Managing Nutritional Status-Malnutrition and Dehydration

Managing Nutritional Status-Malnutrition and Dehydration 

The purpose of this course is to familiarize the learner with nutrition, malnutrition and dehydration, and the impact on the older adult. Information on challenges associated eating and nutrition, the impact of the dining environment on nutritional status, and ways to prevent malnutrition and dehydration will be presented. This course engages the learners in how to assist a person with eating and identify the signs of malnutrition and dehydration.

$20.00

Hours: 1.00
REL-PAC-0-MNSMD

Certificates

Certificates provided by accrediting body (6 Match)

Florida Board of Nursing Home Administrators

1.0 HOURS


Course approved by the Florida Board of Nursing Home Administrators.
Provider # 50-290
NHA/RCAL
This activity is approved for 1.00 contact hours.

California Department of Public Health (CNA)

1.0 HOURS


Relias, LLC is an approved provider of continuing education by the California Department of Public Health, Provider # NAC7001.

The certificate must be retained by the licensee for a period of four (4) years after the course is completed.

This learning activity meets the definition of *** ONLINE *** CEUs. This activity is approved for 1.00 contact hours.

California Department of Social Services Residential Care Facilities for the Elderly

1.0 HOURS


Relias, LLC is approved by the California Department of Social Services as a Continuing Education Training Program Vendor to provide Continuing Education training courses to administrators of residential care facilities for the elderly.

Vendor/Provider # 2000224-740-2;
Approval # 224-0143-32672.

This activity is approved by the California Department of Social Services for 1.00 contact hours.

Washington State Department of Social and Health Services (ALL Direct Care Workers)

1.0 HOURS


Relias Learning, LLC is approved as a Curriculum Developer by the Washington State Department of Social and Health Services. This activity is approved for 1.00 contact hours for all WA State Direct Care Workers. Training Provider Code: WA0624. CE Approval Code: CO1933283

National Association of Long Term Care Administrator Boards (RCAL)

1.0 HOURS


This educational offering has been reviewed by the National Continuing Education Review Service (NCERS) of the National Association of Long Term Care Administrator Boards (NAB) and approved for 1.00 clock hours. If you have any feedback regarding the NAB approved continuing education programs, send your email to the following address: [email protected]

National Association of Long Term Care Administrator Boards (NHA)

1.0 HOURS


This educational offering has been reviewed by the National Continuing Education Review Service (NCERS) of the National Association of Long Term Care Administrator Boards (NAB) and approved for 1.00 clock hours. If you have any feedback regarding the NAB approved continuing education programs, send your email to the following address: [email protected]

Course Details

Course Code: REL-PAC-0-MNSMD
Hours: 1
Type: Online Course
Content Expiration Date: 10/31/2023
Learning Objectives:
Recall common challenges to eating and nutrition with aging.
Identify signs of malnutrition and dehydration.
Explain how the dining environment may impact nutrition.
Recognize how to assist a person with eating.

