FINAL Flashcards
(169 cards)
1
Q
what does ADPIE mean
A
assessment
diagnosis (nursing diagnosis)
planning
implementation
evaluation
2
Q
A nurse writes the following in the care plan: “Encourage ambulation in the hallway twice daily to improve circulation and reduce risk of pressure injuries.” This is an example of:
A. Evaluation
B. Diagnosis
C. Planning
D. Assessment
A
C, creating SMART goals for the patient to achieve
3
Q
what are S.M.A.R.T goals
A
specific
measurable
achievable
relevant
timely
4
Q
list some client teachings for
Integumentary system
A
- keep hydrated
- avoid excessive sun exposure
- use sun protection like SPF and sun hats
- avoid drying soaps
- apply moister to damp skin
5
Q
list some client teachings for
Musculoskeletal system
A
- calcium and vitamin D regularly to help support bones
- practice ROM exercise or go for daily walks to keep body moving (reduces chances of contractures or stiffness)
- stretches
6
Q
list some client teachings for
Cardiovascular system
A
- stress management (stress increases blood pressure)
- lifestyle changes like diet (low sodium diet)
- daily exercise 10 mins walking and slowly increase the time
7
Q
list some client teachings for
Respiratory system
A
- get a pneumonia and influenza immunization shot
- wash hands frequently
- avoid going around people who are sick
- practice good oral hygiene (bacteria from the mouth could affect the brain and lungs)
- do not smoke
8
Q
list some client teachings for
Renal system
A
- ensure regular water intake
- have regular scheduled bathroom brake
- Kegel exercises to strengthen pelvic muscles
9
Q
list some client teachings for
Endocrine system
A
- for diabetes teach patient about lifestyle management of healthy and balanced meals as well as exercising, but also teach patient how to inject themselves and check their blood sugars
- for hypothyroidism (low thyroid) want hormone therapy (levothyroxine) to balance the offset of thyroid in the body
10
Q
normal ranges for blood sugar levels are?
A
4.4-6.1 mmol/L with A1C at or below 7%
11
Q
list some client teachings for
Gastrointestinal system
A
- go when you need to go don’t hold it in
- wear dentures that fit right
- practice good oral hygiene bacteria from the mouth could affect the brain
- eat meals in a relaxed environment
- avoid sitting for a long time after eating to promote peristalsis
12
Q
list some client teachings for
Reproductive system
A
- Kegel exercises to strengthen pelvic muscles
13
Q
list some client teachings for
Neurological system including the sensory system
A
sensory
- regular screening
- no smoking
- protective eye wear to reduce injury
- reduce glare
neurological
- activities that challenge the brain like puzzles
- proper 8 hours of sleep
- regular doctors visits to keep up with health
14
Q
list some client teachings for
Immune System system
A
older adults are at higher risk for infections and getting sick
- practice good hand hygiene
- wear mask when out in public
- be up to date with immunization shots
- stay away from sick people
- avoid sharing with people
- regular doctors visits
- hydration and balanced meals
15
Q
what is creatinine clearance?
A
creatinine clearance tells us how well the kidneys are working and how well medications taken by the patient can process out through metabolization
16
Q
true or false:
males are most likely to abuse alcohol
A
true, men are more likely to abuse alcohol and female are more likely to abuse prescription drugs
17
Q
- most common type of substance use
- it interacts with at least 50% of medications
- with this substance patient will build up tolerance meaning a sedative or analgesic wont be effective
- most people won’t reach out for help as it could be shameful
A
alcohol
18
Q
what are the s/s of alcohol abuse
A
- confused
- shaking
- tremors
- irritable
- sweaty
- loss of coordination and slurred speech
- poor personal care like not eating, taking a bath
19
Q
at what stage of ADPIE do you gather subjective and objective data?
A
assessment
20
Q
true or false for alcohol detoxification can only happen within a specialized facility?
A
true, they have the means to care for the intense symptoms the patient may go through
21
Q
nursing interventions for alcoholics
A
- cut back on drinks
- drink non-alcoholic drinks
- connect with sobers societies like AA
- admit the patient so they can quit (cold turkey) in the right setting around professionals
22
Q
what is the physiology with alcohol and older adults
A
- they get drunk more easily, alcohol stays in the blood longer than normal when aging
- higher risk for stomach ulcers and bleeding because the stomach lining is thin
- alcohol stays longer in the body because the kidneys and livers are slower at metabolizing
23
Q
what conditions have the symptoms anorexia and weight loss linked to them?
