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Lifespan > Nutrition > Flashcards

Nutrition Flashcards

1
Q

what are 6 reasons that nutrition becomes a problem as you age

A
  1. decline in smell and taste -> dec appetite
  2. dec salivation –> inhibits chewing
  3. mastication is impaired (dental losses) -> loss of teeth or poorly fitting dentures
  4. esophageal motility dec
  5. dec hydrochloric acid in stomach
  6. postural changes
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2
Q

what are normal age-related physiologic changes that occur in body composition

A
  1. dec in lean body mass
  2. dec in total body protein per ms
  3. dec in energy metabolism related to dec total protein mass
  4. dec in total body water
  5. inc in body fat w dec in fat stores
  6. loss of bone density
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3
Q

what GI system changes are seen w aging

A

dec secretion of digestive enzymes and mucus
loss of ms tone in stomach
dec peristalsis
formation of intestinal diverticula

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4
Q

how does kidney function decrease with age

A

dec renal blood flow
dec glomerular filtration
dec renal tubular function

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5
Q

how does liver function change w age

A

dec in liver enzymes
- impacts metabolism of carbs and breakdown of drugs and alcohol
- buildup of glucose

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6
Q

why might an aging adult develop DM 2

A

dec in beta cell function and insulin end-organ responsiveness
-> progressive glucose intolerance

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7
Q

what fluid needs are associated w aging (3)

A

dec perception of thirst
dec response to serum osmolarity
dec ability to concentrate urine following fluid deprivation

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8
Q

what are the current recommendations for fluid needs of aging adults

A

30mL/kg/day or 50% of body weight in ounces

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9
Q

what is the most common fluid or electrolyte disturbance in older adults

A

dehydration

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10
Q

what are common s/sx of dehydration

A

dec urine output
HoTN
constipation
mucosal dryness
confusion
inc body temp

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11
Q

what is dysphagia

A

inability to swallow

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12
Q

what can dysphagia be associated with

A

CVA
CAs
burns
trauma
neuro degen disorders
meds
agitation
weakness

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13
Q

what does dysphagia place the person at risk for

A

aspiration –> aspiration PNA

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14
Q

what are compensatory strategies for dysphagia

A

upright posture 90deg
chin tuck
turn head to weak side
tilt head to strong side
dec rate of eating/drinking
alternate solid w liquid
liquid by spoon

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15
Q

why is a chin tuck a good compensatory strategy for dysphagia

A

helps w opening of esophagus and allowing food/fluid to enter

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16
Q

why would you alternate solid w liquids in dysphagia

A

pushes food down

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17
Q

how does basal metabolic rate change over the lifespan

A

rapid decline from birth to age 20
- gradual decline throughout life

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18
Q

basal energy requirements

A

energy requirements appear proportional to lean body mass

basal energy needs: 1kcal/kg/hr

19
Q

what are anthropometric measures taken to assess nutritional status

A

height
weight
skinfold measures
BMI
functional assessment (ADL/IADLs)

20
Q

why may skinfold measurements not be an accurate anthropometric measure

A

change in ms mass

21
Q

how much weight loss is significant

A

5% in 1 mo w/o effort or explanation
10% over 6mo w or w/o effort

22
Q

protein requirements in older adults

A

0.8g –> 1.5g if under stress
15% of total caloric intake

23
Q

carbohydrate requirements in older adults

A

45-65% of total caloric intake

24
Q

fiber requirements in older adults (M vs W)

A

30g per day in men
21g per day in women

complex carbs are better choices bc will likely include fiber

25
Q

fat requirement in older adults

A

20% of total caloric intake

26
Q

which mineral requirements change w age

A

iron
zinc
b12
vit D

27
Q

how does iron requirements change w age and what is the clinical presentation

A

dec efficiency of iron uptake

see fatigue and weakness

28
Q

clinical presentation of zinc deficiency in older adult

A

dec immune system

29
Q

what can impact B12 requirements in older adults

A

cholesterol
atrophic gastritis

these impact the absorption of B12

30
Q

why does vit D requirements change w age and what is the clinical significance of this

A

dec sunlight and ability to process vit D

important in bone mineralization and immune factors

31
Q

how does calcium requirements change w age

A

inc

32
Q

why is it important to monitor shifts in electrolytes

A

compensation mechanisms are less efficient

33
Q

what can cause dec in K+ and what is the clinical presentation

A

dec w use of diuretics

see ms weakness

34
Q

what is the clinical presentation of phosphate deficiency

A

ms weakness

35
Q

what is hyponatremia and what is its clinical presentation

A

dec serum sodium

weakness
ms cramps

36
Q

what is the clinical presentation of Mg deficiency

A

tremors
ms weakness

37
Q

what is albumin a risk indicator for

A

morbidity and mortality

*lacks sensitivity and specificity as nutritional indicator

38
Q

what is considered low albumin and what is it a prognostic value of

A

<3.5g/dL

more probable as a marker for injury, dz, or inflammation

39
Q

what could prealbumin levels be used for and what is a limitation of this

A

may better reflect short-term changes in protein status (shorter half-life)

largely same limitations as albumin

40
Q

what is cachexia characterized by

A

anorexia
ms wasting
early satiety

41
Q

who is cachexia is commonly seen in

A

alzheimers
CA
end stage renal dz
institutionalized pts

42
Q

what are risk factors for poor nutritional status

A

EtOH or substance abuse
cog dysfunction
dec exercise, sedentary
depression, mental health
functional limitations
limited mobility
inadequate funds
limited ed
med problems, chronic dz
meds
poor dentition
restricted diet
poor eating habits
social isolation

43
Q

what are strategies to prevent undernutrition

A

cater to pt food preferences
avoid restrictive “therapeutic diets” unless clinical value is certain
enhance pts preparedness for meal
enhance comfort, taste, appearance of food
enhance social aspect
provide adequate time
address dental/ oral complaints of chewing discomfort/dysfunction

Lifespan (20 decks)

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