Clinical Assessment & Patient Care Flashcards

In the MDS 3.0 Section K, which weight change is flagged as significant weight loss?

Answer: 5% in 30 days or 10% in 180 days

CMS defines significant weight loss as 5% or more in 30 days or 10% or more in 180 days.

An older adult on warfarin wants to start eating more leafy greens. What is the best guidance?

Answer: Keep vitamin K intake consistent from day to day

Consistent vitamin K intake keeps the INR stable, and warfarin doses can then be adjusted to that intake.

Long-term metformin use in an older adult with diabetes calls for monitoring of which nutrient?

Answer: Vitamin B12

Metformin impairs B12 absorption, and deficiency can worsen neuropathy and cognitive decline in older adults.

Using the Fried frailty phenotype, an older adult with three of the five criteria is classified as:

Answer: Frail

Three or more Fried criteria indicate frailty, and one or two indicate pre-frailty.

Which IDDSI level describes 'minced and moist' food texture?

Answer: Level 5

IDDSI Level 5 is minced and moist, between Level 4 pureed and Level 6 soft and bite-sized.

For a frail older resident with type 2 diabetes, several chronic conditions, and moderate cognitive impairment, which A1C goal is generally appropriate per ADA guidance?

Answer: Less than 8.0%

ADA suggests a less strict A1C goal of about <8.0% for older adults with complex or intermediate health to limit hypoglycemia risk.

Before restarting nutrition in a severely malnourished older adult at high refeeding risk, which step is recommended?

Answer: Give thiamine and start energy at about 10-20 kcal/kg/day

Guidelines advise thiamine before feeding, a cautious energy start, and close monitoring of phosphorus, potassium, and magnesium.