PrepU: Digestion & Nutrition

The nurse is caring for an older adult client who is prone to developing constipation. The client asks; "What can I do to prevent this from happening?" Which recommendation(s) will the nurse make? Select all that apply.

"Get exercise each day." "Eat more fruits and vegetables." "Increase the amount of water you drink each day."

A client diagnosed with dysphagia has difficulty moving food from the mouth to the esophagus. Which instruction(s) would the nurse provide when teaching the client how to manage this disorder? Select all that apply.

Cut food into small bites Sit upright to avoid choking Drink milkshakes or other thickened liquids

An older adult client with a history of renal failure is admitted with dehydration and hyponatremia. The nurse identifies which assessment finding(s) as being consistent with the client's diagnosis of dehydration? Select all that apply.

Decreased skin elasticity Confusion Increased blood urea nitrogen (BUN)

An adult child caring for an older adult parent calls the nurse, stating concern about the parent's chronic bad breath and stubborn plaque on the teeth. Which teeth-cleaning measure should the nurse recommend for this older adult?

"A manual toothbrush is most effective when giving oral hygiene"

The unlicensed assistive personnel (UAP) notices that an older adult client's oral intake has been poor since being admitted to the care area. The UAP reports this finding to the nurse, but says, "I am not concerned since older people do not need to eat much anyway." Which response by the nurse would be appropriate?

"Even though older adults may not need quite as many calories, they need as many nutrients as you or I."

The nurse discusses dental health with an 81-year-old client. Which client statement would the nurse identify as accurate?

"Fluoride treatments might help strengthen the enamel on my teeth."

After an older adult client receives new dentures, the nurse provides instruction about their use and care. Which client statement indicates that teaching has been effective?

"I suppose that I'll have to get these resized and adjusted."

An older adult client asks why he has two normal bowel movements within 30 to 45 minutes in the morning. Which is the nurse's best response?

"Incomplete emptying of the bowel is expected with age."

An older adult 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."

An older adult reports that the dentures are rubbing against the gums and causing discomfort. The client is not wearing the dentures at all now and states it will be too expensive to buy another set. What is the nurse's best response?

"Sometimes dentures can be lined to ensure a proper fit."

An older adult 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."

During a home visit, the nurse is asked by an older client if vitamin and nutritional supplements can compensate for decreased food intake. Which response by the nurse would be appropriate?

"Vitamin and nutrient supplements can be useful short-term, but only if they don't interact with prescribed medications."

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."

A 78-year-old client states eating 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."

The nurse is caring for a group of clients diagnosed with chronic illness. Which client is at highest risk for depression?

65-year-old client who has irritable bowel syndrome and lives alone

An 80-year-old client who has just spent 2 days at the beach with the family is demonstrating confusion and has concentrated urine. Which action will the nurse take?

Administer fluids

The nurse suspects that an older adult's diarrhea is related to medications. Which medication should the nurse consider as causing this client's problem?

Ampicillin

During a home visit, the nurse observes an older client place prepared food on a plate for dinner. Which observation indicates that additional teaching is required?

Beef steak 50% of the plate, green beans 25%, potato 25%

During a home visit, the nurse notes that an older adult client has many types of vitamins, minerals, and herbal supplements on the kitchen counter. The client was recently discharged from the hospital after having an acute myocardial infarction. Which instruction would be appropriate for the nurse to make about the client's supplements?

Check with the health care provider to confirm safe use

The nurse supports a number of seniors in a community health clinic. Which client will the nurse identify at highest risk for dental caries?

Client with a poor diet

A 70-year-old client tells the nurse, "I've been taking a laxative every day for years." Which would the nurse suspect as being related to this laxative abuse?

Dehydration

The nurse suspects that an older adult client is having problems with eating. What assessment finding may cause the nurse to make this clinical determination?

Dentures in a glass of water in the bathroom

After reviewing a client's list of medications the nurse asks if the client ever experiences a dry mouth. Which medication on the list caused the nurse to ask the client this question?

