Chapter 9 Nutri N Hydration

CHAPTER 9
NUTRITION AND HYDRATION

OBJECTIVES
Discuss nutritional requirements and factors affecting nutrition for
older adults
Describe a nutritional screening and assessment
Identify interventions that promote adequate nutrition and hydration for
older adults
Discuss assessment of and interventions for older adults with dysphagia
List interventions that promote good oral hygiene for older adults
Develop a plan of care to assist an older person in developing and
maintaining adequate nutrition and hydration
MOSBY ITEMS AND DERIVED ITEMS © 2014, 2010, 2005 BY MOSBY, INC., AN IMPRINT
OF ELSEVIER INC. 2
NUTRITION
The key element is preserving the health of

older adults.
The quality and quantity of a diet will help
prevent, delay the onset of, and manage
chronic disease processes.
MOSBY ITEMS AND DERIVED ITEMS © 2014, 2010, 2005 BY MOSBY, INC.,
AN IMPRINT OF ELSEVIER INC.
3
OLDER ADULT NUTRITIONAL
CONCERNS
Generally, older adults need fewer calories than
younger adults.
Limit saturated fat and trans fatty acids.
Protein consumption in older adults is usually
compromised.
Fiber-content foods are lacking in the diet of older
adults.
Vitamin intake is generally good for older adults; they
should increase the consumption of the crystalline
form of vitamin B12.
4
OBESITY
Usually, the older adult is viewed as

underweight and frail; however, the concern
of obesity in older adults is increasing.
Maintaining weight is a clinical
recommendation.
Weight loss in older adults needs further
investigation.
5
MALNUTRITION
Malnutrition is a state in which a deficiency, excess, or
imbalance of energy, protein, and other nutrients causes
adverse effects on body form, function, and clinical
outcomes.
Between 16% and 30% of older adults are malnourished.
Many older adults have protein levels consistent with
malnutrition.
Malnutrition consequences include infections, a delayed
healing process, pressure ulcers, anemia, hypotension,
impaired cognition, hip fractures, and increased mortality
and morbidity.
6
REASONS FOR MALNUTRITION
Age-associated changes occur in taste and smell.

Digestive system is slow as a result of pathological
conditions.
Aging teeth are worn, making eating difficult.
Saliva is reduced, and a dry mouth is common.
7
APPETITES OF OLDER ADULTS
Appetites are influenced by physical activity,

functional limitations, smell, taste, mood,
socialization, and comfort.
Healthy older people are less hungry and more full
before meals.
Older adults:
Consume smaller meals at a slower pace.
Eat fewer snacks.
Become satisfied more rapidly.
8
LIFELONG EATING HABITS
Are developed out of tradition, ethnicity, and

religion.
The older adult may be isolated from social events
during which food is provided.
Effects of medications and/or a disease process
may cause a disinterest in food.
Excessive drinking decreases eating habits.
9
INFLUENCES ON NUTRITION
Chronic conditions such as heart failure and
chronic obstructive pulmonary disease (COPD)
Side effects of medications
Poverty
Limited transportation to the grocery store
Inability to prepare meals
Financial factors that influence the choice of foods
10
HOSPITALIZATIONS AND LONG-
TERM RESIDENCY AFFECTING
NUTRITION
Compromised ability to feed self
Lack of interest in eating
Inadequate staffing members who do not allow enough
time for feeding the slower eater
Restrictive diets or complaints of the taste of food
Environment in which the patient eats
Dementia
11
IMPLICATIONS FOR
GERONTOLOGICAL NURSING
AND HEALTHY AGING
Need for nutritional screening and assessment of
client’s ability to eat
Tools to evaluate nutrition in older adults
Mini Nutritional Assessment (MNA)
Minimum Data Set (MDS)
Twenty-four-hour dietary recall
Three-day dietary history
12
OBSERVABLE PHYSICAL
EXAMINATION DATA RELATED TO
NUTRITION
Nutritional data consists of:
Height and weight
Vital signs
Condition of tongue, lips, and tongue
Skin turgor, texture, and color
Functional abilities
Overall appearance
Anthropometrical measurements
13
BIOCHEMICAL MEASUREMENTS
 Measurements in the nutritional assessment

include:
 Complete blood count  Urinalysis
 Total lymphocyte count  Serum albumin
 Thyroid level  Cholesterol
 Comprehensive  Hemoglobin
metabolic panel  Serum transferrin
 Liver function tests
AN IMPRINT OF ELSEVIER INC. 14
INTERVENTIONS TO INCREASE
FOOD INTAKE
Nutrition education
Medication that stimulate appetite (orexigenic
drugs)
Hydration management
Continued oral health care
15
ASSESSMENT OF HYDRATION
Signs and symptoms of dehydration include:

 Vomiting, diarrhea, febrile episodes
 Volume deficits
 Weight loss
 Malnutrition
 Infections
 Dry mucous membrane
 Delayed return in skin turgor
 Increased blood urea nitrogen (BUN)
 Dark urine
 Dysphagia
AN IMPRINT OF ELSEVIER INC. 16
INTERVENTIONS FOR
DEHYDRATION
Oral hydration
 Mild to moderate dehydration
 Individuals who can drink
 Individuals who do not have mental or physical
compromise
 Water is the best fluid to offer
 Other clear fluids may also be useful
Intravenous therapy
 Replace 50% of loss within first 12 hours
Hypodermoclysis (HDC)
17
DYSPHAGIA IN THE OLDER
ADULT
Goal is to maintain nutritional status through the
functional ability to swallow safely.
Aspiration is the most dangerous complication
with someone who suffers with dysphagia.
Feeding tubes assist with nutrition in the older
adult.
18
ASSESSMENT OF DYSPHAGIA
Assessment
Observe client during mealtime
Identify risk factors
Determine risk for aspiration
Referral to speech-language pathologist for
comprehensive evaluation
19
ORAL CARE OF OLDER ADULTS
Regular examinations
Impaired manual dexterity, possibly inhibiting
ability to brush teeth
Ultrasonic tooth brush
Oral mucosa
Dentures
20
IMPLICATIONS FOR
GERONTOLOGICAL NURSING
AND HEALTHY AGING
Nutritional health is important for:
Biological needs
Cognitive abilities
Independence
Self-esteem
21
REFERENCES
Touhy, T.A., & Jett, K.F. (2014). Ebersole and

Hess' Gerontological Nursing & Healthy Aging
(4th ed.). St. Louis, Elsevier.
Touhy & Jett Powerpoint
www.youtube.com
www.consultgerirn.org
MOSBY ITEMS AND DERIVED ITEMS © 2014, 2010, 2005 BY MOSBY, INC., AN IMPRINT
OF ELSEVIER INC. 22

Chapter 9 Nutri N Hydration

Uploaded by

Document Information

Original Title

Copyright

Available Formats

Share this document

Share or Embed Document

Sharing Options

Did you find this document useful?

Is this content inappropriate?

Copyright:

Available Formats

Chapter 9 Nutri N Hydration

Uploaded by

Copyright:

Available Formats

CHAPTER 9

NUTRITION AND HYDRATION

The key element is preserving the health of

Usually, the older adult is viewed as

Age-associated changes occur in taste and smell.

Appetites are influenced by physical activity,

Are developed out of tradition, ethnicity, and

 Measurements in the nutritional assessment

Signs and symptoms of dehydration include:

Touhy, T.A., & Jett, K.F. (2014). Ebersole and

You might also like