Exam 2- Nursing Management of the Older Adult Flashcards
(85 cards)
1
Q
Life expectancy varies by…
A
Gender and race
2
Q
Preventative health care (3)
A
Encouragement
Community-based support services
Promote lifelong health behaviors
3
Q
Which of the following interventions is the MOST effective way to promote preventative healthcare in the older adult population?
A) Encouraging a high-protein diet to enhance muscle strength
B) Advising a one-time pneumonia vaccine at age 65
C) Recommending bi-annual bone density tests starting at age 70
D) Encouraging regular moderate exercise to maintain cardiovascular health
A
D) Encouraging regular moderate exercise to maintain cardiovascular health
4
Q
Leading cause of death
A
Heart disease
5
Q
Decreased cardiac output
A
Myocardial hypertrophy
6
Q
Reduced stroke volume
A
Increased fibrosis
7
Q
Hypertension and increased workload
A
Calcium and fat deposits
8
Q
Slower heart recovery rate due to…
A
Stress
9
Q
Orthostatic hypotension
A
BP drops when standing up or sitting down
10
Q
Age-related change in the respiratory system: onset
A
Subtle and gradual
11
Q
What happens to respiratory efficiency in older adults?
A
Diminished
12
Q
What happens to inspiratory and expiratory force in older adults?
A
Reduced
13
Q
What happens to lung mass in older adults?
A
Decreases
14
Q
What happens to residual volume in older adults?
A
Increases
15
Q
Most significant risk factor for respiratory system in older adults
A
Smoking
16
Q
What happens to epidural proliferation in older adults?
A
Decreases
17
Q
What happens to the dermis in older adults?
A
Becomes thinner
18
Q
What happens to elastic fibers in older adults?
A
Reduced
19
Q
What happens to collagen in older adults?
A
Becomes stiffer
20
Q
What happens when subcutaneous fat diminishes?
A
Less likely to conserve body heat
21
Q
With wrinkling and sagging of the skin, what happens?
A
Loss of resiliency
22
Q
Does hair pigmentation change?
A
Yes, and balding may ocur
23
Q
Why does sex decline for women?
A
Loss of partner, widowhood
24
Q
Why does sex decline for men?
A
Poor health, erectile dysfunction, medications, and emotional factors
25
What happens to the reproductive system in females?
Vaginal narrowing
Decreased elasticity
Decreased vaginal secretions
Involution
Decreased tone
26
What happens to the reproductive system in males?
Less firm tests but may continue to produce viable sperm up to 90+ years of age
Diminished production of testosterone
27
What happens to the filtration rate in older adults?
Decreased
28
What happens to the tubular function?
Diminished, with less efficiency in reabsorbing and concentrating the urine
29
What happens in the genitourinary system from the response of stress?
Slower restoration of acid-base balance
30
What can occur in the genitourinary system in males?
Benign prostatic hyperplasia
31
What occurs in the genitourinary system in females?
- Relaxed perineal muscles
- Detrusor instability (urge incontinence)
- Urethral dysfunction (stress urinary incontinence)
32
Normal BUN
7-20
33
Normal creatinine
0.7-1.3
34
What happens to sense of thirst, smell, and taste in older adults?
Decreases
35
What happens to salivation in older adults?
Decreases
36
What happens with chewing and swallowing food in older adults?
More difficulty
37
What happens to esophageal, gastric emptying in older adults?
Delayed
38
What is diminished in the gastrointestinal system in older adults?
Secretion of gastric acid and pepsin
39
What happens to gastrointestinal motility in older adults?
Reduced
40
Do older adults require more or fewer calories?
Fewer
41
Recommendations for nutritional health in older adults?
Reduce fat intake
Intake sufficient protein, vitamins, minerals, and dietary fiber for health and prevention of disease
42
What may interfere with food shopping and meal preparations?
Budgetary constraints and physical limitations
43
Factors that affect sleep quality (5)
- Respiratory problems
- Restless leg syndrome
- Nocturia
- Pain
- Dementia
44
Consequences of poor sleep (6)
- Cognitive decline
- Increase risk for falls
- Daytime fatigue
- Reduced physical and mental health
- Reduced quality of life
- Poor ICU outcomes
45
What is there a loss of in the musculoskeletal system in older adults?
Loss of bone density
Loss of muscle strength
Loss of muscle size
46
What deteriorates in the MSK system in older adults?
Muscle fibers and cell membranes
47
What happens to joint cartilage in the MSK system in older adults?
