TOPIC 5: DIGESTION & NUTRITION
A daughter caring for her older father calls the nurse, stating she is concerned about her father's chronic bat and stubborn plaque on his teeth. Which teething cleaning measure should the nurse recommend for this older client?
"AN ACTUAL TOOTHBRUSH IS MOST EFFECTIVE WHEN GIVING ORAL HYGINE"
A nurse assesses older adults at a senior center. One older adult has a body mass index (BMI) of 15. Which response by the nurse is appropriate?
"HAVE YOU BEEN LOSING WEIGHT?"
The nurse instructs a client with a hiatal hernia. Which statement indicates that teaching has been effective?
"I NEED TO STOP DRINKING COFFEE"
The nurse instructs a client with a hiatal hernia. Which statement indicates that teaching has been effective?
"I NEED TO STOP WITH THE COFEE"
An older client asks why he has two normal bowel movements within 30-45 in the morning. Which of the following is the best response?
"INCOMPLETE EMPTYING OF THE BOWEL IS EXPECTED WITH AGE."
An older client is concerned about bleeding gums when brushing teeth. What should RN respond to client?
"IT COULD MEAN YOU HAVE THE BEGINNING OF PERIODONTAL DISEASE"
The adult child of an older client with stomach cancer asks what can be done to prevent the development of the disease. What should the nurse respond to this family member?
"LIMIT THE INTAKE OF RED MEAT"
A nurse teaches older adults about nutrition. Which statement shows the nurse that the older adult requires further teaching?
"MY OVER-THE-COUNTER BETA-CAROTENE PILL IS APPROPRIATE FOR LONG-TERM USE."
A client experiencing constipation asks which laxative should be used. What should the nurse respond to this client?
"SENNA IS A NATURAL LAXATIVE THAT IS AVAILABLE IN TABLETS OR TEA"
An older adult states, "I just feel so full so fast, I can't eat any more." Which response is most appropriate?
"SLOWER EMPTYING OF YOUR STOMACH MAY BE THE CAUSE"
An older client asks if it is "normal" to have to move the bowels twice within the same hour. What should the nurse respond to this client?
"THIS IS A NORMAL AGE-RELATED CHANGE."
The nurse is interviewing an older client's nutritional status. Which question should the nurse use to assess the client's diet?
"WHAT FOODS DO YOU EAT IN A TYPICAL DAY?"
A 78-year-old female states she eats 3 full servings of fruits and vegetables per day. What is the nurse's best response?
"YOU SHOULD INCORPORATE AT LEAST 2 MORE SERVINGS INTO YOUR DIET"
An older client has just been fitted with new dentures. What should the nurse emphasize when teaching about the care of dentures?
- CLEAN DENTURES EVERY DAY - SOAK DENTURES IN WATER - REMOVE DENTURES AT NIGHT - CLEAN GUMS BEFORE APPLYING THEM
The nurse is caring for an older adult who is experiencing frequent episodes of constipation. When assessing the client, the nurse should consider what potential contributing factors? Select all that apply.
- INACTIVTY - SLOWER PERISTALSIS - ADVERSE EFFECTS OF MEDS - REDUCED FOOD INTAKE
A client weighs 176lbs. How many grams of protein should nurse instruct him to ingest per day?
80 GRAMS (at least 1g protein per kg of weight)
The health care provider strongly suggests that an older female client increase the daily intake of fluids to 2.7 liters per day. When instructing the client on this amount, how many ounces of fluid should the nurse instruct the client to consume each day?
90 OUNCES (2.7L x 1000 = 27000mL/30mL (1oz)=90)
A RN admits an older client to the hospital with a diagnosis of failure to thrive. Which lab data should the nurse expect?
ALBUM 2.8 mg/dL and RBCs 4.1 cells/mcL
The nurse suspects that an older client's diarrhea is related to medications. Which medication should the nurse consider as causing this client's problem?
AMPICILLIN
An older client experiences heartburn, belching, and regurgitation. Which diagnostic test should the nurse anticipate being prescribed for this client?
BARIUM SWALLOW
A 60yo client asks why it is so easy to gain weight, but difficult to lose. What should the nurse respond to this client?
