Exam 1

Question 1

what is the goal of functional assessment screening?

Answer 1

restore/improve health

monitor changes

enhance independence

identify disabilities/risks

screen for issues needing further assessment

evaluate need to resources

avoid making a person more frail

Question 2

Screening vs. diagnostic

Answer 2

screening tools are standardized tools to identify the RISK of a problem and target at risk populations, independent nursing intervention and they may direct us toward diagnostics or nursing intervention

diagnostics tests are used to identify or diagnose a specific medical condition and are individualized to the person and requires an order by a licensed physician

Question 3

what makes a good screening tool?

Answer 3

easy to use
inexpensive 
accurate
sensitivity
specificity 
treatable condition

Question 4

what three things does a functional assessment involve?

Answer 4

physical
psychological
socio-economical

Question 5

functional assessment screening includes a systematic review of these areas

Answer 5

vision/hearing
mobility
oral/nutrition
cognition
ADL and IADL
home environment
social support
chronic pain 
medications

Question 6

failure to consider a client’s functional status can lead to

Answer 6

excess disability

Question 7

vision screening

Answer 7

condition of glasses
Rosenbaum (reading)
Snellen chart

Question 8

hearing screening

Answer 8

whisper test

finger rub

Question 9

lower extremities screening

Answer 9

get up and go test

Question 10

what does DRIP stand for

Answer 10

D= delirium, depression, dementia
R= retention, restricted mobility and/or environment
I= infection, inflammation, impaction
P=pharmaceuticals, polyuria

Question 11

quadruple A’s of nutrition

Answer 11

appearance
appetite
access
ability

Question 12

Cognitive function/screening tools

Answer 12

Delirium, depression, dementia 
mini-mental status exam (MMSE)
mini-cog
geriatric depression scale (GDS)
cornell depression scale

Question 13

Falls

Answer 13

1 in 3 OA over 65 fall each year

Question 14

what is the 5th leading cause of death in OA

Answer 14

accidents
deaths from falls is 2/3
most occur at home
more health problems=greater fall risk

Question 15

fallers vs nonfallers

Answer 15

used mobility devices more

lower functional independence

rated the usability of their homes lower

cane users

person-environment fit model better predictor than environmental hazards adaptations

Question 16

what causes falls? (person factors)

Answer 16

postural hypotension

weakness

functional cognitive, and sensory changes

medication

pain

poor balance

Question 17

what causes a fall? (environmental factors)

Answer 17

poor lighting

slippery or uneven flooring

unexpected objects

restraints

lack of structural support

Question 18

Prevention of falls (at home)

Answer 18

secure or eliminate loose rugs

remove clutter

assess for adequate lighting

assess bathroom for grab bars

emergency alert system

obtain referrals for OT and PT

Question 19

screening for falls

Answer 19

get up and go test
morse fall scale
tinetti balance screen
hendrich fall assessment

Question 20

Nursing role in fall prevention

Answer 20

primary in fall prevention are the INTERDISICPLINARY team and coordination between setting

Question 21

what patients and families need to know about falling

Answer 21

it is not a normal part of agin

the risk of falling can be minimized

falling may be an early sign of illness

Question 22

osteoporosis and falls

Answer 22

osteoporosis has a greater impact than cancer of disability and death

bone mass loss

prevention is goal (screen with bone density)

effective treatment (complexx medication regimens, calcium, vit D, biphosphonates)

Question 23

prevention and treatment for osteoporosis

Answer 23

weight bearing excerise

balancing exercises

healthy diet- rich in calcium and vitamin D

start prevention in the 20s

Question 24

Tinetti Fall Assessment- Balance

Answer 24

sitting balance
arises
attempts to rise
immediate standing balance
standing balance 
nudged
eyes closed
turning 360 degrees
sitting down

Question 25

tinetti balance assessment-gait

Answer 25

``` indication of gait step length and height foot clearance step symmetry step continuity path trunk walking stance ```

Question 26

changes in sleep with aging

Answer 26

more naps increased sleep latency (longer to fall asleep) increased awakenings and arousal decreased stage 3 and 4 (slow wave deep sleep) decreased rem sleep reduced sleep efficiency decreased melatonin levels

Question 27

poor sleep can lead to

Answer 27

decreased attention, vigilance and memory increased depression increased problems with balance increased car accidents increased HTN, CVD morbidity and mortality in those with sleep apnea

Question 28

common sleep disorders

Answer 28

insomnia chronic pain obstructive sleep apnea restless leg syndrome/periodic limb movement disorder

Question 29

what is insomnia (assessment included)

Answer 29

the inability to fall asleep or stay asleep as long as desires assessment involves obtaining sleep history (naps?, coffee, alcohol, pain?) and tools are epworth and pittsburgh sleep quality and index

Question 30

causes of insomnia

Answer 30

depression anxiety/PTSD dementia parkinsonism

Question 31

managing insomnia

Answer 31

help elder adjust to changing sleep rhythms manage health conditions cognitive therapy for depression/anxiety gentle yoga/stretching exercises

Question 32

what is obstructive sleep apnea

Answer 32

most common cessation/reduction in airflow for greater than 10 sec caused by obstruction/collapse of airway leads to oxygen desaturation loud, chronic snoring lack of dreaming

Question 33

causes of sleep apnea

Answer 33

``` obesity family history of OSA men>women small airways (allergies, trauma, anatomy) smoker ```

Question 34

risks of sleep apnea

Answer 34

dementia cardiovascular disease poor blood sugar control day time sleepiness

Question 35

treatment for sleep apnea

Answer 35

identify it weight loss stop aggravating factors (alcohol, smoking, etc.) CRAP machines surgery

Question 36

restless leg syndrome/periodic limb movement disorder

Answer 36

repetitive movement of legs during sleep common in parkinsonism, renal disease, diabetes and spinal disease medications may exacerbate problem (antidepressants, antipsychotics, alcohol) worse in the evening onset during inactivity nighttime leg twitching helps to move

Question 37

supplements that may help restless legs

Answer 37

iron magnesium folic acid/B-complex

Question 38

RLS home remedies

Answer 38

OTC pain meds warm baths and massage warm or cool packs relaxation techniques exercise improve sleep hygiene

Question 39

Sleep hygiene

Answer 39

consistent sleep and wake schedule create a regular, relaxing bedtime sleep-conductive environment comfortable mattress and pillows used bedroom only for sleep and sex finish eating at least 2-3 hours before bed exercise regularly avoid caffeine limit alcohol

Question 40

Pain

Answer 40

the most common reason for seeking health care services

Question 41

Nocioceptive Pain

Answer 41

occurs when pain receptors are stimulated during injury or trauma caused by active illness, injury, and/or inflammatory process lasting less than 6 months (acute pain)