A
- GERD
- hiatal hernia
- acid reflux
(the symptoms of weight loss and anorexia in elders are often symptoms of underlying conditions)
24
Q
what are the 3 D’s
A
dementia
delirium
depression
25
- not normal part of aging
- loss of interest or pleasure in daily activities for at least two weeks
- feelings of sadness and crying
- this is a common mental health problem
- older people will show physical symptoms like lack of sleep or loss of appetite
depression
26
- slow onset of actions
- memory, thinking and social abilities are affected
- irreversible state that progresses over years
dementia
27
- fast onset but also symptoms leave once condition is dealt with
- cant think clearly, disoriented
- will cause temporary confusion
delirium
28
list some consequences of delirium include
- longer stays in the hospital
- increased risk of falls and wandering
- confusion or outbursts
- functional decline if underlying condition isn't dealt with
29
interventions for delirium
- don't re-arrange the patient's space when they are already feeling confused
- re-orientate the patient
- communicate in simple terms and be considerate of your facial expressions and tone
- assess medications that could have caused this fast onset of symptoms
30
a progressive state where condition becomes worse and is irreversible
a. dementia
b. delirium
dementia
31
how to provide care for patients with dementia
- use simple language and avoid medical terminology to avoid confusing the patient more
- keep to the patients routine to avoid confusing them and getting the patient agitated
- providing person centered care and looking at the patient more than just their condition
- practicing DIPPS
dignity
independence
privacy
preference
safety
- taking the pt back to 100% like letting them do tasks they can do independently like brush their hair
32
what does DIPPS mean
dignity: treating the patient as a patient and with respect just because they may not speak up or understand doesn't mean you provide them with less care
independence: support the patient with letting them do as much as they can like allow them to pick their clothes out for the day, or brush their hair
privacy: ensure privacy to the patient when providing care again because they cant speak for themselves doesn't mean you can provide care with the room door open or curtains open where other residents can walk by
preference: respect their routine and wishes like lets say before the decline of the patient they liked putting lotion on every morning continue that on in their care
safety: keeping the patient physically and emotionally safe like keep environment clutter free to avoid falls, check in with patient to see how they feel
33
An older female adult with dementia exhibits new
behaviours, including crying and verbalizing the same
phrase repeatedly; furthermore, the behaviour has
increased over two days. Which intervention should the
nurse implement in response to this behaviour?
a) The nurse tells the older adult that he will
remember what she says if she stops crying
b) The nurse attributes these findings to
deterioration in cognitive function
c) The nurse checks the medication administration
record for missed doses or drug interactions
d) The nurse presents probing questions to the
patient about her behaviour
C, the symptoms increased over the span of 2 days which is sudden
34
what is the digestive system and list the anatomy
*starts*
mouth
pharynx / larynx (which is the voice box)
esophagus (with the help of peristalsis food goes down)
stomach (with gastric acid food gets mushed up into chyme, stomach is located in the LUQ)
small intestine
large intestine
anus
*ends*
35
what are the 3 sections of the small intestine
- duodenum
- jejunum
- ileum
36
small intestine anatomy
- where the chemical breakdown and absorption of the nutrients happens
- small intestine is 20 feet long (length of a car)
- consists of 3 sections duodenum, jejunum, ileum
37
large intestine anatomy
- large intestine absorbs the remaining water and eliminates waste through the anus
- section starts at the cecum (starting of large intestine also attached to the appendix)
- ascending colon (located at the right side of abdomen) liquid stool
- transverse (located across the abdomen) mushy stool
- descending colon (located at the left side of the abdomen) solid but not fully formed stool
- sigmoid colon (located between the iliac crest and the rectum) fully formed stool
- rectum which ends at anus (waste gets dispelled)
38
what are some age related changes in the digestive sistem
- less saliva production (dry mouth = xerostomia is common) -> advise patient to keep water near or candy to relieve the dry mouth
- teeth wear down /decay -> regular visits to the dentist and remember to floss to avoid periodontal diseases
- loss of sphincter muscles that communicate to the body when to go which causes loss stoles
- decline in taste buds so food will start tasting the same-> use foods that have a stronger smell so the nose can sense it before the tastebuds do
- peristalsis slows down with can cause regurgitation of food because of how slowly it moves down -> offer small meal portions and patient to sit upright
39
what is a gastroscopy
- a endoscopic examination
- a visual examination of the upper gastrointestinal system (esophagus, stomach, adn duodenum)
40
what is the most common GI complaint
constipation
due to
- mediation like opioids
- poor habits like not moving around, eating fiber, or not enough water intake
- holding it in when you need to go which can cause impaction of the stool
41
- esophagoscopy (procedure visualizing the esophagus)
- gastroscopy (focus is mainly on the stomach)
- gastroduodenoscopy (stomach, and duodenum)
- esophagogastroduodenoscopy (esophagus, stomach, and duodenum)
- endoscopic retrograde cholangiography (assess the bile ducts that carry bile from the liver to small intestine)
are all procedures of what body system?