BASAL METABOLIC RATE DECLINES BY 2% FOR EACH DECADE OF LIFE AFTER AGE 25
During a phys exam the RN suspects that an older client has a NIACIN deficiency. What finding caused the nurse to make this clinical decision?
BROWNISH PIGMENTATION (pallor=anemia,purpura=vitCdef,dermititis=zincdef)
An older adult states she began taking the herb feverfew along with her daily low-dose aspirin. The nurse should closely assess for which possible effect of a herb-drug interaction?
BRUISING
The RN reviews the vitamins supplements that an older client takes daily. Which supplement should the RN recommend that the client alter the dosage?
CALCIUM 1200mg (if calcium is used, no more than 500mg at a time)
The nurse notes that an older client appears pale. Which action should the nurse take to determine if the pallor is caused by a gastrointestinal problem?
CHECK FOR BLOOD IN THE STOOL
The RN notes that an older client is schedule for extracorporeal shock wavev lithotripsy. For which health prob is this treatment indicated?
CHOLELITHIASIS
The nurse notes that an older client is scheduled for extracorporeal show wave lithotripsy. For which health problem is this treatment indicated?
CHOLELITHIASIS
An older male who consumes an excessive amount of calcium reports lower, right-sided abdominal pain. What should be the nurse's first action?
COLLECT A URINE SPECIMEN
A client has a stricture where the esophagus meets the stomach. For which type of dysphagia should the nurse plan care for this client?
DELIVERY (difficulty moving food from esophagus to stomach // transfer - food from mouth to esophagus // transport - food down the esophagus)
The nurse suspects that an older client is having problems with eating. What assessment finding caused the nurse to make this clinical determination?
DENTURES IN A GLASS OF WATER IN THE BATHROOM
After reviewing a client's list of meds the RN asks if the client ever experiences a dry mouth. Which med on the list caused the nurse to ask this question?
DIURETIC
An older client asks for an antacid AFTER eating dinner. What should nurse suggest to client?
EAT SMALLER MEALS SEVERAL TIMES A DAY
An older client with a weight loss of 7kg the last month asks what can be done for constant hiccuping. Which health problem should the nurse suspect this client is experiencing?
ESOPHAGEAL CANCER
An older client asks what can be done to enhance sleep and eliminate a naggin headache that comes on towards the end of the day. Which herb should the RN suggest that the client limit the intake?
GREEN TEA (can cause insomnia and headaches)
An older client, who states he recently started herbal therapy, complains of losing weight and has a loss of appetite. Which herb should the nurse suspect might be the cause of anorexia?
GREEN TEA (too much = anorexia)
During a phys exam the RN notes flaccid skin around the entrance to an older client's anus. What should RN suspect is occurring with client?
HEMORRHOIDS
During a physical exam the nurse notes flaccid skin around the entrance to an older client's anus. What should the nurse suspect is occurring with client?
HEMORRHOIDS
A nurse teaches a health education class for older adults about constipation. Which point should the nurse stress?
IF OLDER ADULTS NEED A MED TO PROMOTE BOWEL IRREGULARITY, A BULK-FORMING AGENT IS NEEDED DAILY.
An older adult who lives alone without air conditioning during the summer months is admitted and diagnosed with dehydration. Which assessment finding does the nurse expect to see with this condition?
INCREASED CREATININE
The nurse is concerned that an older female client is at risk for developing breast cancer. What assessment finding caused the nurse to have this concern?
INGESTS 2-16os CANS OF BEER EACH EVENING
An older client is concerned about bleeding gums when brushing the teeth. What should the nurse respond to this client?
IT COULD MEAN YOU HAVE THE BEGINNING OF PERIODONTAL DISEASE
The nurse is teaching a class to older adults about oral health practices. What teaching should the nurse include for this client population?
LEMON-GLYCERIN SWABS SHOULD BE AVOIDED AS THEY DRY THE MUCOSA AND ERODE TOOTH ENAMEL
A client does not understand why the blood calcium level remains low despite taking the prescribed amount of calcium supplement each day. For which other nutrient should the nurse assess if this client is ingesting?
MAGNESIUM
The nurse notes that an older client experiencing weight loss has several missing teeth and the remaining ones have evidence of gum erosion. Which nursing diagnosis should the nurse select to address these findings?
