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Geri Ch 10 Nutrition

Terms in this set (21)

Benefits of exercise in the older adult
Exercise is effective in maintaining skeletal muscle mass, and it enhances functional status and fitness levels for aging adults by 10 to 20 years
Physiologic changes in the older adult that affect nutritional status
- Organ function declines with age
- May alter digestion, Metabolism, absorption of nutrients, and the ability to eliminate waste products via the kidneys.
- Tooth loss or ill fitting dentures, mouth dryness, and decreased esophageal motility.
- More frequent gastric and intestinal problems associated with less efficient enzyme function and alterations in the intestinal mucosa
- Delayed gastric emptying, Hiatal herniation, And decreased secretion of gastric juices may cause bloating and discomfort
- Changes in the pH of the gastrointestinal tract may lead to the malabsorption of the B vitamins
Isotonic dehydration
Results from the loss of sodium and water, as during a gastrointestinal illness
Hypertonic dehydration
Results when water losses exceed sodium losses.
It is the most common and may occur from fever or limited fluid intake
Hypotonic dehydration
May occur with diuretic use when sodium loss is higher than water loss
Psychosocial and socioeconomic factors affecting malnutrition
- Food may be sacrificed, specially as a percentage of income required for healthcare rises
- The cost of medication for older adults has significantly compromised many already low income budgets
- Social isolation may be a significant factor contributing to mountain attrition
- Grieving over the loss of a spouse or friends also affect diet quality and intake
Nutritional screening - when it's done
On admit
Components of nutritional assessment
Demographic and psychosocial data
Medical history
Dietary history
Anthropometrics
Medications and laboratory values
Physical assessment
Diet history includes
Number of meals or snacks per day
Chewing or swallowing difficulties
Gastrointestinal problems
Symptoms that affect eating
Oral health and denture use
History of diseases or surgery
Activity level
Use of medications
Appetite
Need for assistance with meals and meal preparation
Food preferences
Allergies and aversions
Food recall
Anthropometrics
Height and weight are the mainstays.
Young-old tend to be overweight
Old-old tend to be underweight
Laboratory values: ALBUMIN
- It is the serum protein most frequently cited in reference to malnutrition.
- It reflects the liver's ability to synthesize plasma protein.
- Half life of about 21 days.
- May be affected by noon status and hydration.
- Less than 3.5 point five g may indicate some degree of malnutrition
Laboratory values: TRANSFERRIN
- It is a carrier protein for iron and has a shorter life of 8 to 10 days.
- It is a more rapid predictor of protein depletion
- Levels below 200 mg mate indicate mild to moderate depletion
- Levels below 100 maY indicate severe depletion
Laboratory values: PREALBUMIN
It is a carrier protein for retinal- binding protein and has a half-life of 2 to 3 days.
It is often used in acute care
Levels below 5 mg/dL are considered reflective of severe protein depletion
My plate focuses on
Emphasizes and stresses that one half of an individual's food plate should be comprised of fruits and vegetables
Minimum of five servings of fruit and vegetables daily
Drug nutrient interactions
* Acetaminophen - liver failure
* Aspirin - all servers and heartburn
* Digitalis - anorexia, Decreased renal clearance
* Coumadin - acts as an antagonist to vitamin K
* Phenytoin - decreased calcium absorption
* All steroids - increased appetite and weight, increased folic acid, Decreased calcium
* Furosemide/ lasix - decreased drug absorption with food, Monitor potassium
* Spironolactone - increased drug absorption with food
* Thiazides - decreased magnesium, zinc, and potassium
Therapeutic diets
Therapeutic diets include those which are restricting sodium (2gr), protein (high) , cholesterol, total calories (restrictions), fat, or gluten (45g carbs for diabetics)
Types of feeding tubes
Enteral tube - a feeding tube is placed below the area of obstruction; feeding tubes may be placed into the stomach or intestine.
Nasogastric tube - placed through the nose
Gastrostomy - directly in the stomach
PEG - placed in the stomach for decompression and simultaneous feeding into the intestine
Jejunostomy - directly into the jejunum
Types of specialized nutrition
Standard - whole protein and complex carbohydrates
Modified protein - peptide
Elemental - amino acids
Dysphagia major complications and how to prevent
Aspiration of liquids or solids may occur and lead to aspiration pneumonia.
Referral to a speech therapist
Thickeners may be added to liquids
Patients must be assisted during meals
Elevate position
Parenteral nutrition PPN what is it and when is it administered?
- Parenteral nutrition (PPN) - intravenous solution that includes dextrose, amino acids, vitamins, minerals, electrolytes, trace elements, and water.
- It is administered through up Central venous catheter, tunneled catheter, peripherally inserted central catheter, or implanted port into a large vein (hypertonic so it's thick)
- It's indicated when the gastrointestinal tract cannot be used for enteral feeding or cannot absorb adequate nutrients to maintain health.
- Severe inflammatory bowel disease, fistula, acute pancreatitis, and massive bowel resection
Failure to thrive is characterized by
The deterioration in biologic, psychological, and social domains, weight loss and a lack of any obvious explanation
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