upper GI
42
- colonoscopy (exams all the colons + cecum)
- proctoscopy (visual examination of the rectum or anus)
- sigmoidoscopy (visual examination of the sigmoid colon)
are tests done to what part of the system
lower GI
43
what is important for our health, happiness, independence, quality of life, important for healing, physical and mental functioning
nutrition
44
esophageal cancer cause plus s/s
- no known cause but factors like smoking, drinking, poor oral hygiene and eating spicy foods (eat in moderations)
s/s of esophageal cancer
- progressive dysphagia (trouble swallowing becomes worse and worse get patient to sit up right when eating to avoid aspiration)
45
what are the 2 types of mouth cancer and list the sites and list the s/s
- squamous cell carcinoma (occurs on the lips, tongue, tonsils, buccal mucosa (check), floor of the mouth.
- basal cell carcinoma (occurs on the lips)
s/s
- tongue irritation / pain that travels from tongue to ear
- loose teeth / trouble of dentures fitting in
- presence of leukoplakia (white patches in the mouth)
46
list some causes and risk factor for oral cancer
- alcohol
- tobacco
- sun exposure
- papillomavirus (skin warts)
- poor nutrition/ oral hygiene and flossing
- week immune system
- genetics
47
list some patient teaching for oral cancer
- avoid know risk factors like drinking, smoking, chewing tobacco
- practice good oral hygiene
- eat well balanced meals that can help with healing
- early detection for mouth pain or toothaches
- get vaccinated for papillomavirus will lower risks of getting oral cancer
48
periodontal disease and the s/s
- begins with the gums
- caused by poor oral hygiene
s/s
- gums become red, swollen adn bleed easily
49
what are some patient teachings for periodontal disease
- go for regular check ups so it can be caught early
- brush teeth 2 a day and floss
- eat less sugar in your diet as it can feed the bacteria within the mouth making condition worse
50
what is the Valsalva maneuver
- rapid change in blood flow that can cause one to pass out when straining
- can be dangerous for people who have heart conditions
51
what are hemorrhoids
- swollen blood vessels around the anus and rectum could ne internally or externally
52
what is fecal impaction
- stool is hard and dry so it becomes stuck
- digital fecal impaction (you needa dig the poop out with the finger)
53
what are some medications that can be used for constipation
- stool softeners
- laxatives (careful old ppl love this and build dependence)
54
what would be your nursing interventions for an older adult who is constipated
- promote consistency and routine (dont hold it in!!!)
- eat more fiber in meals (whole wheat bread, brown rice, oatmeal, fruits like apples, berries, veggies like broccoli or carrot
- eat more prunes or prune juice
- movement and hydration is key
- medications like laxatives
55
what does eructation mean
burping
56
what is a hiatal hernia
- portion of the stomach travels up to the esophagus, theres a protrusion through the diaphragm allowing the ball or hernia to be felt
57
what are the causes of hiatal hernias
- long term bed rest or reclining position
- obesity
- constantly lifting things that can make your diaphragm muscles weaker
58
what are the s/s for hiatal hernia
- feeling full
- dysphagia (difficulty swallowing)
- heartburn and regurgitation
- eructation (burping)
59
patient teaching for hiatal hernias
- sit up right when eating
- dont go lay down or sleep after eating right away
- eat in smaller portions but more often if needed
60
what is a peptic ulcer and list the causes and the s/s
- open sore in the GI track lining
(because of the loss of tissue from the GI track open sores begin forming)
- drugs, stress, and infection
- most ulcers are caused by H. pylori
- burning pain
- nausea
- weight loss
- anorexia
61
care for a patient with a peptic ulcer and assessments
assessments
- GI focused assessment
- pain assessment
- assessment of medications like overuse of NSAIDS
- assess VS
- inspect, auscultate and palpate the abdomen
pt
- teach patient to take medications as prescribes to reduces the symptoms of heartburn
- tell patient to experiment with foods if it causes discomfort avoid eating that food next time
62
age related changes in the urinary system
- loss of 50% of the nephrons
- kidney shrinks
- urine creatinine declines because nephrons decline and they filter the creatinine out
- nocturia is common waking up at night to use the bathroom
- bladder muscles weaken causing incontinence (incontinence is not normal part of aging but its common)
63
what are some diagnostic tests for the urinary system
