Mrs. SJ is a 78 year old woman lived in assisted living facility. She is 5’4” an

Question

Mrs. SJ is a 78 year old woman lived in assisted living facility. She is 5’4” and weighs 110 pounds. Her usual body weight as an adult was 125 pounds and she was at this weight when she moved to assisted living 3 months ago. She can move independently with a walker.

1. Research each medication Mrs. SJ is taking and list the possible nutritional complications for each. (7) Mobic (meloxicam) nonsteroidal anti-inflammatory Diovan (valsartan) antihypertensive Lasix (furosemide) -diuretic Norpace (disopyramide phosphate) antiarrhythmic Ambien (zolpidem tartrate) sedative-hypnotic Ativan (lorazepam) depresses CNS Bactrim DS (trimethoprim and sulfamethoxazole) antibiotic

2. What nutrition assessment/screening tool should be used for Mrs. SJ? What is the score using this tool? What does this score indicate? (3)

3. You would like to collect a diet history. List four methods for obtaining dietary intake data and list one advantage and one disadvantage for each (8)

4. Which method do you think is best to use to collect Mrs. SJ’s food intake data and why? (2)

5. Mrs. SF complains of constipation, what can you tell her? (2)

6. Who is at greatest risk for drug-nutrient interactions? (3)

Explanation / Answer

Nutritional Complication:

1.meloxicam (Mobic)

swelling or rapid weight gain;nausea, upper stomach pain, itching, loss of appetite, clay-colored stools, jaundice ,upset stomach, diarrhea, bloating, gas;

2.Diovan (valsartan)

diarrhea, nausea, stomach pain, weight loss, vomiting,

3. Lasix (furosemide)

loss of appetite,severe pain in upper stomach spreading to back, nausea and     vomiting;

weight loss, rapid weight gain, low potassium ,low calcium, diarrhea, constipation, stomach pain;

mild itching or rash.

    4. Norpace (disopyramide phosphate)

   Dry mouth, constipation ,GI upset, hypoglycemia, hypokalemia, jaundice

5.Ambien (zolpidem tartrate)

lack of appetite,unusual tiredness or weakness,dry mouth

difficulty swallowing,sores, ulcers, or white spots on the lips or in the mouth

6. Ativan (lorazepam)

Upper stomach pain, dark urine, jaundice (yellowing of the skin or eyes).

Weakness.

7.Bactrim DS (trimethoprim and sulfamethoxazole)

diarrhea, anorexia, nausea, vomiting and rash,anemia.

2. Determine tool can be used to aseess the nutritional status of SJ

Scoring

0-2               Good

3-5                 At moderate nutritional risk

6 or more      At high nutritional risk.

Four methods for obtaining dietary intake data

• Food records. Food records, also called food diaries, require that the subject (or observer) report all foods and beverages consumed for a specified period (usually one to seven days).

Advantage:

The amounts consumed can be estimated as accurately as possible.

Disadvantage

Rely on memory

• 24-hour dietary recalls.

The 24-hour dietary recall consists of a listing of foods and beverages consumed the previous day or the 24 hours prior to the recall interview.

Advantage:

  Can be conducted face to face.

Disadvantage

Need specification of quantity for accurate measurements.Hence less reliable.

Food frequency questionnaires.

A food frequency questionnaire (FFQ), sometimes referred to as a "list-based diet history", consists of a structured listing of individual foods or food groupings.

Advantage

The method may be more accurate than other methods for estimating average intake of those nutrients having large day-to-day variability and for which there are relatively few significant food sources

DisAdvantage:

Time consuming.

Food habit questionnaires.

It is designed to collect either general or specific types of information, such as food perceptions and beliefs, food likes and dislikes, methods of preparing foods, use of dietary supplements, social settings surrounding eating occasions.

Advantage:

  This approaches are commonly used in rapid assessment procedures The

Disadvantage:

We can delete or include contents of questionnaire as per need.

4. Food frequency questionnaires will be the best method to collect SJ food intake data Because its a structured tool And she doesnt need to rely on her memory being an elderly.

5.I recommend her to take fibre rich diet,Green leafy vegetable and fruilts.

6. Elderly individuals are at risk for drug-nutrient interactions because of the presence of multiple diseases, polypharmacy, malnutrition, and impaired metabolism in elderly.

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