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Gero > Gero- Nutrition chapter 14 > Flashcards

Gero- Nutrition chapter 14 Flashcards

1
Q

What are preventable diet related disease s the half all all American adults have?

A
  • Cardiovascular disease
  • Type 2 Diabetes
  • Overweight
  • Obesity
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2
Q

What are factors impacting nutritional needs?

A
  • chronic disease
  • eating habits
  • ethnicity
  • socialization
  • income
  • transportation
  • housing
  • mood
  • food knowledge
  • functional impairments
  • health
  • dentition (health of mouth/teeth can you chew)
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3
Q

What are age-related requirements?

A
  • Dietary Guidelines
  • Choose Myplate
  • Older adults generally need less calories b/c activity decreases and metabolic rates slow down
  • Require same/higher nutrients
  • Increase protein for “vulnerable patients”
  • use to recover if illness occurs*
  • limited saturated fats and trans fatty acids to under 2%
  • Protein: increase for older adult who tends to experience protein deficiency when Ill “minimize frailty”
  • Fiber: 25 g fiber recommended daily.
  • Vitamins/Minerals: 5 servings of fruits/ veggies, A, C, E, Potassium, B12 b/c decrease absorption
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4
Q

What is obesity associated with?

A 
Increased costs
Functional impairment 
Disability 
Chronic Disease
Admission to nursing home
  • more than a third person >60 yr are obese
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5
Q

What is the obesity paradox?

A

***Obesity Paradox: persons who survived to 70 yrs had lower mortality (death) rate if they were overweight (b/c nutritional needs are met/ overate w/o cardiac issues or diabetes)

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6
Q

Where are risen incidence rates for malnutrition?

A

Acute care
Long term care
Community

***b/c patients are not eating

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7
Q

Why are institutionalized adults are at high risk for malnutrition?

A

Chronic Disease
Functional Impairment

**Pt may not be able to eat on their own, eat slowly, eating slowly inhibits feeding b/c of lack of time

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8
Q

What are other problems associated with not being able to eat?

A
  • Pain
  • Cognitive Impairment
  • Depression
  • Mouth hurt (hurt to chew)
  • Dysphagia (if pt can’t swallow may spit food back out)
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9
Q

What are patient increased risk for when malnourished?

A 
Infection
PU
anemia (needs protein/green leafy veggies) 
Hip fractures 
Hypotension
Impaired cognition 
Increased morbidity and mortality
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10
Q

What is malnutrition r/t?

A

Deficient macro/micronutrients

Inflammation

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11
Q

What screenings are done for a patient w/ malnutrition?

A
  • Comprehensive screening/assessment

- Head to toes assessment (is patient over- malnourished/under-malnourished)

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12
Q

What are factors affecting the fulfillment of nutritional needs?

A
  • Life long eating habits
  • socialization
  • Socioeconomic deprivation (Availability of food)
  • Transportation
  • Chronic diseases/conditions
  • Polypharmacy
  • Inactivity
  • High-fat, High volume meals
  • Comorbid conditions
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13
Q

What chronic disease affect nutrition?

A

GERD
Diverticular Disease
Dysphagia

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14
Q

What is GERD?

A

A syndrome where there is damage to the mucous from gastric contents moving backward from the stomach to the esophagus.

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15
Q

What are risk factors for GERD?

A

Hiatal hernias
Obesity
Cigarette smoking/second hand smoking

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16
Q

What are symptoms for GERD?

A

Persistent cough
Exacerbations of asthma
Intermittent chest pain (burning, pressure, can hit nerve in arm must distinct from cardiac chest pain)

17
Q

What causes dysphagia?

A

Aspiration (lungs)
Distress
Dehydration (not getting enough fluids b/c inability to swallow)
Malnutrition (b/c inability to swallow)

18
Q

Dysphagia occurs secondary to what deficits?

A

Stroke
Parkinson’s Disease
Neurological Damage (Otopharyngeal Dysphagia)
Muscular Damage

19
Q

Who do you refer the patient to when suffering from dysphagia?

A

Speech Language pathologist
Do a swallow test
Determine diet: mechanical, soft, liquids, thin liquids….etc

20
Q

What are implications for gerontological Nursing? “Assessments”

A

Nutritional screening/assessments:
“Mini Nutritional Assessment”
-Mini-data set (includes risk factors/triggers evaluation.)
-Interview/physical assessment
-Anthropometrical assessment
-Weight/Height (BMI)
-Biometrical analysis/measures of visceral protein

21
Q

What are implications for gerontological Nursing? “Interventions”

A

Formulate around specific problems “individualized”

NURSES ROLE: Ensure adequate nutrition to promote healthy aging

Collab: Interprofessional team “dietitians..etc”

22
Q

What do we as nurse “consider” during interventions ?

A
  • Modify environment
  • Supervision
  • Feeding techniques- may need spoon instead of fork (enhance intake, preserve dignity/ independence)
  • Evaluate outcome does something need to be changed/ modified
23
Q

What are nutritional problems in institutional settings?

A

Feeding assistance (50% of residence are not able tp eat independently

What will you assess for?

  • Can they hold as spoon or fork? (WHICH ONE NEEDED)
  • Can they get food from plate to mouth?
  • Can they chew/swallow?
  • Can they think to eat? Cognitive- Parkinson’s can not get food to mouth b/c they shake. if so patient may need feeding assistance.
24
Q

What is Medicare/Medicaid implemented rule w/ feeding assistance?

A

8 hours if approved training

25
Q

What interventions are used to enhance intake in LTC?

A
  • Restorative dining rooms
  • Ethnic food choices
  • Easy access to refreshment stations w/ juices, water, -healthy snacks, and finger foods- things they won’t choke on cut up well.
  • Other considerations: restrictive diet /caloric supplements, pharmacological therapy, and patient education

*** (ask patient what he/she would like she eat/drink- better than them dehydrating)
Family involvement

26
Q 
What is the estimated number of institutionalized older adults who are unable to eat independently? 
40 
50
60
70
A

50%

27
Q 
Which condition affects nutrition in the older adults? 
Diabetes
Heart Disease
Dysphagia 
Gout
A

Dysphagia

Gero (7 decks)

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