MAINTAINING

FLUID BALANCE
AND MEETING
NUTRITIONAL
NEEDS
GROUP 2
 NUTRITION AND AGING
• Nutritional needs do not remain static
throughout life.
• Nutrition is crucial for health
maintenance, rehabilitation and disease
prevention.
• An understanding of older adults’
nutritional needs is essential to providing
good nursing care.
CALORIE INTAKE
Calories are units of heat that are used to measure
the available energy in consumed food.
FACTORS THAT INFLUENCE HOW MANY CALORIES
WILL BE USED BY A PERSON
• Activity patterns
• Gender
• Body size
• Age
• Body temperature
• Emotional status
• In general, when a person’s caloric intake is in
balance with the energy needs of the body, his or
her weight remains constant. When caloric intake
exceeds energy needs, the excess is converted
into adipose (fat) tissue for storage, and the
individual gains weight. When caloric intake is
less than the energy needs, the person loses
weight.
SOURCES OF CALORIES

Various nutrients provide different amounts of calories

• Fats yields 9 calories/gram
• Carbohydrates and protein both yields 4 calories/gram
• Vitamins, minerals, and water yield no calories.
• Alcohol yields 7 calories/g and has no nutritional
value.
• The lowest recommended daily intake to
adequately meet nutritional needs is 1,200
calories.
Your
 NUTRIENTS
• it is a substances that provide nourishment essential for
the growth, development, and maintenance of bodily
functions.
• Although caloric needs often decrease with age, the need
to include all of the various nutrients does not.
• Nutrient requirements remain crucial.
• Focus on nutrient-dense, low-calorie foods.
• Vital nutrients needed by all people include carbohydrates,
 MYPLATE
• is a visual representation of healthy eating habits
designed by the U.S. government. Divided into
color-coded food groups, which include
vegetables, fruits, grains, and protein, with dairy
on the side. Regardless of the total amount of food
consumed, the proportion of food from each group
should remain in balance.
• offers a health plan that encourages users to
adopt healthier eating habits and increase
physical activity.
DIETARY RECOMMENDATIONS

• Enjoy food, but eat less.

• Avoid oversized portions.
• Increase fruits, vegetables, and whole grains.
• Choose low-fat dairy options.
• Reduce sodium intake.
• Drink water instead of sugary drinks.
CARBOHYDRATES

provide a ready source of energy

for the body
 SIMPLE
CARBOHYDRATES
are used
most readily by the body
because their bonds are
easily
broken.
 COMPLEX
CARBOHYDRATES
must be broken down into
simple sugars before
they can be used by the
body.
• Foods that contain complex
carbohydrates usually also contain
other nutrients.
• The Institute of Medicine recommends
that 45%-65% of calories should
come from carbohydrates.
• usually contain significant
amounts of soluble fiber, a
substance humans cannot
digest, which forms bulk
and aids in bowel
elimination.
• are digested more slowly,
helping to maintain stable
blood sugar levels
 PROTEIN
are composed of amino acids, which are
essential for tissue repair and healing. Protein
needs remain constant or may increase
slightly with aging to compensate for the loss
of lean body tissue.
Protein consumption can be affected by
many factors, including the ability to
procure and prepare food, the cost of
foods containing protein, and even the
ability to chew common high-protein
foods.
DETERMINE YOUR NUTRITIONAL HEALTH
DETERMINE YOUR NUTRITIONAL HEALTH
Tissue replacement and repair
continue throughout life. Any
condition in which tissue integrity
is altered (e.g., surgery and
pressure ulcers) increases the
amount of protein needed to aid in
tissue repair.
 complete proteins
incomplete proteins,
Red meats, poultry, fish,
eggs, and dairy products Plant foods, such as legumes
(peas and beans), nuts, and
cereals (whole grains and
rice),

Complementary proteins consist of two or more incom-plete

proteins that together provide adequate amounts of essential
amino acids.
Some foods that are high in protein, such as
steak, ham, organ meats, egg yolks, hard
cheese, and whole milk, also contain large
amounts of fats. Excessive consumption of
proteins with a high fat content can contribute
to elevated blood levels of cholesterol and
triglycerides, which, in turn, contribute to
plaque formation and atherosclerotic changes
in the blood vessels.
FATS
• also known as lipids, are a type of
macronutrient that provides a concentrated
source of energy.
• Fat is desirable because it adds flavor to food
and provides a sense of fullness with a meal.
• Fats should be limited to about 20% to 35% of
total daily caloric intake, this recommendation
does not change with aging.
 TYPES OF FATS

1. Good Fats: Monounsaturated and

polyunsaturated fats (e.g., olive oil, fish).
2. Bad Fats: Saturated and trans fats (e.g.,
fried foods, processed snacks).
 LIPOPROTEINS

- are complexes of lipids

(fats) and proteins that
transport fats through • Fats are incorporated into
the bloodstream. lipoproteins: HDL, LDL,
VLDL.

