Chronic Disease Management Flashcards

For an older adult with hypertension following the DASH eating plan, what sodium level provides greater blood pressure reduction?

Answer: 1,500 mg/day

The DASH-Sodium trial showed the greatest blood pressure reduction at about 1,500 mg sodium per day.

An older adult with heart failure should be taught to report which weight change to the care team?

Answer: A gain of 2-3 lb overnight or 5 lb in a week

Rapid weight gain of 2-3 lb in a day or 5 lb in a week signals fluid retention and worsening heart failure.

What is the appropriate dietary guidance for an older adult starting warfarin?

Answer: Keep vitamin K intake consistent from day to day

Consistent vitamin K intake allows stable INR dosing; avoiding vitamin K entirely is unnecessary and limits diet quality.

Why may body weight underestimate malnutrition in an older adult with heart failure?

Answer: Fluid retention can mask loss of lean body mass

Edema and fluid overload can hide muscle and fat loss, so physical exam findings and trends should be used alongside weight.

An older adult taking simvastatin asks about drinking grapefruit juice daily; what is the best response?

Answer: Grapefruit juice can raise statin levels and increase myopathy risk

Grapefruit inhibits intestinal CYP3A4, raising simvastatin levels and the risk of muscle toxicity.

An older adult taking lisinopril for hypertension wants to use a salt substitute; what is the main concern?

Answer: Hyperkalemia from potassium chloride in the substitute

Most salt substitutes contain potassium chloride, and ACE inhibitors reduce potassium excretion, raising hyperkalemia risk.

An older adult experiences dizziness and falls after large meals because of postprandial hypotension; which dietary strategy helps most?

Answer: Smaller, more frequent meals with less rapidly absorbed carbohydrate

Large, high-carbohydrate meals worsen splanchnic blood pooling, so smaller meals with less refined carbohydrate reduce postprandial blood pressure drops.