A hospitalized older adult who recently had surgery and a wound ...

[Sufayan.ah]

A hospitalized older adult who recently had surgery and a wound infection postoperatively is noted to be losing weight despite consuming his meal trays and snacks. One reason that this might be occurring is:
 
  a. an injury may trigger inflammatory medi-ators that increase metabolic rate and im-pair nutrient utilization.
  b. an injury may cause malabsorption of nu-trients.
  c. most hospitalized older patients do not consume adequate amounts of micro- and macronutrients.
  d. most hospitalized patients do not have accurate weights recorded upon admis-sion.

Question 2

A nursing student asks the instructor, Our textbook discussed the obesity paradox in older adults. I am not sure I understand; isn't obesity bad for everyone? The best response by the in-structor is:
 
  a. While there is evidence that obesity in younger people lessens life expectancy, it remains unclear whether overweight and obesity are predictors of mortality in older adults.
  b. Obesity is usually not a concern in older adults, as most older people tend to weigh less than they did when they were young-er.
  c. Obesity is a concern in all age groups; however, over the past decade obesity in older adults has decreased.
  d. Obesity in older adults is less of a con-cern than we once thought; individuals over age 65 with a higher BMI have a lower mortality rate.

[IRincones]

Answer to Question 1

ANS: A
One trajectory for malnutrition is inflammation-related malnutrition; in this situation, malnutrition develops as a consequence of injury, surgery, or disease that triggers inflammatory mediators that contribute to an increased metabolic rate and impaired nutrient utilization. An injury does not necessarily cause malabsorption of nutrients. There is no evidence that most hospitalized patients do not consume adequate diets, and there is also no evidence that accurate weights are not rec-orded for most hospitalized patients.

Answer to Question 2

ANS: A
There is evidence that obesity in younger people contributes to a decreased life expectancy. However, in older adults, it is not clear whether obesity is a predictor of mortality. Recent evi-dence demonstrated that for people who have survived to 70 years of age, mortality risk is lowest in those with a BMI classified as overweight. Persons who increased or decreased BMI have a greater mortality risk than those who have a stable BMI, particularly in those aged 70-79. Obesity is prevalent in older adults. The proportion of older adults who are obese has doubled in the past 30 years. More than one-third of individuals 65 years and older are obese with a higher preva-lence in those 65-74 years than in those 75 years and older.