CH 11: Nutrition and Hydration

Question 1

nutrition influences the body’s:

Answer 1

Ability to defend body against disease
Maintain anatomic and structural normality
Think clearly
Absorb and use energy

Question 2

QUANTITY of caloric needs decrease due to…

Answer 2

Older body has less lean body mass with more adipose tissue (doesn’t burn calories quickly)
Metabolic rate declines
Potential low activity level

Question 3

as we age, quality and quantity of nutrition must be:

Answer 3

continuously monitored
need a higher quality of caloric intake

Question 4

fiber requirements

Answer 4

Soluble (oats and pectin): lowers cholesterol, improves glucose tolerance and prevents obesity, CV disease, and colorectal cancer
Insoluble (grains, veggies, fruits): improve bowel activity

Question 5

carb requirements

Answer 5

Good for energy and fiber
Needs to be reduced (high intake of carbs stimulate a high release of insulin  hypoglycemia)

Question 6

protein use

Answer 6

Helps maintain enzyme systems and renew body protein

Question 7

calcium requirements

Answer 7

Maintains musculoskeletal system and blood clotting
Take no more than 500 mg at a time (large amounts don’t absorb well)
Good intake with Vitamin D and magnesium

Question 8

modified MyPlate requirements for older adults

Answer 8

Five servings of fruits and veggies in a variety of ways
Limit foods in trans and saturated fats, salt, and added sugars
Whole grains with vitamins and minerals

Question 9

MyPlate for older adults: nutritional supplements

Answer 9

Common nutrient deficiencies
Excess intake of vitamins and minerals
Drug Interactions

Question 10

special nutrition needs for women

Answer 10

Low-fat intake
Reducing/avoiding alcohol intake
Increased daily calcium intake
Other non-nutritional needs

Question 11

nutrition related conditions

Answer 11

osteoporosis
cancer
heart disease

Question 12

factors effecting nutritional status

Answer 12

Tooth erosion with tooth loss
Decreased saliva production
Increased taste threshold
Decreased thirst sensations and hunger contractions
Weaker gag reflex
Decreased peristalsis
Less HCl, pepsin, and pancreatic acid production
Less efficient cholesterol stabilization
Increased fat content
Decreased pancreatic enzymes

Question 13

hydration in older adults

Answer 13

Intracellular fluid is lost  decreased total body fluids
Fluid loss + decreased fluid intake = life-threatening dehydration
Older adults more sensitive to overhydration from decreased cardiac and renal function
Age-related decline in body fluids reduces the margin of safety due to insufficient fluid consumption or extra fluid that is lost!
Monitor fluid intake and output

Question 14

s/s of dehydration in older adults

Answer 14

dry inelastic skin
dry-brown tongue
sunken cheeks
concentrated urine
BUN >60
confusion

Question 15

age related factors for dehydration

Answer 15

Age-related reductions in thirst sensation
Fear of incontinence
Lack of accessible fluids
Fluid restrictions based on medical history
Inability to obtain or drink fluids independently
Lack of motivation
Altered mood or cognition
Nausea, vomiting, and GI disorders/distress

Question 16

oral health for odler adults

Answer 16

Dental care in early years affects later years
Poor dental care + environmental influences + inappropriate nutrition + changes in gingival tissue = tooth loss

Question 17

s/s of periodontal disease

Answer 17

bleeding gums
red/swollen/painful gums
pus at gums
chronic bad breath
loosening of teeth from gums

Question 18

interventions and education for oral health

Answer 18

Use a toothbrush, not swab
Aging does NOT equal tooth loss
Explore the reasons why the client has not seen a dentist (if applicable)
Diluting commercial mouthwash with water
Extract loose teeth
Daily flossing
Denture care, regular wear of dentures, do not wear poorly fitted dentures
Good regular dental care at ALL ages

Question 19

Common due to decreased stomach motility, less gastric secretion, and decreased gastric emptying time
Older adults may decrease food intake or use antacids _ could cause more issues

Answer 19

indigestion and food tolerance

Question 20

interventions for indigestion and food intolerance

Answer 20

6 Small meals
Eliminate specific foods
Sitting up 30 min after meals
Adequate fluid intake and activity

Question 21

Due to neuro conditions and GERD

Answer 21

dysphagia

Question 22

contributing factors for dysphagia

Answer 22

onset
types of foods
consistent or periodic occurrences
symptoms of complications

Question 23

interventions for dysphagia

Answer 23

Speech pathologist
Aspiration precautions
Tilt head and place food on a particular part of the tongue

Question 24

reasons for anorexia

Answer 24

medication side effects
inactivity
physical illness
age-related changes
mood

Question 25

interventions for anorexia

Answer 25

Identify cause
High-calorie diet
Tube feeding vs. Hyperalimentation
Psych referral and therapy
Meds for appetite stimulant
Monitoring intake, output, and weight

Question 26

reasons for constipation

Answer 26

decreased peristalsis
inactivity
medication side effects
decreased fiber and fluid

Question 27

interventions for constipation

Answer 27

Diet (fluids and fiber; bananas, prunes, carrots, oatmeal)
Activity
Meds (only after other measures are unsuccessful; senna most common)
Toilet schedule

Question 28

causes of malnutrition

Answer 28

From age-related changes
meds
socioeconomics
eating patterns

Question 29

s/s of malnutrition in older adults

Answer 29

Weight loss >5% in month; >10% in 6 months
Weight 10% below or 20% above ideal
Serum albumin <3.5
H/H < 12/35
Delirium, lethargy, fatigue
Depression
Visual disturbances
Dermatitis and hair loss
Pallor
Delayed wound healing

Question 30

interventions for malnutrition

Answer 30

Services (Meals on Wheels, SNAP, home health aides, counseling, meal prep and shopping services)
Encourage friends and family to bring treats
Multidisciplinary collaboration
Nutritional assessment
Consider ethnic, social, and religious factors
Respect dietary restrictions and tolerances