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Nutrition, Hydration, Sleep & Rest in the Older Adult — Quick Reference

Nutrition

  • Aging & nutrition: changes include ↓ lean body mass, ↑ adipose tissue
    • ↓ Basal metabolic rate → \text{lower calorie needs}
    • ↓ absorption: calcium, vitamin D, magnesium
    • Dental changes → chewing/swallowing issues
  • Nutritional requirements:
    • Protein: 10\% - 20\% of total calories
    • Fat: <30\% of total calories
    • Soluble fiber: lowers cholesterol, improves glucose tolerance
    • ≥ 5 servings fruits & vegetables daily

Hydration

  • Hydration needs:
    • Males: 16 glasses/day; Females: 11 glasses/day
  • Barriers: incontinence, fear, mobility, cognition
  • Risks: restriction → infection, constipation, confusion
  • Risks: overhydration → cardiac/renal strain

Sleep & Rest in Older Adults

  • Sleep changes: \downarrow deep sleep, \uparrow nighttime awakenings
  • ↑ Daytime napping
  • Risks: meds, depression, pain, nocturia
  • Consequences: \downarrow cognition, \uparrow fall risk, impaired healing

Threats to Nutrition & Hydration

  • Dysphagia (transfer, transport, delivery types)
  • Anorexia (illness, meds, inactivity)
  • Constipation (↓ peristalsis, meds, ↓ fiber/fluids)
  • Malnutrition (weight changes, low albumin, anemia)

Nursing Interventions

  • Nutrition: small, frequent, high-protein meals; upright position; dietitian & speech consult
  • Hydration: offer fluids regularly; monitor urine/skin/BUN
  • Sleep: hygiene, limit caffeine, assess for sleep apnea & depression

Nursing Role in Health Promotion

  • Screening & early intervention
  • Patient/family education
  • Community resources: Meals on Wheels, SNAP, senior centers
  • Patient-centered: cultural, spiritual, socioeconomic factors

NCLEX-Style Practice Questions

  • Harris-Benedict equation considers? \text{Age, height, weight, gender}
  • By age 70, most women have some degree of osteoporosis (T/F)? → \text{True}
  • Dysphagia: difficulty moving food from mouth to esophagus? → \text{Transfer dysphagia}

Case Study – Clinical Judgment

  • Mrs. L, 82 y/o, admitted with dehydration, confusion, poor intake, dentures loose
    • PMH: CVA (mild dysphagia), HTN, arthritis
  • Ask: Priority assessments? Interventions? Anticipated risks?

Closing

  • Older adults = high risk for nutrition, hydration, sleep issues
  • Nursing interventions = prevention & patient-centered care
  • Think NCLEX: Safety, Health Promotion, Risk Reduction