Degenerated joint cartilage
48
What is difficult to maintain in the nervous system in older adults?
Homeostasis
49
In the NS, there are decreased nerve cells in older adults. What does this mean for the brain?
Small loss of brain mass
50
What happens to the speed in nerve conduction in the NS in older adults?
Reduced
51
What happens along with physical illness in older adults?
Increased confusion, loss of environmental cues
52
In the NS, older adults may become faint and lose balance. What is this?
Reduced cerebral circulation
53
Primary cause of loss of vision
Macular degeneration
54
What happens with vision in older adults?
- Diminished ability to focus on close objects
- Inability to tolerate glare
- Difficulty adjusting to changes of light intensity
- Decreased ability to distinguish colors
55
Prejudice or discrimination against older adults
Ageism
56
Negative images in society
An understanding of the aging process and respect for each person as an individual can dispel the myths of aging
57
Psychosocial aspects (3)
Ageism
Fear of aging
Negative images in society
58
Common stressors (5)
- Normal aging changes that impair physical function, activities, and appearance
- Disabilities from injury or chronic illness
- Social and environmental losses related to loss of income
- Decreased ability to perform previous roles and activities
- Death of significant others
59
Coping: Who do older adults commonly rely on for comfort during stressful times?
Their families and spiritual beliefs
60
Abilities to adapt to change, make decisions, and respond predictably are determined by...
Past experiences
61
Where do most older adults live?
In the community
62
Places for older adults to live (5)
- Nursing home
- At home or with family
- Continuing care retirement communities
- Assisted living facilities
- LTC facilities
63
Focuses on physiology, pathology, diagnosis, management of disorders, and diseases of older adults
Geriatrics
64
Nursing process applied to older adults in all environments, including acute, intermediate, skilled care, and in the community
Gerontologic/geriatric considerations
65
Combined biologic, psychological, sociologic study of older adults within their environment
Gerontology
66
Nursing management for older adults (9)
- Supporting cognitive function
- Promoting physical safety
- Promoting independence in self-care activities
- Reducing anxiety and agitation
- Improving communication
- Providing for socialization and intimacy needs
- Promoting adequate nutrition
- Promoting balanced activity and rest
- Supporting home, community-based, and transitional care
67
Aging changes alter drug... (4)
Absorption
Metabolism
Distribution
Secretion
68
Polypharmacy
Administration of multiple medications at the same time; common in older adults with several chronic illnesses
69
Nursing implication for medication dosage
Start low, go slow
70
Most common mental health problems in older adults
Depression
Increased suicide risk
Substance misuse
Delirium
71
Acute, confused state that begins with disorientation
Delirium
72
If mental illnesses aren't immediately evaluated and treated, what might happen?
Can progress to changes in LOC, irreversible brain damage, and sometimes death
73
Dementia symptoms onset
Subtle and progresses slowly
74
Accounts for 70% of dementia
Alzheimer's disease
75
Non-Alzheimer's disease
Degenerative, vascular, neoplastic, demyelinating, infectious, inflammatory, toxic, metabolic, and psychiatric disorders
76
Seventh leading cause of death for adults over age 65
Alzheimer's disease
77
Alzheimer's disease affects how many of those 85 years and older?
Half
78
Is Alzheimer's a normal aging process?
No
79
Two types of Alzheimer's disease
Familial/early onset
Sporadic/late onset
80
Nursing management of Alzheimer's (9)
- Supporting cognitive function
- Promoting physical safety
- Promoting independence in self-care activities
- Reducing anxiety and agitation
- Improving communication
- Providing for socialization and intimacy needs
- Promoting adequate nutrition
- Promoting routine, including balanced activity and rest
- Supporting home, community, and transitional care
81
Geriatric syndromes (9)
- Geriatric triad
- Impaired mobility
- Dizziness
- Falls and falling
- Urinary incontinence
- Increased susceptibility to infection
- Altered pain and febrile responses
- Altered emotional impact
- Altered systemic response
82
Elder neglect and abuse (6)
- Physical
- Psychosocial
- Emotional
- Sexual
- Abandonment
- Financial exploitation
83
Potential economic effects in older adults (5)
- Social services
- Health care costs of aging
- Home health care
- Hospice services
- Aging with a disability
84
When reviewing the need for medication, there are 3 things to do
- Factors that affect compliance
- Keep medication regimen as simple as possible
- Strategies to improve compliance
85
What nursing implications for medication?
Assess knowledge
Review need for medication, coordination of prescriber
