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HUNT243 Exam > Lecture 24: Older Adult Nutrition Part 2 > Flashcards

Lecture 24: Older Adult Nutrition Part 2 Flashcards

1
Q

What are geriatric patients?

A

elderly individuals who often require specialised medical care due to the natural aging process

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2
Q

What are the main focuses for geriatric patients?

A
  • Prevention and treatment of malnutrition
  • Prevention and treatment of low-intake dehydration
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3
Q

What is dehydration?

A

Water losses exceeding water replacement caused by either an inadequate intake of fluid, or excess loss (volume depletion), or both

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4
Q

Why is it important to know the cause of dehydration?

A

As this will inform your intervention

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5
Q

What does dehydration in older adults contribute to?

A
  • Confusion
  • Constipation
  • UTIs
  • Risk of falls
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6
Q

What are seven signs and symptoms of dehydration?

A
  1. Upper body weakness
  2. Speech difficulty
  3. Confusion
  4. Dry mucous membranes in nose and mouth
  5. Longitudinal tongue furrows
  6. Dry tongue
  7. Sunken appearance of eyes in their sockets
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7
Q

What physiological factors increase dehydration?

A
  • Decreased thirst sensation
  • Decreased concentrating ability of the kidneys
  • Lower total body fluid stores
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8
Q

What psychological factors increase dehydration?

A
  • Cognitive impairment
  • Self-restriction (fear of incontinence)
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9
Q

What physical factors increase dehydration?

A
  • Reduced dexterity
  • Poor vision
  • Poor motility
  • Reliance on feeding assistance
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10
Q

What co-morbidities increase dehydration?

A
  • Poorly controlled diabetes
  • Dysphagia
  • Early satiety
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11
Q

What environmental factors increase dehydration?

A
  • Hospitalised/aged care
  • Reliance on carers for fluid
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12
Q

What are examples of volume depletion?

A
  • Diarrhoea
  • Vomiting
  • Hyperthermia
  • Bleeding
  • Diuretic Medications
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13
Q

Who should be considered at risk and encouraged to consume adequate amounts of fluids?

A

All older adults
- Everyone is considered at risk to prevent low-intake dehydration

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14
Q

What drinks should be given to older adults for hydration?

A

A range based on their preferences
- Doesn’t really matter what the fluid is, just to ensure they are maintaining hydration

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15
Q

What are the fluid recommendations for older adults?

A

Women = 1.6 Litres
Men = 2.0 Litres

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16
Q

What is the ICD?

A

International Classification of Disease

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17
Q

What is ICD-10-AM?

A

10 codes are used in hospitals to define morbidity statistics and get a good understanding of them

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18
Q

What does ICD-10-AM define malnutrition as?

A

BMI <18.5kg/m2 or unintentional weight loss of >5% with evidence of suboptimal intake resulting in subcutaneous fat loss and/or muscle wasting

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19
Q

What percent of older adults are malnourished or at risk globally?

A

1/4

20
Q

What is the definition of unintentional weight loss?

A
  • Not universally defined
  • Weight loss of 5% or more of BW in the past 3-6 months
21
Q

What are potential causes of unintentional weight loss?

A
  • Underlying, undiagnosed disease or illness
  • Protein-energy malnutrition
  • Poverty
  • Functional decline
22
Q

What are signs you can notice that older adults are malnourished?

A
  • Clothes are getting lose
  • Jewellery is loose
  • Belt has been tightened
  • Dentures becoming loose
  • Not enjoying favourite meals anymore
23
Q

Malnutrition can cause increased…

A
  • Infection risk
  • Risk of falls
  • Hospital stays
24
Q

Malnutrition can lead to decreased?

A
  • Strength
  • Immunity
  • Ability to do usual daily activities
  • Quality of life
  • Life expectancy
25
Q

What is the prevalence of malnutrition across Australia and NZ?

A

up to 17%

26
Q

What is the prevalence of risk of malnutrition across Australia and NZ?

A

up to 63%

27
Q

Where is there a higher prevalence of malnutrition?

A
  • Older adults >80 years
  • Women
  • Multiple morbidities
28
Q

Who is screening for malnutrition recommended for?

A

For all older adults, across all health settings
- So we can early identify those who are and those who are at risk

29
Q

What are the different screening tools available for malnutrition?

A
  • Anthropometry
  • Questions around weight loss, changes in appetite and/or food intake
30
Q

What is the most common tool for screening malnutrition?

A

MNA

31
Q

What is MNA?

A

Mini Nutritional Assessment grading system to identify malnutrition or the risk of malnutrition

32
Q

What is the grading system for MNA?

A

12-14 = Normal
8-11 = At risk
0-7 = Malnourished

33
Q

What are the steps to take after nutrition screening?

A

Screening -> Identification -> Diagnosis -> Treatment

34
Q

Screening is NOT a…

A

Diagnosis

35
Q

What are the three causal subcategories of diagnosis of malnutrition?

A
  • Disease related malnutrition driven by inflammation
  • Disease related malnutrition with no perceived inflammation
  • Malnutrition due to starvation not related to disease
36
Q

What is malnutrition due to starvation not related to disease?

A

Either related to hunger, socioeconomic factors or psychological factors

37
Q

What is a nutrition assessment an assessment of?

A
  • Anthropometry
  • Biochemical markers
  • Dietary assessment
  • Lifestyle factors
  • Functional capacity
  • Hydration
38
Q

To be able to conduct a good intervention we need…

A

a really good, comprehensive nutrition assessment

39
Q

What does dietary assessment include?

A
  • Detailed food intake
  • Estimation of food consumption
  • Energy and protein intake
40
Q

What is functional capacity?

A

Things like hand grip strength and the ability to go from sitting to standing

41
Q

What are factors that influence food intake?

A
  • Access to food
  • Disease and Medication
  • Personal preference
  • Ability to self feed
  • Family wishes
  • Ageing changes
  • Activity and mobility
  • Mood
42
Q

What are food first stratagies of malnutrition?

A
  • High Protein High Energy Extras (HPHE)
  • Food fortification
43
Q

What are oral nutrition supplements used for malnutrition intervention?

A
  • OTC supplements (e.g., Complan, Sustagen)
  • Funded oral nutrition supplements
44
Q

What is re-screening in malnutrition intervention?

A
  • Repeating MNA
  • Comprehensive nutrition assessment
45
Q

What is PHARMAC?

A

Form used to get prescriptions - special authority

46
Q

Nutrition screening is…

A

Quick and easy - anyone can perform it

47
Q

Early identification =

A

Early intervention

HUNT243 Exam (19 decks)

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