Chapter 13: Nutrition for Older Adults
D
A 68-year-old man who has steadily gained excess weight over the years complains that it is too late for him to make any changes in diet or exercise that would effectively improve his health, particularly the arthritis he has in his knees. Which of the following would be the nurse's best response? a. "You're right. You should have made changes long ago. You cannot benefit from a change in diet and exercise now." b. "It is too hard for older people to change their habits. You should just continue what you've been doing and know that it's a quality of life issue to enjoy your food." c. "It may not help to change your diet and exercise, but it certainly wouldn't hurt. Why don't you give it a try and see what happens? d. "It is not too late to make changes, and losing weight through diet and exercising are more effective at relieving arthritis pain than either strategy is alone. And older people often are better at making lifestyle changes than are younger adults."
D
A 71-year-old female client has functional limitations, in part caused by obesity. The nurse is discussing the need to lose weight with this client but she is not receptive to the idea. What is one reason this woman might have for not agreeing with the suggestion to lose weight? A) The client feels that losing weight can cause a strain on the body. B) The client feels that she would feel worse if she lost weight. C) The client does not feel that her weight impedes her functionality. D) The client does not feel the need to make changes at this point in her life.
A
A 79-year-old client has been admitted to a long-term care facility that follows a liberal diet approach. The family is concerned that this will hurt the client due to a long history of high cholesterol and desire a low-cholesterol diet. How might the nurse respond? A) Malnutrition is a greater threat than hypercholesterolemia. B) The client is too old to worry about it now. C) The facility does not offer specialized, individual diet options. D) If the cholesterol hasn't gone down yet,
A
A client complains that she is not eating any more than she did when she was 30 years old and yet she keeps gaining weight. Which of the following would be the nurse's best response? a. "As people get older, they lose muscle mass, which lowers their calorie requirements, and physical activity often decreases too. You can increase the number of calories you burn by building muscle with resistance exercises and increasing your activity." b. "You may not think you are eating more calories but you probably are because the only way to gain weight is to eat more calories than you burn." c. "Weight gain is an inevitable consequence of getting older related to changes in your body composition. Do not worry about it because older people are healthier when they are heavier." d. "You need fewer calories now than when you were 30. The only way to lose weight is to eat less than you are currently eating."
A
A client is trying to understand where cheese fits into the MyPlate for Older Adults. The nurse explains that according to this plan, cheese is in which section? A) Protein B) Milk C) Dairy D) Fat
B
A mineral likely to be consumed in inadequate amounts by older adults is a. Iron b. Potassium c. Zinc d. Sodium
B
Arthritis is a leading cause of functional limitation among older adults. Osteoarthritis (OA) is the most common form of arthritis. What is the greatest known modifiable risk factor of OA of the knee? A) Nutritional deficiency of folic acid B) Overweight C) Moderately inactive lifestyle D) Inadequate intakes of calcium
decrease
Calorie needs ______ with age.
C
Dehydration can be a concern in the elderly population. The modified MyPlate for Older Adults recommends eight glasses of water per day. What is the AI for water for a 65-year-old male? A) 1.7 L/day B) 2.7 L/day C) 3.7 L/day D) 4.7 L/day
C
For a long-term care resident, a restrictive diet could decrease quality of life. When should restrictive diets be used in long-term care facilities? A) When a resident has decreased intake and weight loss B) For hospice care C) When a significant improvement in health can be expected D) For one week a month
half
Intake surveys consistently show that older adults consume approximately _____ the recommended amount of fiber.
loss of apetite
Is a key indicator for malnutrition
Anorexia of Aging
Is a term used to describe the natural decrease in food intake that occurs even in healthy older adults in response to a decrease in physical activity and metabolic rate.
Alzheimer's disease
Is the most common form of dementia among older adults
D
It has been established that many people over 50 years have low serum levels of vitamin B12. Where is it recommended that older adults get most of their vitamin B12 from? A) Citrus fruits and juices B) Red meats C) Milk and dairy products D) Fortified cereals
Osteoporosis
It is a disease characterized by a decrease in total bone mass and deterioration of bone tissue, which leads to increased bone fragility and risk of fracture.
Aging
It is a gradual, inevitable, complex process of progressive physiologic, cellular, cultural, and psychosocial changes that begin at conception and end at death.
Obesity
It is a major cause of preventable disease and premature death.
Osteoarthritis (OA)
It is associated with aging and normal "wear and tear" on joints
sarcopenia
It occurs when age-related loss of skeletal muscle mass is accompanied by loss of muscle strength and function.
Arthritis
Leading cause of disability
C
Magnesium is one of the nutrients that older adults often do not get enough of. What are the recommended sources of magnesium for the elderly? A) Fruit juices B) Carrots C) Yogurt D) Potatoes
D
Most recommended levels of intake for vitamins and minerals do not change with aging. An exception to this is the recommended dietary allowances of vitamin D, which are higher in adults over age 50 years. What causes the body's need for vitamin D to increase over the age of 50 years? A) The ability to absorb calcium, which decreases with age B) The potential risk for coronary heart disease, which uses vitamin D C) The increased consumption of coffee and tea interferes with vitamin D synthesis D) The ability to synthesize vitamin D from sunlight, which decreases with age
A
Nutrition therapy in the elderly has different goals than at other times across the lifespan. What is a primary goal of diet intervention for the elderly? A) Maintain quality of life B) Prolong life C) Prevent the development of complications D) Treat chronic disease
C
Older adults doing resistance exercises to rebuild lost muscle may also need to increase their intake of what nutrient to achieve their objective? a. Calories b. Carbohydrates c. Protein d. Iron
D
Older adults need adequate protein in their diet. What are the approximate protein needs per day for an older adult weighting 132 pounds (60 kg)? A) 24 g/day B) 36 g/day C) 44 g/day D) 48 g/day
C
Osteoarthritis (OA) is a disease that predominantly plagues the elderly. What can weight loss do for older people with OA? A) It has no effect on arthritis symptoms. B) It aggravates arthritis symptoms. C) It relieves symptoms in the weight-bearing joints. D) It relieves symptoms throughout the body.
