LC is a 78-year-old male who is hospitalized as a result of pneumonia. He has a history of;
Poorly controlled diabetes peripheral vascular disease
He is 5’9″ tall and has a usual body weight of 230 lbs. (as of 1 month prior). Upon admission, his weight is 224 lb. He is alert and responsive x 3. He responds to verbal commands without impairment and is able to feel and voice his pain and discomfort.
He has been running a fever for the past couple of days, causing his skin to be fairly moist, requiring linen changes at least twice per day. Right now, his ability to walk is limited by his illness, and he has been sitting in his recliner or lying in bed for the past three days without much movement – other than to use the restroom or adjust his position. When LC moves, it requires him to grab the chair arm or bedside table and slide himself in and out of the chair or bed. Since he has been sick, he hasn’t had much of an appetite, but he has no problems eating independently. He has been eating about 25% to 50% of his meals and hasn’t felt like consuming many beverages between meals.
Upon admission to the hospital, LC’s skin assessment conducted by the nurse revealed a butterfly-shaped pressure injury measuring 6 cm long x 4 cm wide on his sacrum. The wound has well-defined edges (not attached to the wound base), full-thickness skin loss, visible adipose tissue in the injury, granulation tissue, and tunneling. Light yellow loosely adherent slough covers about 30% of the wound bed, and a moderate amount of purulent exudate is present. No fascia, muscle, tendon, ligament, cartilage, or bone is exposed. The skin surrounding the wound is hypopigmented. Pitting edema extends about 1 inch around the wound. As the nutrition professional, you have been consulted to provide nutrition recommendations for healing LC’s pressure injury.
What risk factors for developing a pressure injury does LC demonstrate? Provide a rationale with references for how each factor increases his risk for pressure injury.
Using evidence-based guidelines, describe three nutrition interventions that would outline for LC to promote the healing of his pressure injury. Be sure to individualize recommendations to LC’s situation. Provide rationale and references.
Compare existing nutrition and healthcare services for older adults in the United States.
What services should be recommended for LC? Provide a rationale that includes a description of why it is important to provide food and nutrition services to older adults.
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