- urinalysis (Clean-catch midstream tell patient to void and stop and void again this time collecting the sample) the dip stick tests that assess WBC, nitrates, and leukocytes)
- urine culture and sensitivity (sterile sample so tell patient to pee a bit and pee again this time collecting the sample -> collect midstream sample) this tests diagnoses UTI or bacteria in the urine, samples must be collected before any medication or treatment is given medication could alter the results
64
what is cystitis, cause, and s/s
inflammation of the urinary bladder
cause
- bacterial infection like from a catheter
s/s
- hematuria (blood in the urine)
- fever
- confusion and change in behavior in older adults
- urgency and frequency
- abdominal pain
65
cystocele and rectocele causes, s/s, and treatments
cystocele is the bladder bulges into the vagina
rectocele is the rectum bulges into the vagina
causes
- childbirth and pregnancy
- weakening of the pelvic floor muscles
s/s
- Dyspareunia (painful or difficulty during sexual intercourse)
- re-ocuring bladder infections
- back and pelvic pain
treatments
- kegal exercises
66
Decreasing force of urinary stream, frequency, nocturia,
and post-voiding dribbling in older men are symptoms of
__________.
a) benign prostatic hypertrophy (hyperplasia)
b) urinary tract infection
c) testicular torsion
d) varicocele
A, UTI in men
67
The physician has ordered a diagnostic blood test to determine the kidneys' ability to excrete wastes.
The blood test ordered is:
a) Blood urea nitrogen (BUN)
b) Serum creatinine
c) Creatinine clearance
d) Urine culture and sensitivity
b
68
theories based on the belief that the rate of aging is directly related to the organism’s rate of living and that external events cause damage to the organism’s
cell include all the following except:
a) Programmed Aging
b) Cross link
c) Oxidative Stress
d) Wear and tear
A
69
What is the leading cause of disability in old age?
a) Arthritis
b) Cancer
c) Injury
d) COPD
A,
70
the nurse administers and antibiotic and Naproxen to an
older female adult. Which laboratory test should the
nurse monitor to gauge if the older adult’s kidneys are able to metabolize the medications?
a) Urine Creatinine
b) Bilirubin
c) White Blood Cells (WBC)
A
71
An older adult has been diagnosed with a nutrition imbalance. Which status? age-associated intestinal problem should the nurse be aware of when planning goals and interventions to improve this older adult’s nutritional
a) Older adults have less intrinsic factor secretion
b) Older adults have short, broad, small intestinal villi
c) Older adults have decreased gastric smooth muscle
d) Older adults have decreased large intestinal motility
D, slower GI mobility meaning food moves more slowly through the system
B, would be absorption issues
72
Sickle cell anemia is a genetic disease occurring almost exclusively in:
a) African Americans
b) Native Americans
c) Hispanics
d) Caucasians
A
73
Incidence of hypothyroidism increases with age, especially among women.
a)True
b) False
A
74
An older male adult with diabetes mellitus complains to
the nurse that his feet feel like they are burning. What should the nurse recommend to this older adult to improve his discomfort?
a) Well-fitting leather shoes
b) Knee-high nylon stockings
c) Soaking feet in warm water
d) Antifungal powder on feet
A
75
The diagnostic test that visualizes valve abnormalities
is a(n):
a) Electrocardiogram (ECG)
b) Holter monitor
c) Stress test
d) Echocardiogram
D, uses sound waves that creates visual images (like an ultra sound)
A, are pads that are placed on the chest records electrical activity of the heart
76
The nurse emphasizes that the lifestyle change that has the greatest effect on reducing the average systolic range is:
a) Dietary sodium reduction
b) Aerobic physical activity
c) Moderation of alcohol consumption
d) Weight reduction
D
77
The most serious complications of chronic obstructive pulmonary disease (COPD) are:
a) Respiratory failure and heart failure
b) Respiratory failure and infection
c) Infection and heart failure
d) Pulmonary embolism and spontaneous pneumothorax
A
78
A potentially chronic reversible obstructive airway inflammation triggered by allergens or irritants is:
a)Chronic bronchitis
b) Cor pulmonale
c) Asthma
d) Emphysema
C
79
the nurse is looking after a 73-year old female in a nursing
home who states she is having poor appetite with fatigue,
increasing dyspnea with exertion and at rest, and a
productive cough with yellow sputum. The client has
smoke one pack of cigarettes daily for 45 years. BP
140/90, pulse 100 beats/min, respirations 28 breaths/min,
Temp 38.1 C. What nursing intervention is correct for the
nurse to follow in caring for this client?
