6.4 Nutrition, Hydration, and Elimination
Key Takeaways
- CNAs assist with meals while protecting aspiration safety, dignity, and independence.
- Position residents upright for eating unless the care plan says otherwise.
- Report coughing, choking, pocketing food, poor intake, nausea, vomiting, diarrhea, constipation, and swallowing problems.
- Elimination care requires privacy, prompt assistance, hygiene, and accurate reporting.
- Hydration support includes offering fluids as allowed and recording intake.
Nutrition And Feeding
Meal assistance is not just placing food in a mouth. It includes identity, diet, positioning, pace, observation, and dignity.
Before feeding:
- Check the resident identity.
- Confirm the diet tray matches the resident.
- Position the resident upright, often 75-90 degrees.
- Provide hand hygiene.
- Describe foods if helpful.
- Encourage independence.
Aspiration Risk
Aspiration means food, fluid, or secretions enter the airway. It can cause choking or pneumonia.
Report:
- Coughing during meals.
- Wet or gurgly voice.
- Pocketing food in cheeks.
- Drooling.
- Trouble swallowing.
- Shortness of breath after eating.
- Recurrent fever after meals.
Stop feeding and report if the resident shows signs of choking or aspiration.
Hydration
Offer fluids as allowed. Some residents have fluid restrictions, thickened liquids, or swallowing precautions. Follow the care plan.
Signs of dehydration may include dry mouth, dark urine, dizziness, confusion, constipation, and poor skin turgor.
Elimination
Toileting care protects dignity. Answer requests promptly, provide privacy, use gloves, wipe front to back for females, and perform hand hygiene.
Report:
- Pain or burning with urination.
- Blood in urine or stool.
- Constipation or diarrhea.
- No bowel movement by policy.
- New incontinence.
- Unusual odor with symptoms.
Exam Tip
For feeding questions, the safest answer is usually upright positioning, slow pace, small bites, and reporting swallowing problems.
A resident coughs repeatedly while drinking thin liquids. What should the CNA do?
Why should a resident be positioned upright for meals?