Outline:
Hour One I. Introduction a. Meet Mrs. Mary Smith II. Learning Engagement Activity: Questions (multiple choice) III. Overview of healthy eating IV. What is malnutrition a. Incidence and risk i. Present in 3% of adult hospital patients ii. Contributes to increased length of stay in hospital admissions iii. Cost more to care for people with malnutrition iv. Have a higher risk of dying b. Causes of malnutrition i. Lack of nutrients ii. Unbalanced diet iii. Medical problems c. Inadequate intake of food i. Most common cause of malnutrition 1. Loss of appetite secondary to an illness 2. Depression and mood changes 3. Medications 4. Dislike of food being served d. The result of malnutrition i. The brain is starved ii. Organs not able to function iii. Muscles do not have enough energy and protein e. Eating too few calories f. The need for protein i. Muscles ii. Immune system iii. Heal wounds iv. Normal body function v. Too little leads to malnutrition g. Malnutrition stages i. Malnutrition ii. Confusion iii. Skin breakdown iv. Complications with other health conditions h. Learning Engagement Activity – Questions (multiple choice) V. Malnutrition risk factors and screening a. Risk factors i. Financial status ii. Living arrangements iii. Health status b. Diagnostic characteristics i. Insufficient energy intake ii. Weight loss iii. Loss of muscle iv. Loss of subcutaneous fat v. Localized or generalized fluid accumulation that may mask weight loss vi. Diminished functional status c. What is a nutritional screen? i. Screen is a first step in identify people at risk ii. Can be completed in multiple settings iii. Nutritional screening tools 1. Validated too 2. Easy to use 3. Reliable for the people being screened d. Early intervention of malnutrition i. Determining risk 1. Self MNA (mini nutritional assessment) a. Intake b. Weight loss c. Mobility d. Level of stress or illness e. Presence of dementia or sadness f. Scoring 2. Risk factors a. Oral health b. Dependent for eating c. Dehydration related to fever and infection d. Swallowing and functional impairments e. Impact of chronic disease f. Change in nutritional needs ii. Learning Engagement Activity: Questions (multiple choice) VI. Hydration a. Water is an essential nutrient b. 55% of an older adult’s body weight c. How the body maintains fluid balance i. Thirst ii. Kidneys d. Water recommendations i. Total water intake types 1. Drinking water 2. Part of food ii. Total water intake recommendations 1. 2.7 liters per day for women 2. 3.7 liters per day for men e. Fluid content of foods f. How much does someone need to eat or drink? i. Women 1. 72 ounces of fluid (9 cups) 2. 18 ounces of fluid from food ii. Men 1. 100 ounces of fluid (12.5 cups) 2. 25 ounces of fluid from food g. Why do older people drink less fluids? i. Decline in taste, smell, and thirst ii. Chewing and swallowing problems iii. Physical problems 1. Mobility 2. Fear of incontinence VII. Dehydration a. Imbalance of body water b. Most common fluid and electrolyte disturbance in older adults c. Severe imbalance can be life threatening d. Causes of dehydration i. Illness ii. Fever iii. Diarrhea iv. Vomiting v. Infection vi. Dementia vii. Chronic renal disease viii. Diabetes mellitus ix. Use of diuretics x. Use of laxatives e. Clinical signs of dehydration f. Warming signs and symptoms of dehydration i. Decreased fluid intake ii. Decreased food intake iii. Weight loss iv. Dry mouth and tongue v. Decreased urine output vi. Constipation and fecal impaction vii. Decreased skin turgor viii. Sunken eyeballs ix. Increased heart rate x. Lowered blood pressure g. To prevent dehydration i. Offer cool treats ii. Offer the right food consistency iii. Offer fluids throughout the day iv. Keep fluids within easy reach v. Offer foods with high fluid content such as watermelon h. Dehydration among older adults i. Food and dining experience 1. Choice 2. Access 3. Individualization 4. Health eating pattern 5. Quality service 6. Responsiveness 7. Share a meal ii. What contributes to poor food intake 1. Inadequate assistance 2. Poor food quality 3. Lack of sensitivity to individual needs 4. Lack of choice 5. Suboptimal dining environment iii. Eating with others promotes social interaction iv. Dining environment 1. Noise 2. Seating 3. Table settings 4. Lights 5. Food preparation i. Learning Engagement Activity: Questions (multiple choice) VIII. Assisting with meals a. Before the food arrives i. Make the environment attractive ii. Help with toileting needs iii. Assist with handwashing iv. Ensure dentures, eye glasses in place b. Assist with eating i. Follow any specific therapeutic diets ii. Prepare foods for eating iii. Use clothing protector iv. Sit with the person v. Describe the food and how it was prepared vi. Use hand-under-hand approach vii. Offer small amounts viii. Allow time ix. Offer a beverage during meal x. Talk with the person xi. Wash and dry hands afterwards xii. Remove clothing protector c. Learning Engagement Activity: Video – “Helping a person eat and drink in late stage dementia” Teepa Snow, (6:11 minutes) IX. Measuring, recording, and reporting food intake a. Why monitor? i. Measure of nutritional status ii. Determine medication dose iii. Monitor changes in health iv. Indicator of diuretic therapy b. How to obtain an accurate weight i. Procedure ii. Types of scales iii. Frequency c. Signification weight change management i. 5% loss in one month ii. 7.5% loss in three months iii. 10% loss in six months d. Significant weight loss i. Reasons 1. Inadequate oral intake 2. Difficulty chewing or swallowing 3. Problem with meal 4. Disease process ii. Risks 1. Pressure ulcers 2. Higher death rate 3. Infections 4. Delayed healing 5. Hip fractures e. Monitoring hydration i. Who? 1. Individuals with dementia 2. Individuals with dysphagia (difficulty swallowing) 3. Individuals with limited mobility ii. When? 1. Record fluids a. Meals b. Medications c. Social events d. Nutritional supplements e. In-between meals iii. How? 1. Maintain log of all fluids 2. Intake and output measurement a. Mrs. Smith case study 3. Monitor weight a. FM case study iv. Learning Engagement Activity: Questions (multiple choice) X. Conclusion and summary XI. Final exam (posttest)

Instructor: Nancy Munoz, DCN, MHA, RD, FAND
Dr. Munoz is a Clinical Nutrition Manager responsible for guiding the clinical nutrition therapy services and supervising the performances of 65 dietitians in 78 skilled nursing facilities. Her responsibilities include development, communication and implementation of efficient and effective nutrition protocols. Dr Munoz teaches, reviews manuscripts, writes continuing education programs and works on evidence analysis projects for the Academy of Nutrition and Dietetics. Disclosure: Nancy Munoz, DCN, MHA, RD, FAND has declared that no conflict of interest, Relevant Financial Relationship or Relevant Non-Financial Relationship exists.
Relias will be transparent in disclosing if any commercial support, sponsorship or co-providership is present prior to the learner completing the course.
Course Delivery Method and Format
Asynchronous/Online Distance Learning; please see certificate details for specifics on delivery format.
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All courses offered by Relias, LLC are developed from a foundation of diversity, inclusiveness, and a multicultural perspective. Knowledge, values and awareness related to cultural competency are infused throughout the course content.
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All characteristics and organizations referenced in the following training are fictional. Any resemblance to any actual organizations or persons living or dead, is purely coincidental.
To earn continuing education credit for this course you must achieve a passing score of 80% on the post-test and complete the course evaluation.
Accommodations
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