Author Question: What evidence-based practice information should the nurse base decisions on regarding assigning ... (Read 54 times)

BRWH · **on:** Jul 11, 2018

What evidence-based practice information should the nurse base decisions on regarding assigning ancillary staff to long-term care clients requiring feeding assistance?

a. The staff should be allowed at least 20 minutes per patient to provide feeding assistance.
b. 50 of long-term care residents require some degree of assistance with eat-ing.
c. Long-term care clients eat better when fed in a community environment like a dining room.
d. Poor nutrition and hydration is primarily affected by the client's physical condition.

Question 2

A 76-year-old is moderately obese but otherwise healthy. When asking whether weight loss is important at this point in life, the nurse respond based on the rationale that:

a. The obesity paradox research shows that weight is not a great mortality risk for this client
b. Ideal weight is a goal that is appropriate for all age groups
c. The client needs to discuss these issues with a registered nutritionist
d. In order to maintain wellness, the client needs to lose weight in a controlled, healthy manner

Swizqar · **Reply #1 on:** Jul 11, 2018

Answer to Question 1

ANS: A
Having one staff person for every two or three residents who need feeding assistance would allow the resident 20 to 30 minutes with the staff and such an intervention creates a marked improvement in the individual client's nutritional status. It is true that the incidence of eating disability in long-term care is high with estimates that 50 of all residents cannot eat independently, but this option does not provide the focused information needed to determine an appropriate intervention. While eating in a community setting may have an impact on socialization and minimize social isolation, there is not proof to confirm it has a positive effect on nutrition. Research has shown that inadequate staffing in long-term care facilities is associated with poor nutrition and hydration with 50 of residents significantly increasing their oral food and fluid intake during mealtime when they received one-on-one feeding assistance.

Answer to Question 2

ANS: A
It remains unclear whether overweight and obesity are predictors of mortality in older adults and concerns have been raised about encouraging apparently overweight older people to lose weight. In what has been termed the obesity paradox for people who have survived to age 70, mortality risk is lowest in those with a BMI classified as overweight. Overweight older people are not at greater mortality risk, and there is little evidence that dieting in this age group confers any benefit. Ideal weight and weight loss are issues that do not appear to have the same degree of importance for the older adult as they do for the rest of the population. The nurse is capable of discussing such issues with the client and needs to refer to a nutritionist only when more specific information is needed.