NURS 6540 Week 7: Common Geriatric Syndromes – Nutritional Concerns Essay Assignment Paper

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NURS 6540 Week 7: Common Geriatric Syndromes – Nutritional Concerns Essay Assignment Paper

NURS 6540: Advanced Practice Care of Frail Elders | Week 7

Approximately 2.5 million households with elders are food insecure. This food insecurity among the geriatric population is not always a result of financial troubles, but can also be attributed to lack of transportation, limited functional abilities, and/or health issues that present barriers (Feeding America, n.d.). Consider Mrs. Stewart, an 82-year-old widow and Parkinson’s patient. Mrs. Stewart is unable to drive or prepare meals for herself because of Parkinson’s disease. Knowing she would not be able to eat properly given her limited functional abilities, she accepted meals from Meals on Wheels (Meals on Wheels Association of America, n.d.). Although Mrs. Stewart sought assistance before her nutritional concerns posed additional health issues, not all food insecure patients are as proactive. As an advanced practice nurse assessing these patients, you must identify issues that could have nutritional consequences and recommend the appropriate interventions.

This week, as you study nutritional concerns for geriatric patients, you examine tools used to assess functional abilities. You also explore the impact of functional abilities and medical conditions on the nutritional health of patients. Finally, you consider strategies for improving nutrition issues for this patient population.

Learning Objectives

By the end of this week, students will:

• Assess patients using tools for inpatient and long-term patient care
• Assess the impact of functional abilities on nutrition and hydration
• Assess the impact of medical conditions on patient diets
• Analyze strategies for improving nutrition issues
• Apply key terms, concepts, and principles related to nutrition concerns for geriatric patients
• Evaluate diagnoses for patients*
• Evaluate treatment and management plans*

*These Learning Objectives support assignments that are assigned this week, but due in Week 8.

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Resnick, B. (Ed.). (2016). Geriatric nursing review syllabus: A core curriculum in advanced practice geriatric nursing (5th ed.). New York, NY: American Geriatrics Society.

 

• • Chapter 29, “Nutrition and Weight” (pp. 221-228)

This chapter describes age-related changes that affect nutrition in older adults. It also examines nutrition screening and assessment, nutrition syndromes, nutritional interventions, and legal and ethical issues related to older adult nutrition.

 

• • Chapter 30, “Feeding and Swallowing” (pp. 229-232)

This chapter examines age-related changes that cause swallowing and feeding problems. It also examines strategies for assessing patients with swallowing and feeding problems.

Holroyd-Leduc, J., & Reddy, M. (Eds.). (2012). Evidence-based geriatric medicine: A practical clinical guide. Hoboken, NJ: Blackwell Publishing.

 

• • Chapter 11, “Keeping Things Moving: Preventing and Managing Constipation” (pp. 140–154)

This chapter defines chronic constipation and describes strategies for diagnosing, preventing, treating, and managing constipation. It also examines pharmacological treatments, identifying adverse effects of these treatments, as well as contraindications.

Kowlessar, N., Robinson, K., & Schur, C. (2015, September). Older Americans Benefit from Older Americans Act Nutrition Programs. Retrieved January 8, 2019, from https://nutritionandaging.org/wp-content/uploads/2015/10/2015_0928_AoA_Brief_September.pdf, 1–15.

Plawecki, K., & Chapman-Novakofski, K. (2010). Bone health nutrition issues in aging. Nutrients, 2(11), 1086–1105. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3257623/

 

This article describes the impact of osteoporosis on older adults. It then presents interventions for maintaining bone health as well as outcomes of each intervention.

American Geriatrics Society. (2012). American Geriatrics Society updated Beers Criteria for potentially inappropriate medication use in older adults. Retrieved from http://www.guideline.gov/content.aspx?id=49933

 

This article examines three categories of medications that impact older adults: those that are potentially inappropriate and must be avoided, those that are potentially inappropriate and must be avoided in older adults with certain diseases, and those that must be used with caution.

Nutrition.gov. (2014). Life stages: Seniors. Retrieved from http://www.nutrition.gov/life-stages/seniors

 

This website provides links to resources related to nutrition for seniors. It focuses on nutritional concerns, health issues, and nutrition education.

Required Media

Hartford Institute for Geriatric Nursing. (n.d.). Hartford Institute Videos: The Lawton Instrumental Activities of Daily Living Scale [Video file]. Retrieved August 1, 2014, from https://consultgeri.org/try-this/general-assessment/issue-23

Note: The approximate length of this media piece is 41 minutes.

 

This media presentation demonstrates how to assess patients with the Lawton Instrumental Activities of Daily Living (IADL) Scale.

Discussion: Nutrition and Hydration

Geriatric patients have many nutritional and hydration concerns that impact their health and ability to acquire sufficient nutrients. Advanced practice nurses evaluating these patients must be able to account for all barriers that prevent elders from obtaining adequate nutrition, including medical conditions, transportation, finances, physiologic changes, and functional abilities. When evaluating patients, it is important to consider how they eat, what their diet consists of, and whether they have any special dietary needs that are not being met. Assessment tools, such as the Lawton Instrumental Activities of Daily Living (IADL) Scale, are an integral part of this evaluation process as they help providers identify potential obstacles for patients. In this Discussion, you assess a patient at your current practicum site and consider strategies for improving any nutrition or hydration issues.

To prepare:

• • Review this week’s media presentation, as well as 29 and 30 of the Resnick text.
  • Assess a patient using tools for inpatient and long-term patient care, such as the Lawton IADL Scale.

Note: You should coordinate this opportunity with the Preceptor at your practicum site.

• Consider whether nutrition and/or hydration might be impacted by the patient’s functional abilities. Reflect on whether the patient is able to go out and get food to eat, cook meals, safely use the stove, etc.
• Consider the patient’s diet and whether they have any special dietary needs due to medical conditions, such as congestive heart failure, end-stage kidney disease, diabetes, oral health issues, etc. Reflect on whether or not the patient is attempting to compensate for a medical issue and thus creating a deficiency or excess in his or her diet.
• Based on your patient assessment, think about strategies for improving any nutrition issues that might have presented (e.g., nutritional supplements, community resources such as Meals on Wheels, referral to a nutritionist or dietician, etc.).

By Day 3

Post a description of the patient assessment you performed using a tool for inpatient and long-term patient care, such as the Lawton IADL Scale. Explain whether nutrition and/or hydration might be impacted by the patient’s functional abilities. Then, describe the patient’s diet and whether he or she has any special dietary needs due to medical conditions. Address whether or not the patient is attempting to compensate for a medical issue and thus creating a deficiency or excess in his or her diet. Finally, explain strategies for improving any nutrition issues that might present during the patient assessment.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues on two different days in one or more of the following ways:

• Suggest additional strategies for improving nutrition issues for your colleagues’ patients.
• Offer and support an alternative perspective based on your own experience and additional literature search.
• Validate an idea with your own experience and additional literature search.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Remember, once you click on Submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking on Submit!

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