified as a risk factor for anorexia in older adults
75
Functional Consequences Affecting Digestion and Nutrition include:
Ability to procure, prepare, and enjoy food
Changes in oral function
Poor nutritional status and weight changes
Malnutrition (Undernutrition)
76
Malnutrition (Undernutrition):
What is it?
The intake of nutrients that is less than the amount required to meet daily needs
77
Malnutrition (Undernutrition):
What is an independent risk factor for poor nutrition?
Being 75 years of age and older is an independent risk factor for poor nutrition
78
Malnutrition (Undernutrition):
Prevalence of malnutrition caries with what? Where is it highest?
Prevalence varies according to setting: Malnutrition is as high as 35% in community settings
79
Malnutrition (Undernutrition)
Malnutrition on hospitalized patients affects how many people?
Malnutrition among hospitalized patients is estimated to affect as many as one in two patients at admission, while many others develop malnutrition throughout hospitalization
80
Malnutrition (Undernutrition)
What percent of people are malnourished when discharged from hospitals?
Up to 65% of older adult patients are malnourished when discharged from the hospital.
81
Malnutrition (Undernutrition)
For a diagnosis of malnutrition, what is needed?
For a diagnosis of malnutrition, two or more of the following characteristics must be present:
82
Malnutrition (Undernutrition)
For a diagnosis of malnutrition, two or more of the following characteristics must be present:
* Insufficient energy intake
* Weight loss
* Loss of muscle mass
* Loss of subcutaneous fat
* Localized or generalized fluid accumulation that may mask weight loss
* Diminished functional status as measured by handgrip strength
83
Malnutrition (Undernutrition)
What is the most important indicator of nutritional deficit and overall poor nutritional status?
Unintentional weight loss is the most important indicator of nutritional deficit and overall poor nutritional status.
84
Malnutrition (Undernutrition):
What is it a precursor to?
Malnutrition is a precursor to frailty and has serious consequences,
85
Malnutrition (Undernutrition):
Malnutrition is a precursor to frailty and has serious consequences, including what?
including infections,
pressure injuries,
anemia,
hypotension,
impaired cognition,
sarcopenia (low muscle mass associated with aging),
hip fractures,
prolonged hospital stay,
institutionalization,
increased dependence,
reduced quality of life,
and increased morbidity and mortality.
86
Malnutrition (Undernutrition)
How much more likely are malnourished patients likely to develop pressure injuries and infections?
Malnourished patients are twice as likely to develop pressure injuries and three times as likely to have infections.
87
Malnutrition (Undernutrition)
What other types of patients are reportedly malnourished?
Almost half of the patients who fall during hospitalization are reported to be malnourished.
88
Malnutrition (Undernutrition)
What is likely to happen to older adults admitted for malnutrition?
Older adults who are admitted to the hospital with malnutrition are more likely to have longer hospital stays and die before discharge.
89
Pathologic Condition Affecting Digestion and Nutrition
include:
Constipation
90
Pathologic Condition Affecting Digestion and Nutrition
include: Constipation- what is it?
Decrease in normal frequency of defecation accompanied by difficult or incomplete passage of stool and/or passage of excessively hard, dry stool
91
Pathologic Condition Affecting Digestion and Nutrition
include: Constipation- risk factors?
Functional impairments,
depression,
pathologic conditions
adverse medication effects,
laxative abuse
and poor dietary patterns
92
Pathologic Condition Affecting Digestion and Nutrition
Constipation- risk factors?
laxative abuse : like?
laxative abuse (Long-term use of magnesium-based laxatives)
93
Pathologic Condition Affecting Digestion and Nutrition
Constipation- risk factors?
pathologic conditions : like?
pathologic conditions (e.g., endocrine, metabolic, and neurologic disorders),
94
Pathologic Condition Affecting Digestion and Nutrition
Constipation- risk factors?
poor dietary patterns : like?
poor dietary patterns (e.g., inadequate intake of bulk, fiber, and fluid)
95
Pathologic Condition Affecting Digestion and Nutrition
Constipation-
What is a nursing role to correct this?
*Nursing -If older adults need a medication to promote bowel regularity, a bulk-forming agent is needed daily. (such as Metamucil or Citrucel)
96
Pathologic Condition Affecting Digestion and Nutrition
Constipation-
What is a nursing role to correct this: What is recommended?
A daily intake of 25 g of fiber is recommended and must be combined with adequate amounts of fluid. Insufficient amounts of fiber in the diet and insufficient fluids contribute to constipation.
97
Nursing Assessment of Digestion and Nutrition includes:
Nutritional status and usual eating patterns
Risk factors that interfere with optimal nutrition
Factors that influence eating patterns
Negative functional consequences of altered digestion or inadequate nutrition
98
Nursing Assessment of Digestion and Nutrition:
What is the major purpose of this nursing assessment?
Major purpose of this nursing assessment is to identify opportunities for health promotion interventions
99
Nursing Assessment of Digestion and Nutrition:
What are you interviewing/ observing about?
Interviewing about digestion and nutrition
Observing cues to digestion and nutrition
100
Nursing Assessment of Digestion and Nutrition:
What assessment tool is used?
The Mini Nutritional Assessment (MNA) tool
101
Nursing Assessment of Digestion and Nutrition:
The Mini Nutritional Assessment (MNA): Where can it be used?
The MNA® can be used in a variety of settings to detect those elderly patients (65 and older) who could benefit from early nutrition intervention.
This includes on admission to hospitals or nursing homes, in geriatric clinics, geriatric feeding programs, health screenings and health fairs, geriatric day programs, assisted living sites, home care settings, dental clinics, dialysis centers, community-based nursing programs, and physician offices.
101
Nursing Assessment of Digestion and Nutrition:
The Mini Nutritional Assessment (MNA) tool scoring?
0-7 points -malnutrition
8-11 points - at risk for malnutrition
12-14 points – normally nourished
102
Nursing Assessment of Digestion and Nutrition:
The Mini Nutritional Assessment (MNA): How often is it used?
The MNA® may be used to re-screen for nutrition risk every three months.
103
BMI Guidelines;
What is a health weight defined as?
Based on extensive research, different BMI categories were set for older adults, where healthy weight was defined as a BMI ranging from 23 to 29.9 kg/m².
104
BMI Guidelines;
What BMI is associated with significantly increased risk of mortality?
This stems from the fact that researchers noticed that a BMI below 23 and above 33 is associated with a significantly increased risk of mortality.
105
BMI Guidelines
Why are geriatric BMI guidelines different from general population?
Human bodies change with age - an older person has more fatty tissue than a younger individual.
Moreover, a higher BMI is associated with greater energy stores and a better nutritional state overall.
106
BMI Guidelines
Underweight:
BMI range for adults? Older adults?
< 18.5
< 23
107
BMI Guidelines
Normal:
BMI range for adults? Older adults?
18.5 – 24.9
23-29.9
108
BMI Guidelines
Overweight:
BMI range for adults? Older adults?
25 – 29.9
>30
109
BMI Guidelines
Obese:
BMI range for adults?
30+
110
Nursing Interventions to Promote Healthy Digestion and Nutrition include:
Promoting optimal nutrition and preventing disease
Addressing risk factors that interfere with digestion and nutrition
Addressing nutritional problems in health care settings
Teaching older adults and caregivers about oral and dental health
Addressing oral health care needs of older adults in health care settings