NUTRITIONAL DEFICIENCY RELATED TO LIMITED ABILITY TO CHEW FOODS
A client with colorectal cancer is scheduled for a colon resection. What teachings should the nurse prepare for this client?
OSTOMY CARE
An older adult states he has been having heart palpitations ever since he added a vitamin and nutrient supplement to his diet. Which vitamin or nutrient should the nurse assess for on the label of the client's supplement?
POTASSIUM
The nurse is assessing a client's gastrointestinal system. Which approach should the nurse use to determine the status of the client's vagus nerve?
PRESS A TONGUE DEPRESSOR ON THE TONGUE AND CLIENT SAYS "AHHHHHHHHHH"
A nurse manager of the long-term care facility develops plans to reduce nutritional deficits. Which intervention is appropriate to include in the plan?
PROMOTE ORAL CARE FOR RESIDENTS MULTIPLE TIMES A DAY
A nurse notes that an older client has difficulty swallowing a bolus of food when eating. Which suggestion should the nurse make to the HCP upon this observation?
REFERRAL FOR A SPEECH-LANGUAGE PATHOLOGIST
An older adult develops diarrhea. Which is the priority intervention for the nurse?
REVIEW THE CLIENT'S MED LIST
A nurse teaches older adults about nutrition. Which statement shows the nurse that the older adult requires further teaching?
RISK OF ASPIRATION
A client's family brings their older female family member to the emergency department, stating, "She is not eating well." The nurse should assess for which sign of malnutrition?
SERUM ALBUMIN LEVEL 2.7g/100mL
An 88yo client asks the nurse why she is prone to chronic constipation. The nurse should explain what age-related physiological change?
SLOW PERISTALSIS
An older adult states, "I just feel so full so fast, I can't eat any more." Which response is MOST appropriate?
SLOWER EMPTYING OF YOUR STOMACH MAY BE THE CAUSE
An older client presents with decreased skin turgor; a brown, dry tongue; sunken cheeks; concentrated urine; and a blood urea value of 70mg/dL. Based on these findings, the nurse should also assess for which priority problem?
SODIUM & POTASSIUM IMBALANCES
An older client does not like to drink water and drinks only a few cups of tea each day. What should the nurse suggest the client ingest to increase this client's intake of fluids?
SOUP
The nurse observes nursing assistive personnel provide mouth care to an older client. For which observation should the nurse intervene?
SWABBED THE LOWER BACK MOLARS WITH LEMON-GLYCERIN SWABS
A nurse evaluates the plan of care for a client who experienced an ischemic stroke. Which assessment finding should signal the nurse to the possibility that the client has developed dysphagia?
THE CLIENT POCKETS FOOD IN THE AFFECT CHEEK DURING MEALS
An older client with controlled chronic illness has no interest in eating and is losing weight. What should RN assess first?
THE REASON FOR NO INTEREST IN EATING
An older client has esophageal dysphagia. What intervention should the nurse plan for this client?
THICKEN LIQUIDS (eases swallowing)
An older client says food does not taste the same as it used to. What should the RN consider this client is experiencing?
TONGUE ATROPHY
The nurse is teaching a class to older adults about oral health practices. What health promotion activity should the nurse recommend?
VISIT A DENTIST EVERY 6 MONTHS TO DETECT ORAL DISEASES
The nurse analyzes an older client's routine eating plan for vitamin consumption. On which vitamin should the nurse focus when doing this analysis?
VITAMIN B (vitB6 is one of the most common nutrients found to be deficient in older adults)
A health care provider has prescribed a calcium supplement for an older adult. Which other important nutrient should the nurse teach the client to eat to promote calcium absorption?
VITAMIN D & MAGNESIUM
An older client with a Hx of DVT should be taught to avoid excessive intake of which vitamin or nutrient?
VITAMIN K
An older adult client reports that he often experiences "indigestion" after each fatty foods. He states that this never used to happen to him when he was younger and asks the nurse why this is now the case. What is the nurse's best response?
WITH AGE, REDUCED PANCREATIC SECRETIONS CAN AFFECT THE DIGESTION OF FATTY FOODS