Gerontology Chpt 6 Flashcards
A patient with Parkinson disease has difficulty swallowing. The patient is able to meet dietary requirements when he can do which of the following? Select all that apply.
1. Eat solid food
2. Drink thin liquids
3. Eat a meal in 20 minutes
4. Swallow without choking
5. Drink thickened liquids
Answer: 4, 5.
1. Feeding a patient who has difficulty swallowing any type of solid food is inappropriate.
— 2. Thin liquids are very difficult to swallow for individuals who have dysphagia.
- 3. This patient may take much longer to eat because special precautions must be taken.
X 4. When the patient swallows without choking and takes his time eating, he is safely able to meet dietary requirements.
X 5. Thickened liquids may be a part of this diet.
An older man is hospitalized with pneumonia and has a poor nutrition intake. The patient’s appetite may improve it:
1. His food is pureed.
2. All liquids are served warm.
3. A roll is served with each meal.
4. He is served small meals frequently
Answer: 4.
4. Frequent small meals are easier to digest and not as overwhelming to the patient.
1. No indication exists for pureed foods.
2. There is no reason to believe that warm liquids would increase his appetite.
3. Rolls would most likely not stimulate his appetite.
The nurse is caring for an older adult with partial-thickness burns from a kitchen accident. After nutrition teaching, which breakfast choices by the patient would indicate she understands her nutritional needs?
1. Two poached eggs, toast with jam, whole milk, coffee
2. Dry cereal with skim milk, orange juice, coffee
3. Pancakes with syrup, two strips of bacon, apple juice
4. Oatmeal with skim milk, orange juice, coffee
Answer: 1.
1. Eggs and whole milk provide needed protein and calories.
2. Cereal, juice, and skim milk will provide carbohydrates and vitamins but little protein and few calories.
3. Pancakes are carbohydrates for increased calories but bacon is a fat, not a protein.
4. Qatmeal provides carbohydrates and fiber, orange provides vitamins, but protein is low.
An older woman recently moved to the United States from the Middle East.
She does not like to drink cow’s milk or eat most cheeses. What is a culturally acceptable food that would best help meet the need for calcium?
1. Yogurt
2. Broccoli
3. Sardines
- 4. Tofu
Correct answer: 1
It is important to remember that good nutrition can be achieved within any culture. Special planning with the dietitian is often necessary to achieve adequate nutrition and meet cultural preferences within an institutional setting. A culturally acceptable food for a person of Middle Eastern descent that would best help meet the need for calcium is yogurt.
An older man who lives alone in an apartment is placed on a sodium-restricted diet because of heart failure. He asks you to help him make good diet choices. Which foods should he avoid?
(Select all that apply.)
1. Canned tomato soup
2. Deli bologna or ham
3. Grilled steak
4. Frozen spaghetti dinner
5. Pancakes
6. Boiled eggs
Correct answers: 1, 2, 4
Prepared foods such as canned soups or vegetables, lunchmeats, and frozen dinners are high in sodium content and are common in the diet of many older adults.
An 85-year-old woman was admitted to the hospital. Clinical indicators of inadequate nutrition include which of the following? (Select all that apply.)
1. Thin, brittle hair
2. Hgb 10.2; Hct 33
3. Thin, dry skin
4. Slow reflexes
5. Pale conjunctiva
Correct answers: 1, 2, 5
Clinical indicators of inadequate nutrition include loss or change in consistency of the hair (thin, brittle hair), a decrease in hemoglobin and hematocrit, and pallor of the mucous membranes, such as the conjunctiva (which could indicate an iron deficiency). Thin, dry skin and slower reflexes are normal physiologic changes associated with aging and do not necessarily indicate inadequate nutrition.
An older adult is taking furosemide (Lasix) to reduce edema. Dietary teaching for this person would best include directions to increase dietary intake of which of the following foods? (Select all that apply.)
1. Bananas
2. Apple juice
3. Tomatoes
4. Oranges
5. Grapes
6. Milk
Correct answers: 1, 2, 4, 6
Potassium deficiency, or hypokalemia, is a common problem in older adults. Many diuretic and antihypertensive medications deplete the body of potassium. Furosemide (Lasix) is a loop diuretic; therefore it is not potassium sparing. A person taking furosemide would need to increase dietary intake of potassium. Dietary sources of potassium include citrus fruits, milk, bananas, apple juice, and baked potatoes.
