Chronic Disease Management Flashcards

In an older adult with COPD and CO2 retention, which macronutrient has the highest respiratory quotient when oxidized?

Answer: Carbohydrate

Carbohydrate has an RQ of 1.0, producing the most CO2 per O2 consumed, so overfeeding carbohydrate can worsen hypercapnia.

Which strategy best helps an older adult with COPD who becomes short of breath during meals?

Answer: Small, frequent, energy-dense meals with rest before eating

Small, frequent, nutrient-dense meals and rest before eating reduce dyspnea and gastric distension while meeting needs.

What are the RDA levels of calcium and vitamin D for a woman over age 70 with osteoporosis?

Answer: 1,200 mg calcium and 800 IU vitamin D

The RDA for women over 70 is 1,200 mg calcium and 800 IU (20 mcg) vitamin D daily.

How should an older adult take oral alendronate?

Answer: With 6-8 oz plain water on an empty stomach, staying upright for 30 minutes before eating

Bisphosphonates are poorly absorbed and irritate the esophagus, so they need plain water, an empty stomach, and an upright position.

An older adult with Parkinson's disease has motor fluctuations after high-protein lunches; which nutrition approach is appropriate?

Answer: Distribute or time protein to avoid competition with levodopa absorption

Large neutral amino acids compete with levodopa for absorption and transport, so timing or redistributing protein improves drug response.

The PROT-AGE study group recommends what protein intake for older adults with an acute or chronic disease?

Answer: 1.2-1.5 g/kg/day

PROT-AGE suggests 1.0-1.2 g/kg/day for healthy older adults and 1.2-1.5 g/kg/day for those with acute or chronic illness.

For a resident with advanced dementia and declining oral intake, what feeding approach does the American Geriatrics Society recommend?

Answer: Careful hand feeding

The AGS recommends careful hand feeding because tube feeding does not improve survival, aspiration, or comfort in advanced dementia.