HDL: Healthy fat that protects

against disease.
LDL: Contributes to blood vessel
disease.
VLDL: Primarily composed of
triglycerides; lesser risk.
• Some individuals who have been eating high-
cholesterol foods for their entire lives may be
reluctant to change their eating habits as they
age. They may find it difficult or unpleasant to
shop for and prepare foods in new ways. Others
can successfully alter their dietary intake to
avoid foods high in these substances.
VITAMINS
• Vitamins are organic compounds found naturally
in foods. They can also be produced synthetically.
• Vitamins are needed for a variety of metabolic and
physiologic processes.
• Vitamins are classified as fat-soluble or water-
soluble.
• The fat-soluble vitamins include vitamins A, D, E,
and K.
• Vitamin C and the B-complex vitamins are water-
soluble.
• It is theorized that antioxidant vitamins can
block or neutralize free radicals and prevent
cell damage, thereby slowing the effects of
aging and preventing diseases such as cancer,
heart disease, and Alzheimer disease.
Vitamin deficiencies have been
connected to a variety of problems
experienced by older adults, including
the following:
• Vitamin A deficiency:
Poor wound healing, dry skin, and night
blindness.
• Vitamin B6 deficiency:
Neurologic and immunologic problems,
elevated homocysteine levels (risk factor for
cardiovascular disease).
• Vitamin B12 deficiency:
Neurologic changes that affect sensation,
balance, and memory.
 • Vitamin C deficiency:
Weakness, dry mouth, skin changes, delayed
tissue healing, atherosclerosis, and
decreased cognitive function.
• Vitamin D deficiency:
Bone demineralization or
osteoporosis, because it is essential for
calcium absorption; depression; immune
system dysfunc-tion.
• Vitamin K deficiency:
Increased risk of fractures.
 MINERALS
• Are inorganic chemical elements that are required in
many of the body’s functions.

CALCIUM
-the most abundant mineral in the body
Necessary for: bone and tooth formation, nerve
impulse transmission and conduction, muscle
contraction, blood clotting
-With aging, the bones lose calcium, resulting in
osteoporosis.
Main sources are milk and dairy products
 MINERALS
PHOSPHORUS
• is needed for normal bone and
tooth formation, normal
neuromuscular functioning,
metabolism of carbohydrates, and
regulation of acid-base balance
• Deficiency can lead to weight loss
and anemia
 MINERALS

IRON
• central component of hemoglobin
for oxygen transport , without
adequate amounts of iron, the
body cannot produce enough
hemoglobin.
• Deficiency results in anemia
NUTRITIONAL ANEMIA COMMONLY SEEN IN OLDER
ADULTS

Special Considerations
IRON DEFICIENCY ANEMIA • Oral iron supplement can
• results from inadequate cause GI irritation, thus it
intake of dietary iron should be taken during or
• Folic acid and iron after meals.
supplements are • Enhance absorption with
commonly prescribed. vitamin C
• Patients should be told
that iron will turn the stool
a dark green or black color
NUTRITIONAL ANEMIA COMMONLY SEEN IN OLDER
ADULTS

PERNICIOUS ANEMIA
• caused by deficiency in vitamin B12 which is
required for red blood cell maturation in the
bone marrow.
 MINERALS
SODIUM
• commonly occurring mineral and is one of
the important elements in the body
• involved in acid-base balance, fluid balance,
nerve impulse transmission, and muscle
contraction
• Excessive blood levels of sodium or
hypernatremia can cause fluid retention and
hypertension
 MINERALS
POTASSIUM
• Is the major intracellular ion in the
body.
• Plays an important role in acid-base
balance, fluid and electrolyte balance
and neuromuscular functioning
• Potassium deficiency or hypokalemia
is a common problem in older adult.
 MINERALS
ZINC
• is a trace mineral that plays a role
in protein synthesis
• In adults, insufficient zinc may
result in delayed wound healing,
impaired immune function,
lethargy, skin changes, diminished
sense of smell and taste, and
decreased appetite
 FUNCTIONAL FOODS
• Functional foods are foods that have found to
have overall health benefits and reduce risk
factors for chronic diseases and enhance body
processes that benefit health (Woo, 2011)

• Separated into two categories : Conventional

and Modified
 FUNCTIONAL FOODS
• Conventional foods - are natural whole food
ingredients that are rich in important
nutrients like vitamins , minerals,
antioxidants, and heart healthy fats.

• Ex: Fruits , Vegetables , Nuts , Seeds ,

Legumes , Whole grains , Sea food ,
Fermented foods , Herbs and spices ,
Beverages
 FUNCTIONAL FOODS
• Modified food - foods that have been fortified
with additional ingredients such as vitamins,
minerals, probiotics or fiber to increase food
health benefits.