An older nursing home resident has poor skin turgor, dry mucous membranes, and very concentrated urine. What are the best directions to give to the nursing assistant? (Select all that apply.)
1. Make sure the resident eats everything served at each meal.
2. Offer small amounts of fluids frequently during the day.
3. Provide good oral hygiene.
4. Identify the beverages that the resident prefers.
5. Keep a large container of iced water in the residents room.
6. Give the resident hard candy to suck on.
Correct answers: 2, 4
Small amounts of fluid taken frequently add up to significant fluid intake. Offer fluids, or remind the individual to take a drink every 30 to 60 minutes throughout the day. Many older adults have distinct preferences regarding the type and temperature of beverages they like. Because people are most likely to consume floods and fluids that they like, determine the individual’s preferences.
An older adult is diagnosed with iron deficiency anemia. Which food list is the nurse most likely to include in the patient teaching?
1. Red meat, egg yolks, leafy green vegetables, and dried fruits
2. Whole wheat, legumes, and green vegetables
3. Whole grains, vegetables, legumes, meats, and bananas
4. Fortified milk and margarine, cod liver oil, fatty fish, and eggs
Answer 1: Iron-deficiency anemia results from inadequate intake of dietary iron. Rich sources of dietary iron include red meat, particularly organ meats such as liver; shellfish; egg yolks; leafy green vegetables; and dried fruits.
Which patient is mostly likely to need teaching related to a sodium-restricted diet?
1. A 62-year-old patient who has a wrist fracture with osteoporosis
2. A 57-year-old patient who has hypertension and chronic renal failure
3. A 4-year-old patient who has type 2 diabetes and obesity An 80-year-old patient who has diverticulitis and constipation
Answer 2: The American diet is usually high in sodium, so many people could benefit from a reduced salt diet; however, people with hypertension, renal failure, or cardiac conditions are often placed on sodium-restricted diets.
According to the Institute of Medicine, for a patient who is on a 1500-calorie diet, how many calories should come from carbohydrates?
1. 200-350 calories
2. 450-600 calories
3. 550-1250 calories
4. 675-975 calories
Answer 4: According to the Institute of Medicine, 45% to 65% of calories should come from carbohydrates. 0.45 × 1500 = 675 and 0.65 × 1500 = 975.
For a patient with pernicious anemia, the nurse anticipates that which dietary supplement will be prescribed?
1. Vitamin C
2. Iron injections
3. Vitamin B12
4. Calcium
Answer 3: Vitamin B12, which is required for red blood cell maturation in the bone marrow, is poorly absorbed and deficient in pernicious anemia.
A patient who takes a diuretic and antihypertensive medication reports severe muscle weakness, anorexia, palpitations, irritability, drowsiness, depression, and disorientation. Which laboratory value is the nurse likely to check first?
1. Blood glucose
2. Blood urea nitrogen
3. Serum sodium
4. Serum potassium
Answer 4: The patient is describing symptoms of hypokalemia.
In addition, the nurse knows that diuretics and antihypertensive medication can contribute to low potassium levels.
A frail older adult is seen in the emergency department for excessive vomiting and diarrhea. Which electrolyte imbalance is most likely to manifest?
1. Hyperglycemia
2. Hyponatremia
3. Hyperkalemia
4. Hypocalcemia
Answer 2: Sodium is lost during vomiting and diarrhea. The patient is also likely to lose potassium, and hypoglycemia is also possible if the patient is unable to retain any food or fluids and is not yet receiving IV dextrose solution. Calcium is primarily stored in the bones.
The older patient reports fatigue, exertional dyspnea, tachycardia, palpitations, headache, insomnia, and vertigo. On physical examination, the nurse notes pallor of the mucous membranes, tachycardia, and cool extremities. Based on these assessment findings, which laboratory values) is the nurse most likely to check?
1. Hemoglobin and hematocrit
2. Fasting blood glucose level
3. Potassium and sodium levels
4. Creatinine and blood urea nitrogen
Answer 1: The patient is describing symptoms of anemia, so the nurse is most likely to check the hemoglobin and hematocrit levels first.
