Lecture 5 Nutrition and gastrointestinal function Flashcards
Dysphagia
- Difficulty swallowing, placing the patient at increased risk for aspiration; affects chewing, safety of swallowing, and nutrition.
- Most commonly caused by neurologic and neuromuscular disorders.
- Signs and symptoms: Drool, slurred speech, pocketing food, coughing with food/pills.
- Present in 40-50% of stroke patients, and up to 50% of nursing home residents.
Presbyphagia
Slowed swallowing, due to decreased frequency of peristaltic waves.
Mini Nutritional Assessment (MNA)
An evidence-based tool to screen for malnutrition in older adults; components include food intake decline, weight loss, mobility status, BMI, etc.
Olfaction (the ability to detect and identify odors) is best between the ages of _ and _, and then it gradually declines.
30 and 40 years.
Gustatory function
The ability to taste.
Age-related changes that may impact nutrition
- Less efficient chewing.
- ↓ senses of smell and taste.
- ↓ saliva secretion.
- Slower motility.
- Degenerative changes affecting digestion.
- Daily intake - need fewer but higher quality calories.
The major risk factors impacting nutrition in the older adult are those that _
Interfere with the ability to obtain, prepare, consume, and enjoy food.
Xerostomia
Dry mouth due to decreased salivary flow; not considered a normal part of aging, but experienced by 30% of older adults as a side effect of various medications.
All medications with _ action (e.g., antidepressants, antipsychotics, antiemetics, antihistamines) are likely to cause xerostomia.
Anticholinergic.
A person with Helicobacter pylori infection will experience decreases in _
Gastric acid production (hypochlorhydria).
Vitamins and minerals that are absorbed in the small intestine
- Folate.
- Calcium.
- Vitamin B₁₂.
- Vitamin D.
Older adults have an increased tendency to develop _, due to age-related changes in the large intestine.
Constipation.
The liver assists digestion by producing and secreting bile, which is essential for utilizing _
Fats.
Cholelithiasis
Gallstones - may occur more often in older adults due to diminished bile acid synthesis and increased gallbladder contraction.
Without an adequate intake of _, the body will derive energy from fat and protein, causing an increase in serum cholesterol and triglyceride levels and a depletion of water, electrolytes, and amino acids.
Carbohydrates.
_ is the nutrient that plays an important role in eye health.
Vitamin A.
_ is the risk factor most closely associated with inadequate nutritional intake in older adults in community, acute care, and long-term care settings.
Functional and cognitive impairment.
Cardiac dysrhythmias can be produced by low serum levels of _ and _
Magnesium and potassium.
Gastroparesis
- Poor emptying of food from the stomach, notably in diabetics.
- Signs and symptoms: Nausea/vomiting, reflux, pain, bloating, loss of appetite.
Daily protein intake should be at least _ to _ of total daily calories.
10-20%.
Carbohydrates should make up about _ of total daily calories.
50%.
Dietary fiber vs. functional fiber
Dietary fiber refers to fiber from food intake; functional fiber refers to supplementation with Metamucil, Benefiber, etc.
Fats should make up _ to _ of total daily calories.
20-30%.
About _ of daily water intake should come from from drinking, and about _ should come from foods.
80%; 20%.
Screening for _ prior to hospital discharge is not standardized, and often not performed.
Malnutrition.
Characteristics of malnutrition
- Weakness or lethargy.
- Unintentional weight loss; failure to thrive.
- Diminished muscle mass.
- Marked decrease in subcutaneous fat.
- Impaired ability to respond to infection.
- Loss of visceral protein; edema.
The normal range of serum albumin is _
3.1 - 4.3 g/dL.
Older adults who live alone are at risk for malnutrition in part because people tend to eat _ less when they eat in isolation.
30%.
The leading cause of malnutrition in older adults is _
Depression.
Constipation can be defined as having _ bowel movements weekly.
Two or fewer.
Body mass index (BMI) ranges
18.5 - 25 = normal weight
Below 18.5 = underweight
25 - 30 = overweight
Above 30 = obese
An older adult with anemia would benefit from a diet comprised of _
Legumes, organ meat, and dark green leafy vegetables.
The proper diet order for a stroke patient with garbled speech is _
A mechanically altered diet with nectar thick liquids.
Cherries, radishes, and watermelon are examples of foods that may cause _ in the older adult.
Gas.
Age-related changes impacting the liver
- Decrease in size.
- More fibrous.
- Decreased blood flow.
Older adults should drink _ of water per day.
1.5-2 L (6-8 glasses).
High caffeine intake impacts _ absorption.
Calcium.
