Ch 14

Question 1

Macroenvironment

Answer 1

Elements in larger world that affect people

Question 2

Microenvironment

Answer 2

Immediate surroundings

Question 3

Accidents

Answer 3

7th leading cause if death among older people

Unintentional falls is number 1 injury in ER

Falls leading cause of early institutionalization and long term disability

Question 4

Infections

Answer 4

Altered antigen-antibody response contributes to high chronic conditions

Pnemonia and flun is 8th leading cause of death

Pnemonia leading cause of infection related death

Increased UTI, etc.

Atypical symptoms can delay treatment

Question 5

Medications

Answer 5

Drug administering issues lead to accidents

Drowziness

Diziness

15% of admissions are drug related

Question 6

Importance of environment

Answer 6

Continual assess environment to ensure it meets needs

Question 7

Environmental safety considerations

Answer 7

Lighting, temp, colors, psychosocial factors, etc.

Question 8

Lighting

Answer 8

Night lights

Exposure to natural light is important

Question 9

Temp.

Answer 9

Recommended temp is 75 F, lower temp can cause hypothermia

Question 10

Colors

Answer 10

Red yellow white-can stimulate pulse, blood pressure, and appetitie

Blue, brown, earthy
-relaxing

Orange-
Stimulate appetitie

Be careful with patterns and lines

Question 11

Scents

Answer 11

Therapeutic scents or aromatherapy

Essential oils

Question 12

Carpeting

Answer 12

Absorb sounds but can cause problems

Static electricity and cling

Difficult wheelchair mobility

Scattered rugs or area rugs can cause fall

Use nonslip surfaces

Question 13

Furniture

Answer 13

Chairs correct height with arm rest

Easy to clean

Avoid obstructions

Question 14

Sensory stimulation

Answer 14

Create environment the senses like
Pictures, sculptures, plants

Sensory stimulation box for bed bound patients

Question 15

Noise control

Answer 15

Has physical ad emotional impact

Question 16

Bathroom hazards

Answer 16

Safety measures:
Lighting
Floor surface, etc

Question 17

Fire hazard

Answer 17

-burn injury risk
-kitchen fires
-careless use of matches or cogarettes

Question 18

Psychosocial impact

Answer 18

Need for own space

Question 19

Enhancing nursing homes and residences

Answer 19

Let them choose decorations

Question 20

Leading cause of fatal and nonfatal injuries

Answer 20

Falls

Question 21

Risk factor for falls

Answer 21

Postural hypotension
-causes diziness upon standing

Give plenty of time to adjust from laying down to standing up. Same for taking a bath

Question 22

Fall prevention

Answer 22

Regular inspection of environment
Fall risk assessment

Question 23

Nursing assessment after fall

Answer 23

Keep immobile until full examination
Might be hard to find fractures
May affect area other than area of impact
Must do psychological assess.
Pay attention for late appearing symptoms

Question 24

Risk with restraints

Answer 24

Can worsen behavior

Can cause medical complications; aspiration, cardiac stress, skin tears

Nonuse of restraints is standard is standard for gerontological nursing

Question 25

Alternatives to restraints

Answer 25

One to one Put patient near nurses station

Question 26

Reducing hydration and nutrition risk

Answer 26

Adequate hydration is difficult for elderly They should consume 1500 mL of fluid daily. Water jello etc. Poor food intake due causes such as oral health, GI issues, etc

Question 27

Addressing risks related to sensory deficits

Answer 27

Vision: reduced peripheral vision, etc. Hearing: misinterpreting instructions. Provide written and oral directions Taste and smell: miss harmful odors. Unable to recognize spoiled food. Excessive consumption of salt and sugar Touch:reduced sensation can lead to skin breakdown. Inability to differentiate temperature.

Question 28

Monitor body temp and preventing infection

Answer 28

Normal temp for older adults is 97 F 99 F can mean fever Hypothermia risk Preventing infection: Prevent iatrogenic infections

Question 29

Interventions for clothing snd med risk

Answer 29

Med: Only use when nevessary Provide education Fall risk increases with anticholinergics, barbiturates, benzodiazepines, psychotrpics, digoxin, clonidine

Question 30

Promote early detection of problems

Answer 30

Teach basic assessmemt RN conduct thorough assessment Correct problems before incident

Question 31

Addressing functional impairment

Answer 31

Assess to see how ADLs are affected Then plan interventions

Question 32

Lighting

Answer 32

Diffused lighting, soft red lighting in bedroom

Question 33

Carpet

Answer 33

Absorbs sound but can cause problems. Static Electricity And cling Difficult wheelchair mobility

Question 34

Flooring

Answer 34

Nonslip sure faces

Question 35

Sensory stimulation

Answer 35

Create environment the senses like

Question 36

Risk factors for falling

Answer 36

Previous falls Unsafe clothing distractions Caregiver related factors

Question 37

Postural hypotension

Answer 37

Causes dizzines upon standing. Give patient alot of time to get up from baths and getting up in general

Question 38

Fall prevention

Answer 38

Active program Regular inspection of environment Proper assessment Orientation to new environment