• Ex: Fortified juices , fortified dairy products

(milk), almond , cashew milk , fortified grains
such as bread and pasta , fortified cereal and
granola , fortified eggs
 FUNCTIONAL FOODS
Functional foods can benefit the elderly in
several ways.
• help maintain cognitive function
• reduce inflammation
• improve bone strength
• help reduce the risk of chronic
diseases such as heart disease or
diabetes
WATER
Benefits of
water:
• Prevents Dehydration
• Maintains Skin Health
• Regulates Body Temperatur
 Role of Water in Human Health

Hydration:
Water is essential for every bodily function, including
temperature regulation, joint lubrication, and maintaining
cellular function
 SUPPORTS DIGESTION:

Water aids in digestion by breaking down food and

facilitating nutrient absorption in the digestive tract,
facilitating the dissolution of vitamins, minerals, and other
nutrients.
WACKY
MALNUTRITION AND THE
OLDER ADULT
• Malnutrition is defined as a disorder of
nutrition resulting from unbalanced,
insufficient, or excessive diet or from
impaired absorption, assimilation, or use of
food
• The risk for developing nutritional
deficiencies increases with aging
 SYMPTOMS OF NUTRITIONAL
PROBLEMS INCLUDE:

• Unintentional weight loss

• Lightheadedness
• Disorientation
• Lethargy
• Loss of appetite
Weight loss is one of the signs of frailty
syndrome in older adults, a syndrome
characterized by increased susceptibility to
stressors that can lead to negative health
outcomes and functional impairment.
Factors
Affecting
Nutrition
The nutritional status of older adults living in
in OLDER
the community is affected

ADULTS
by physiologic, economic, and social factors.
Lack of appetite is commonly
reported. The reasons for this are multiple and
form the basis of risk
assessment. The more risk factors present, the
greater the likelihood of
the older person experiencing nutritional
inadequacy. Overall nutritional
status will be affected if any of these problems
persists for a significant
period of time.
 Physiologic Factors
ALCOHOLISM
CHRONIC HEALTH
FACTORS is suspected to be a risk factor
• Chronic obstructive in a larger percentage of older
• Pulmonary disease adults than is commonly
• Chronic heart failure recognized.
• Arthritis
• Dementia

And many others can interfere with

obtaining and preparing adequate
nutritional food.
Physiologic Factors

SENSORY CHANGES
-can cause problems with safe
preparation and storage of food.
PAIN
- whether it is chronic or acute, can interfere
with an older person’s appetite and desire to
procure, prepare, and consume food
Physiologic Factors
• Problems with chewing,
swallowing, or digesting
-are common causes of impaired nutrition. Poor
oral hygiene, lost teeth, cavities, poorly fitted
dentures, and decreased oral secretions affect
the taste of food and can interfere with the ability
of the older person to chew foods.

• Medications
-can cause an unpleasant change in the taste
of food; suppress appetite; or
cause nausea and vomiting.
 Physiologic Factors
-caused by decreased
• Malabsorption production of
digestive enzymes can
interfere with protein
break down and
absorption of vitamin
B12, calcium, and
folate.
 Economic Factors
• Cost of food -is a concern for many
older adults with limited income.
Any older adults have limited budgets and
may not purchase more costly items,
although they know the nutritional value
and importance of these foods.They may
skip meals or consume inadequate
portions to save money.
• Difficulty getting
transportation
-to obtain food is a serious problem for
older adults, particularly
those who live alone.
 Economic Factors

• Obtaining an appropriate -an be difficult for older

variety adults.
and sufficient amount of Most foods are packaged
food in sizes
appropriate for families of
four or more.
Social Risk Factors
include the following:
• Depression • Loneliness
is a common reason for decreased -or social isolation is one of the more
appetite in older adults. Grief, failing common risk factors for nutritional
health, loss of problems in older adults.
independence, and many other factors can
cause depression.
• Lack of motivation to
cook
is commonly an issue for older
adults. Preparing food for
one or two people can be more
difficult. Most recipes are
intended for four or more
servings. Food often must
be either eaten as leftovers for
several days or wasted.
SOCIAL AND CULTURAL
ASPECTS OF NUTRITION
SOCIAL ASPECTS
• Many older adults like to go out to eat in
restaurants. Many older adults prefer
restaurants with table service rather
than buffets or fast-food establishments,
because they tend to be less noisy and
do not require a person to balance trays
of food.
 CULTURAL ASPECTS
• Food is more than a means of meeting nutritional
needs.
• Food is also used as part of religious ceremonies, in social
Interactions, and as a means of cultural expression.
• Throughout history, food has been linked to the gods. Many
major religions, such as Islam, Judaism, and Catholicism,
include some dietary restric-tions. Cultural influences in food
are also significant.
• Thefoods we eat in our homes from early in life reflect our
culture. It is important to remember that good nutrition can
be achieved within any culture.
Ni barog mo?
its a
PRANKKKK
NURSING DIAGNOSIS AND
NURSING
Interventions
NURSING DIAGNOSIS:
•Risk for Overweight.
Nursing Goals:
•Maintain BMI within normal limits
Nursing Interventions:
1. Assess the Individual carefully to determine the
causes of problem.
3. Identify Cultural Factors
4. Provide Nutrition Education
5. keep a dietary record of the amount of type, and
frequency of food intake.
6. Schedule weekly weight checks
7. Consult with dietitian
Nursing Diagnosis:
• Risk for Imbalanced fluid Volume
Nursing Interventions:
1. Complete a thorough Assessment
2. Monitor Vital Signs
3. Monitor Intake and Output
4. Maintain Adequate Fluid Intake
5. Refer to dietitian, If appropriate
THANK
YOU