Nutrition Flashcards
what are 6 reasons that nutrition becomes a problem as you age
- decline in smell and taste -> dec appetite
- dec salivation –> inhibits chewing
- mastication is impaired (dental losses) -> loss of teeth or poorly fitting dentures
- esophageal motility dec
- dec hydrochloric acid in stomach
- postural changes
what are normal age-related physiologic changes that occur in body composition
- dec in lean body mass
- dec in total body protein per ms
- dec in energy metabolism related to dec total protein mass
- dec in total body water
- inc in body fat w dec in fat stores
- loss of bone density
what GI system changes are seen w aging
dec secretion of digestive enzymes and mucus
loss of ms tone in stomach
dec peristalsis
formation of intestinal diverticula
how does kidney function decrease with age
dec renal blood flow
dec glomerular filtration
dec renal tubular function
how does liver function change w age
dec in liver enzymes
- impacts metabolism of carbs and breakdown of drugs and alcohol
- buildup of glucose
why might an aging adult develop DM 2
dec in beta cell function and insulin end-organ responsiveness
-> progressive glucose intolerance
what fluid needs are associated w aging (3)
dec perception of thirst
dec response to serum osmolarity
dec ability to concentrate urine following fluid deprivation
what are the current recommendations for fluid needs of aging adults
30mL/kg/day or 50% of body weight in ounces
what is the most common fluid or electrolyte disturbance in older adults
dehydration
what are common s/sx of dehydration
dec urine output
HoTN
constipation
mucosal dryness
confusion
inc body temp
what is dysphagia
inability to swallow
what can dysphagia be associated with
CVA
CAs
burns
trauma
neuro degen disorders
meds
agitation
weakness
what does dysphagia place the person at risk for
aspiration –> aspiration PNA
what are compensatory strategies for dysphagia
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
why is a chin tuck a good compensatory strategy for dysphagia
helps w opening of esophagus and allowing food/fluid to enter
why would you alternate solid w liquids in dysphagia
pushes food down
how does basal metabolic rate change over the lifespan
rapid decline from birth to age 20
- gradual decline throughout life
basal energy requirements
energy requirements appear proportional to lean body mass
basal energy needs: 1kcal/kg/hr
what are anthropometric measures taken to assess nutritional status
height
weight
skinfold measures
BMI
functional assessment (ADL/IADLs)
why may skinfold measurements not be an accurate anthropometric measure
change in ms mass
how much weight loss is significant
5% in 1 mo w/o effort or explanation
10% over 6mo w or w/o effort
protein requirements in older adults
0.8g –> 1.5g if under stress
15% of total caloric intake
carbohydrate requirements in older adults
45-65% of total caloric intake
fiber requirements in older adults (M vs W)
30g per day in men
21g per day in women
complex carbs are better choices bc will likely include fiber
fat requirement in older adults
20% of total caloric intake
which mineral requirements change w age
iron
zinc
b12
vit D
how does iron requirements change w age and what is the clinical presentation
dec efficiency of iron uptake
see fatigue and weakness
clinical presentation of zinc deficiency in older adult
dec immune system
what can impact B12 requirements in older adults
cholesterol
atrophic gastritis
these impact the absorption of B12
why does vit D requirements change w age and what is the clinical significance of this
dec sunlight and ability to process vit D
important in bone mineralization and immune factors
how does calcium requirements change w age
inc
why is it important to monitor shifts in electrolytes
compensation mechanisms are less efficient
what can cause dec in K+ and what is the clinical presentation
dec w use of diuretics
see ms weakness
what is the clinical presentation of phosphate deficiency
ms weakness
what is hyponatremia and what is its clinical presentation
dec serum sodium
weakness
ms cramps
what is the clinical presentation of Mg deficiency
tremors
ms weakness
what is albumin a risk indicator for
morbidity and mortality
*lacks sensitivity and specificity as nutritional indicator
what is considered low albumin and what is it a prognostic value of
<3.5g/dL
more probable as a marker for injury, dz, or inflammation
what could prealbumin levels be used for and what is a limitation of this
may better reflect short-term changes in protein status (shorter half-life)
largely same limitations as albumin
what is cachexia characterized by
anorexia
ms wasting
early satiety
who is cachexia is commonly seen in
alzheimers
CA
end stage renal dz
institutionalized pts
what are risk factors for poor nutritional status
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
what are strategies to prevent undernutrition
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
