Nutrition Case Study: Mrs. Jones

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Nutrition Case Study
Mrs. Jones is 80 years old and lives alone in a small apartment. Her daughter lives a couple of hours away and has to prepare and cook her own meals. Upon the visiting her primary doctor for a routine visit, she shares with the nurse that she sometimes feels “tired” and “food gets stuck in my throat”. The nurse observes she is pale and grimaces as she walks in the hallway. Upon further nutritional assessment, Mrs. Jones shares with the nurse that she buys canned foods and frozen meals that can be cooked in the microwave but sometimes forgets to go to the grocery store.

1. Describe the physiologic changes that occur in advanced age that might influence Mrs. Jones food intake and nutritional status:
Changes in the
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Jones lives alone in a one bedroom, leading us to believe she might not be in the best economic position. With her decreased energy and lack of desire to prepare food, she might not have the funds to go out and eat a proper meal.

2. What signs and symptoms might indicate nutritional deficiencies and/or malnutrition? With regard to Mrs. Jones, here warning signs are, tiredness, pale skin, pain while walking, and poor diet.
General warning signs of malnutrition: Weakness or fatigue, decreased immune function, decreased healing ability, changes in behavior or attitude, weight loss, reduced appetite, poor concentration, depression.

3. What other factors should the nurse consider that are possibly impact Mrs. Jones nutritional status?
The first issue that comes to mind is her stating she is having trouble swallowing. This could point to the possibility of a stroke, resulting in decreased muscle function in the muscles surrounding the esophagus. The trouble swallowing could also be a result of Parkinson’s disease, a neurological issue resulting in the loss of muscle control. For these individuals it is suggested they sit up at 90 degrees when eating and avoid all distractions to focus on the task at hand. Aging patients frequently have a decrease in gastrointestinal function, resulting in a decrease in nutrient absorption. Additionally, living alone can trigger depression, resulting in decreased appetite. From my reading
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This would involve setting specific meals and meal times to ensure her dietary needs are met. At this time it would be wise to go over a list of foods with her that would not only meet her dietary demands, but would also fit within her budget as well.
I would then encourage her to sit up straight and focus on the meal when she is eating it. By sitting up straight and focusing on the task at hand, it can allow her to increase her ability to swallow correctly. Aspirating can be a real concern for patients that have trouble swallowing.
If her issues with swallowing continue, I would suggest incorporating a nutrient rich smoothie into her daily diet.

5. What can the nurse teach the Mrs. Jones about food labels and MyPlate?
The nurse could teach Mrs. Jones about the recommended break down of what macronutrients are required daily to insure a healthy diet. The general breakdown for MyPlate is 30% grains, 40% vegetables, 10% fruits, 20% protein, and a small portion of milk represented by the glass.
By showing examples of food labels to Mrs. Jones, the nurse can help teach her what to look for and how it pertains to ensuring a healthy

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