calcium and vitamin D
Osteoporosis prevention begins early in life with an adequate intake of _____ and _____
A
Over the age of 50 years, the body needs a higher intake of vitamin D. What is a good source of the vitamin D needed by older adults? A) Fortified milk B) Green leafy vegetables C) Lean red meats D) Nuts
B
Quality-of-life issues are a priority in the elderly, especially in residents of long-term care facilities. What are the key components in meeting quality-of-life standards among older adults who are residents of long-term care facilities? A) Prevention of depression and diabetes B) Prevention of unintentional weight loss and pressure ulcers C) Prevention of weight gain and hyperlipidemia D) Prevention of low albumin and anorexia
0.8g/kg body weight
RDA for protein for both men and women from the age 19 years on.
B
Sarcopenia is the loss of muscle mass and strength. It is related to a sedentary lifestyle and less than optimal diet. It is a process that begins in the fourth and fifth decades of life. This loss of muscle mass can be halted or reversed with which of the following? A) Aerobic exercise B) Strength-training exercises C) A high-protein diet D) A high-protein diet, high-calorie diet
B
The best dietary advice for the possible prevention of Alzheimer disease is to a. Consume a high-fiber diet. b. Eat a heart healthy diet of fruits, vegetables, whole grains, and seafood. c. Take a multivitamin every day. d. Avoid foods with a high glycemic index.
B
The intake of adequate nutrients is a recommendation to reduce the risk of nutrition-related concerns across the lifespan. Obesity impacts quality of life in the elderly. Along with weight reduction, what vitamins are recommended to help with bone health? A) Vitamin B12 B) Vitamin C C) Vitamin B6 D) Vitamin E
knee
The most commonly affected joint in osteoarthritis
B
The nurse is conducting an assessment on a new client who is being admitted to the long-term care facility. The client is a 69-year-old gentleman who is moderately active. What is the recommended calorie per day intake? A) 2000 cal/day B) 2200 cal/day C) 2400 cal/day D) 2600 cal/day
A
The nurse is doing nutritional screening on older adults at a health fair. What would be an important question to ask while screening an older person for nutritional risk? A) About the use of three or more prescribed or over-the-counter daily medications B) If the person is over 62 years old C) If they had an unintentional weight loss of 3% or more in 60 days D) If they are living in a household with more than one older adult member
A, E
The nurse is meeting with the wife of a client who has Alzheimer disease (AD). She is concerned about her husbands' nutritional status. What can the nurse tell her to watch for that would indicate a possible nutritional problem? Select all that apply. A) Forgetting he had eaten and eating again B) Forgetting which are green vegetables C) Forgetting what food category bread is in D) Forgetting what time to eat E) Forgetting how to shop for food
A
The nurse is working with a client who has chronic constipation. After evaluating the clients' food intake, it is determined that the client needs to ingest more fiber. What is the recommended daily intake of fiber for this 55-year-old female? A) 21 g/day B) 25 g/day C) 30 g/day D) 38 g/day
C
The nurse knows her instructions about vitamin B12 are effective when the client verbalizes he will a. Consume more meat. b. Consume more fruits and vegetables. c. Eat vitamin B12-fortified cereal. d. Drink more milk.
remodeling
Throughout life, bone tissue is constantly being destroyed and rebuilt, a process known as ______.
3.7 L/day and 2.7 L/day respectively
Total water recommended for men is ____ while _____ for women.
True
True or False. A major cause of undernutrition among long-term care residents is loss of appetite. Monitoring of intake is essential to identify problems early, before a downhill spiral develops.
False
True or False. Although loss of lean body mass is a normal consequence of aging, muscle mass can be replaced with resistance exercises and a diet adequate in protein.
True
True or False. In general, calorie needs in older adults decrease due to a decrease in lean body mass and physical activity while the need for other nutrients stays the same or increases.
False
True or False. Most older adults consume adequate amounts of iron. In fact, they are cautioned against consuming supplements that contain iron so as not to exceed the upper limit for iron.
False
True or False. Most older adults meet the recommended intake for water
True
True or False. Older adults do not need more vitamin B12 than younger adults, but their ability to absorb the natural form of B12 from food may be impaired. Adults over the age of 50 years are urged to consume the RDA for vitamin B12 from fortified foods or supplements to ensure adequacy.
True
True or False. Older adults need more protein than younger adults.
False
True or False. The AI for water does not change for men or women from the age of 19 years onward. Older adults have a blunted sense of thirst, yet if they are healthy, normal drinking and eating habits are considered adequate to guide fluid intake.
False
True or False. The prevalence of malnutrition or dehydration among residents of long-term care facilities is from 23% to 85%.
False
True or False. While it is true that peak calcium retention—the period when calcium intake has the greatest impact on bone density occurs between the ages of 4 and 20 years, the efficiency of absorption decreases with age, so the AI for calcium for older adults is higher than that of younger adults.
A, C, D, E
Which of the following may help promote the intake of a resident in long-term care? Select all that apply. a. Use simple verbal prompts to eat. b. Provide three meals a day; avoid snacks. c. Minimize noise and distractions in the dining room. d. Offer finger foods. e. Honor individual preferences; solicit input from resident and family.
Sarcopenia obesity
is obesity characterized by loss of muscle mass and strength combined with an increase in body fat mass
Osteoarthritis (OA)
the most common form of arthritis, can lead to joint degeneration, chronic pain, muscle atrophy, impaired mobility, and poor balance.