Gero- Nutrition chapter 14 Flashcards
What are preventable diet related disease s the half all all American adults have?
- Cardiovascular disease
- Type 2 Diabetes
- Overweight
- Obesity
What are factors impacting nutritional needs?
- chronic disease
- eating habits
- ethnicity
- socialization
- income
- transportation
- housing
- mood
- food knowledge
- functional impairments
- health
- dentition (health of mouth/teeth can you chew)
What are age-related requirements?
- 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
What is obesity associated with?
Increased costs Functional impairment Disability Chronic Disease Admission to nursing home
- more than a third person >60 yr are obese
What is the obesity paradox?
***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)
Where are risen incidence rates for malnutrition?
Acute care
Long term care
Community
***b/c patients are not eating
Why are institutionalized adults are at high risk for malnutrition?
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
What are other problems associated with not being able to eat?
- Pain
- Cognitive Impairment
- Depression
- Mouth hurt (hurt to chew)
- Dysphagia (if pt can’t swallow may spit food back out)
What are patient increased risk for when malnourished?
Infection PU anemia (needs protein/green leafy veggies) Hip fractures Hypotension Impaired cognition Increased morbidity and mortality
What is malnutrition r/t?
Deficient macro/micronutrients
Inflammation
What screenings are done for a patient w/ malnutrition?
- Comprehensive screening/assessment
- Head to toes assessment (is patient over- malnourished/under-malnourished)
What are factors affecting the fulfillment of nutritional needs?
- Life long eating habits
- socialization
- Socioeconomic deprivation (Availability of food)
- Transportation
- Chronic diseases/conditions
- Polypharmacy
- Inactivity
- High-fat, High volume meals
- Comorbid conditions
What chronic disease affect nutrition?
GERD
Diverticular Disease
Dysphagia
What is GERD?
A syndrome where there is damage to the mucous from gastric contents moving backward from the stomach to the esophagus.
What are risk factors for GERD?
Hiatal hernias
Obesity
Cigarette smoking/second hand smoking
What are symptoms for GERD?
Persistent cough
Exacerbations of asthma
Intermittent chest pain (burning, pressure, can hit nerve in arm must distinct from cardiac chest pain)
What causes dysphagia?
Aspiration (lungs)
Distress
Dehydration (not getting enough fluids b/c inability to swallow)
Malnutrition (b/c inability to swallow)
Dysphagia occurs secondary to what deficits?
Stroke
Parkinson’s Disease
Neurological Damage (Otopharyngeal Dysphagia)
Muscular Damage
Who do you refer the patient to when suffering from dysphagia?
Speech Language pathologist
Do a swallow test
Determine diet: mechanical, soft, liquids, thin liquids….etc
What are implications for gerontological Nursing? “Assessments”
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
What are implications for gerontological Nursing? “Interventions”
Formulate around specific problems “individualized”
NURSES ROLE: Ensure adequate nutrition to promote healthy aging
Collab: Interprofessional team “dietitians..etc”
What do we as nurse “consider” during interventions ?
- 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
What are nutritional problems in institutional settings?
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.
What is Medicare/Medicaid implemented rule w/ feeding assistance?
8 hours if approved training
What interventions are used to enhance intake in LTC?
- 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
What is the estimated number of institutionalized older adults who are unable to eat independently? 40 50 60 70
50%
Which condition affects nutrition in the older adults? Diabetes Heart Disease Dysphagia Gout
Dysphagia
