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Ch. 15
study guide questions
Question | Answer |
---|---|
The six basic nutrients | Water, proteins, fats, vitamins, minerals and Carbohydrates (complex/simple) |
Proportions of the plate | fruits, grains, vegetables, protein, and dairy |
Nutritional problems of the elderly or ill | slower metabolism, loss of vision, weakened sense of smell and taste, less saliva, dentures, tooth loss, or poor dental health, less efficient digestion, and use of certain medications. |
Causes of Unintentional Weight Loss | People who are lonely or who suffer from illnesses that affect their ability to chew and swallow, weaker hands and arms due to paralysis and tremors, people with illnesses that affect their ability to chew and swallow, also people who are ill, fatigued, n |
Fluid Restricted Diet | Severe heart disease and Kidney disease. When fluid intake is greater than fluid output, Need to measure and document exact amounts of fluid intake, report to nurse. Ice cream, gelatin, and pudding are also restricted foods. |
Low Sodium Diet (low na) | residents with high blood pressure, heart disease, kidney disease, or fluid retention. No salt |
High Potassium diet( K+) | When taking BP meds and diuretics for residents whose fluid volume reduces. Foods: Bananas, grapefruits, oranges/juice, prunes/juice, dried apricots, rasins, figs, cantaloupes, tomatoes, potatoes w/ skins, sweet potatoes/yams, winter squash, legumes, avo |
Low Protein diet | Kidney disease. (depends on stage of disease/ whether on dialysis or not) Protein is restricted because it breaks down into compounds that may cause further kidney damage. Vegetables and starches: breads and pastas are encouraged. |
Low fat/ low cholesterol diet | High levels of cholesterol; risk for heart attack and heart disease, gallbladder disease, diseases that interfere with fat digestion, and liver disease. Eat lean cuts of meat, limit egg yolks, avoid organ meats, shellfish, fatty meats, cream, butter, lard |
Modified calorie diet | to lose weight or prevent gaining weight. Some may need to gain weight due to malnutrition, surgery, illness or fever |
Bland diet | Gastric and duodenal ulcers can be irritated by foods that increase levels of acid in the stomach. Or intestinal disorders (IBS) avoid caffeinated drinks, spicy food, seasonings, 3 meals or more are usually advised. |
Diabetic diet | People w/ diabetes. Dietitians will make a meal plan with the resident/person. carb counting, meal planning, must eat all that is served for glucose levels, should avoid sugary foods. |
Low-Residue (low fiber) diet | decreases the amount of fiber; whole grains, raw fruits and veggies, seeds, and other foods such as dairy and coffee. For people with bowel disturbances. |
High residue (high fiber) diet | People with constipation and bowel disorders. Increase the intake of fiber and whole grains. Foods include: whole grain cereal, bread, and raw fruits and veggies. |
Gluten-free diet | People for Celiac disease, disorder that can damage the intestines if gluten is consumed. Foods with: wheat flour, tortillas, crackers, breads, cakes, pastas, and cereals are eliminated. Also beer, hot dogs, candy, broths, and meds. |
Vegetarian Diet | Choose to be a vegetarian or certain issues. pg. 265 |
Liquid diet | Usually ordered for a short time for medical conditionor after surgery. Residents needs to keep intestinal tract free of food. Foods that are liquid, clear or full. Clear foods, or cream soups, milk and ice cream |
Soft diet and Mechanical Soft diet | |
Pureed diet | People who have trouble swallowing and chewing. To chop, blend or grind into baby food consistency. Should be thick enough to hold its form in the mouth, does not require person to chew food. |
Thickened Liquids and the Consistency (3) | Residents with swallowing problems. 1. Nectar 2. Honey 3. Pudding 1. thicker than water, thick juice. 2. pours very slowly and the consistency of honey uses a spoon. 3. Liquids have become semi-solid Consume with a spoon |
How can the CNA make dining enjoyable? | assist with grooming/ hygiene before dining, give oral care, offer a trip to bathroom, help wash hands, encourage the use of dentures, eyeglasses, and hearing aids, check environment (temp, odors, sounds), seat next to friends, properly position. |
Dining enjoyable cont' | serve food promptly, plates and trays should look appetizing, give resident proper eating utensils, be cheerful/positive, honor requests |
How to assist resident with eating, and those with special needs | make sure you have the right resident by checking diet card, sit at residents eye level, allow time for prayer if resident wishes, never treat them like a child, test the temp with your hand over plate, cut foods/pour liquids, identify foods in front. |
how to assist resident with eating cont' | ask the resident which food he prefers to eat first, don't mix foods unless asked, don't rush the meal, be social/friendly, give full attention, alternate offering food & drink, if they want a different meal inform dietitian. |
assist resident with special needs while eating | use assistive devices: utensils, help maintain independence with eating, verbal cues must be short and clear, use the face of an imaginary clock to explain position to visually impaired residents. |
special needs while eating cont' | residents with stroke, paralyzed or weaker side, place food on the stronger part of the mouth, place food in residents field of vision, help by using physical cues for residents with parkinson's , poor eating balance sit him in reg dining chair w/ armrest |
special needs cont' | poor neck control a neck brace can be used to stabilize the head, bites down on utensils ask to open their mouth & pull out, pockets food ask to chew and swallow food, holds food in mouth ask to chew and swallow food. |
Signs of swallowing problems (dysphagia) | coughing during or after meals, choking during meals, dribbling saliva, food, or fluid intake from the mouth, having food residue inside mouth or cheeks during and after meals, gurgling during or after meals or losing voice, eating slowly, avoiding eating |
swallowing problems cont' | spitting out pieces of food, swallowing several times per mouthful, clearing the throat frequently, watering of the eyes, food or fluid coming up into the nose, making a visible effort to swallow, breathing rapidly or w/ shorter breaths, diff chewing food |
How to prevent aspiration | |
Explain Intake and Output (I&O) | The body must take in a certain amount of fluid each day, a healthy person needs up to 64-96oz's of fluid each day. The fluid cannot remain in the body it must be eliminated as output. |
How to prevent Dehydration | encourage residents to drink overtime you see them, offer fresh water often or other fluids, ice chips, frozen flavored ice sticks, offer sips of liquid between bites of food, make sure pitcher and cup are near enough and light enough to lift, offer assis |
symptoms of dehydration | drinking less than six 8oz glasses of liquid per day, drinking little or no fluids at meals, needing help drinking from a glass, having trouble swallowing liquids, having frequent vomit/ diarrhea/ fever, easily confused/ tired, dry mouth, cracked lips |
symptoms of dehydration cont' | sunken eyes, dark urine, strong smelling urine, weight loss, and complains of abdominal pain. |
Symptoms of fluid overload | swelling/edema of extremities, weight gain, decreased urine output, shortness of breath, increased heart rate, skin that appears tight, smooth, and shiny. |