Cna prep course Nutrition Bfi- 2018 Module 5 Cna prep course Nutrition Bfi- 2018

nutrition Remember these points about elderly residents and Myplate: Elderly residents may need a modified MyPlate that emphasizes nutrient-dense foods, fiber, and water. Calories may be reduced, but need for vitamins and minerals does not decrease. Dietary supplements may be appropriate.

myplate

supplements

nutrition Remember these points about food preferences: Know and follow residents’ food preferences. Ask questions. Pay attention when residents express preferences, verbally or non-verbally.

nutrition REMEMBER: Residents have a legal right to make choices about their food and to refuse food, and NAs must honor residents’ beliefs and preferences. Do not force feed a resident. If they refuse you must notify the nurse!

Types of diets Therapeutic diet Diet cards Puree a diet for people who have certain illnesses; also called special or modified diet. Diet cards cards that list the resident’s name and information about special diets, allergies, likes and dislikes, and other instructions. Puree to chop, blend, or grind food into a thick paste of baby food consistency. Types of diets

Special diets The following are common special diets: Low-Sodium Diet Fluid-Restricted Diet Low-Protein Diet Low-Fat/Low-Cholesterol Diet Modified Calorie Diet for Weight Management Dietary Management of Diabetes Liquid Diet (Full or Clear) Soft Diet Pureed Diet

hydration Helps prevent constipation and incontinence Dilutes wastes and flushes out urinary system May help prevent confusion Fluid intake is important for several reasons: We need about eight glasses, or 64 ounces, per day. Water is the most essential nutrient for life. Water aids in digestion, absorption of food, elimination of wastes, and maintaining normal body temperature. Water hydration

Hydration Watch for these signs and symptoms of dehydration: • Drinking less than six 8 oz glasses of liquid per day • Drinking little or no fluids at meals • Needing help drinking from cup • Having trouble swallowing liquids • Having frequent vomiting, diarrhea, or fever

dehydration Signs and symptoms of dehydration (cont’d.): Being easily confused or tired Resident has any of the following: Dry mouth Cracked lips Sunken eyes Dark urine Strong-smelling urine Weight loss Complaints of abdominal pain

Remember these guidelines for preventing dehydration: • Report warning signs immediately. • Encourage residents to drink every time you see them. • Offer fresh water and fluids often. • Record fluid I&O. • Offer other forms of liquids if permitted (e.g. ice chips, frozen flavored ice sticks, gelatin). • Offer sips of liquids between bites of food. • Make sure pitcher and cup are close by and are light enough for resident to lift. • Offer assistance.

warning 1 2 3 Always report unintended weight loss or gain Weight gain- cardiac problem (congestive heart failure, renal failure, liver disease) 2 Weight loss- poor intake, dehydration, illness( cancer) 3 warning

nutrition Remember these guidelines for preventing unintended weight loss: • Report observations warning signs to the nurse immediately. • Encourage residents to eat; talk positively about food. • Honor food likes and dislikes. • Offer different kinds of foods and beverages. • Help residents who have trouble feeding themselves. • Food should look, taste, and smell good. Resident may have poor sense of taste and smell.

nutrition Remember these guidelines for promoting appetites: Check the environment. Address odors. Make sure room is a comfortable temperature. Turn off TVs. Do not shout or bang plates or cups. Assist with grooming/hygiene tasks before dining, as needed. Assist with handwashing. Give oral care before eating. Offer a trip to the bathroom before eating. Encourage use of dentures, glasses, and hearing aids.

nutrition REMEMBER: Do not insist on using a clothing protector if a resident does not wish to use one. Use the term “clothing protector” rather than “bib.”

Dysphagia Some geriatric patients suffer from dysphagia Dysphagia- “Difficulty swallowing” means it takes more time and effort to move food or liquid from your mouth to your stomach. Causes- stroke, cancer, GERD, tumors, foreign bodies (ex. food bolus) Symptoms- Coughing during or after meal, Choking during meals, Dribbling saliva, food, or fluid from the mouth, Food residue inside the mouth or cheeks during and after meals, Gurgling sound in voice during or after meals or loss of voice, Slow eating Never offer regular liquids, including water, to residents who need thickened liquids.

Special Liquid consistencies Patients with dysphagia may have special liquid consistencies such as: Honey thickened liquids: slightly thicker, are less pourable, and drizzle from a cup or bowl Nectar thickened liquids: easily pourable and are comparable to apricot nectar or thicker cream soups. Pudding thick: They are not pourable and are usually eaten with a spoon. Special Liquid consistencies

Special patient feedings You may encounter patients with special types of feeding through a peg tube, nasogastric tube or TPN (Total Parenteral Nutrition) or PPN (Peripheral Parenteral Nutrition) Your role is to ensure that the nurses place feedings on hold prior to any care you give to resident and observe for problems As a nursing assistant you can not insert or remove tubes, do the feeding, or clean the tubes. Total Parenteral Nutrition means total nutrition, which is provided when a patient does not receive any other form of nutrition. Highly concentrated with glucose and minerals which are caustic to small veins. Given through picc line or port. Given over a long period of time and sometimes until end of life Peripheral Parenteral Nutrition, or PPN, is only partial. This means that the patient may be getting nutrition from other sources along with the PPN. Less caustic and can be given through smaller peripheral vien. Usually given for less than 10 days.

Assisting with meals you may have to assist residents during meals Use assistive devices as ordered. (special plates, utensils) Resident may need verbal cues to eat (dementia/Alzheimer’s Disease) For visually impaired residents, use imaginary clock face to explain position of food on plate. For residents who have had CVA, place food in unaffected or stronger side of mouth. Make sure food is swallowed. Offer liquids for every 2-3 bites of food Make sure resident has the right meal tray (check name card and diet)