Diuretic

A 78-year-old client reports heartburn on a regular basis after eating. Which topic will the nurse include in the teaching plan?

Eat smaller meals

During an examination, the nurse determines that an older adult client has a weak gag reflex. Which nursing intervention will the nurse include in the plan of care for this client?

Elevate the head of bed for 30 minutes after eating

The nurse is assessing an older adult client's food journal after receiving education to help the client to gain weight. When reviewing the client's entries, what information demonstrates the client has implemented the teaching provided?

Five to six small meals per day noted

The nurse is caring for a client 1 month after a cerebrovascular accident. Which assessment will the nurse perform first?

Gag reflex

An older adult client experiences frequent episodes of constipation. Which recommendation(s) will the nurse include in the teaching plan for this client? Select all that apply.

Include oatmeal for breakfast 3 days per week Eat prunes daily

An 88-year-old client asks the nurse how to treat chronic constipation. Which intervention will the nurse recommend for this client?

Increase fluid intake

After teaching an unlicensed assistive personnel (UAP) about how to feed an older adult client with dysphagia, the nurse determines that the teaching was successful when the UAP identifies which action as appropriate?

Make sure the client is sitting upright whenever consuming food or fluid

The nurse is developing a plan of care for a 75-year-old male client who has had a myocardial infarction (MI). When reviewing the client's medical record, which factor(s) would the nurse identify as increasing the client's risk for constipation? Select all that apply.

Minimal fluid intake since admission Significant activity reduction Administration of several doses of morphine since admission

During a physical examination, the nurse notes that the older adult client has a smooth red tongue. Which follow-up intervention would the nurse anticipate?

Nutritional screening

The nurse notes that an older adult client experiencing weight loss has several missing teeth and the remaining teeth have evidence of gum erosion. Which intervention will the nurse include in the plan of care?

Order a soft diet

An older adult states experiencing heart palpitations ever since adding a vitamin and nutrient supplement to the diet. The nurse checks the label of the client's supplement. For which vitamin or nutrient is the nurse assessing?

Potassium

An older adult client with controlled chronic illnesses has no interest in eating and is losing weight. What should the nurse assess first?

Reason for no interest in eating

A nurse is assessing an older adult client who has been admitted to the long-term care facility. Which finding would the nurse interpret as a potential pathological process rather than a normal age-related change?

Red and swollen gums

The nurse notes that an older client has difficulty swallowing a bolus of food when eating. Which suggestion should the nurse make to the health care provider based upon this observation?

Referral for a speech-language pathologist

The nurse is caring for an unresponsive client who wears partial dentures. Which action will the nurse take to provide oral care for this client?

Remove dentures, brush teeth and dentures daily.

A client's family brings an older adult family member to the emergency department, stating, "My parent is not eating well." The nurse should assess for which sign of malnutrition?

Serum albumin level 2.7 g/dL (27 g/L)

The nurse is concerned that an older adult client is experiencing undiagnosed malnutrition. What information may cause the nurse to make this clinical determination?

Serum albumin level 2.8 g/dL (28 g/L)

After presenting with severe depression following the death of an adult child, a 77-year-old client is prescribed an antidepressant. Recently, the client was diagnosed with an oral fungal infection. Which suggestion by the nurse would be appropriate?

Sipping water to promote saliva

The nurse is preparing to facilitate a referral for an older adult client with dysphagia. To which member of the multidisciplinary team will the nurse place the referral?

Speech-language therapist

The nurse is assessing the oral cavity of an older adult client with xerostomia. Which assessment findings require further follow up by the nurse? Select all that apply.

The client exhibits sore, swollen gums The client has malodorous breath

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 six months to detect oral diseases

The nurse is caring for an older adult client recently admitted for confusion. While analyzing the client's routine eating plan for vitamin consumption, on which vitamin will the nurse focus?

Vitamin B

An older adult client has a history of a deep vein thrombosis. The client should be taught to avoid excessive intake of which vitamin or nutrient?

Vitamin K