a)Document the amount and color of sputum
b)Request chest physiotherapy per the physician’s order.
c)Administer oxygen at 1-3 litres/min per nasal cannula as ordered.
d)Assist client into high-Fowler’s position in bed.
e)All of the above
E
80
Which of the following is incorrect about Pruritis (sensation of itching)?
a)Prominent symptom with dermatitis, eczema and insect bites
b)Can be seen following systemic conditions: renal failure, diabetes mellitus
c)Stress management may help control pruritus
d)Treatment is directed at correcting the symptoms
D
81
Factors that increase the risk of osteoporosis include all of
the following except:
a) Estrogen deficiency
b) Increased physical activity
c) Inadequate calcium
d) Long term Corticosteroid therapy
B
82
A nurse at a long-term care facility has received a report on a newly admitted resident. The resident has been diagnosed with rheumatoid arthritis (RA). The nurse is aware that RA is:
a) Characterized by the degeneration of articular cartilage with hypertrophy of the underlying and adjacent bone
b) A chronic, progressive inflammatory disease
c) When bone absorption surpasses bone formation
d) A rare, acute inflammatory disease that primarily affects skeletal muscle
B
A, is osteoarthritis where cartilage is broken down and bones start to rub together
C, osteoporosis
83
An older female adult with dementia exhibits new
behaviours, including crying and verbalizing the same
phrase repeatedly; furthermore, the behaviour has
increased over two days. Which intervention should the
nurse implement in response to this behaviour?
a) The nurse tells the older adult that he will
remember what she says if she stops crying
b) The nurse attributes these findings to
deterioration in cognitive function
c) The nurse checks the medication administration
record for missed doses or drug interactions
d) The nurse presents probing questions to the
patient about her behaviour
C
84
what is hypertension
high blood pressure
85
what are the 2 different types of hypertension
- primary hypertension
- secondary hypertension
86
what type of hypertension is this
caused by underlying factors like pregnancy or having diabetes contributes to having hypertension
a. primary
b. secondary
B
87
what type of hypertension is this
high BP due to age, genetics, and lifestyle factors usually develops over time
a. primary
b. secondary
A
88
risk factors for hypertension
- atherosclerosis
- diabetes
- dyslipidemia (high lipids in blood vessels)
- obesity
- family history
- unhealthy lifestyle like drinking, smoking, eating bad food
89
s/s of hypertension
- nose bleeds (epistaxis)
- lightheadedness
- occipital headaches (back of the head headaches)
90
what happens if hypertension is left untreated
- could affect the heart leading to coronary artery disease
- affect the kidneys
- brain, lead to a stroke
- and eyes lead to blindness
91
NI for hypertension
- stress management (like yoga or meditation)
- assess baseline bc this 96/54 could be normal for them
- limit sodium and alcohol intake
- assess vs and teach patient how to check their own BP
- medications
- stop smoking
- sleeping 8 hrs
- regular screening
- incorporate physical activity
92
what are some medications you can take for hypertension
- ace inhibitors "end in pril"
- ARB's "end in sartan"
- calcium channel blockers
- diuretics: Lasix's like furosemide
- vasodilators
93
heart murmur
- abnormal sound different than the usual "lub-dub"
- sound could be made because blood is moving too fast in a different direction or because of backflow
94
what is a HDL test
H= healthy
means healthy heart its cholesterol levels are good keep these levels high
95
what are LDL tests
L= lousy
keep these levels low if they become to high plaque buildup in the blood vessels can start happening
96
which of the following is a portable ECG that monitors results for 24-48 hours
a) loop recorder
b) holter recorder
c) multiple-gated acquisition scan
B
97
which of the following creates images of the heart
a) Electrocardiogram (ECG)
b) Holter monitor
c) Stress test
d) Echocardiogram
D
a= pads/patches against the body to measure electrical impulses from the heart
b= portable ECG
c= exercise during ECG monitoring
98
what side of the heart usually fails first
left side
99
what is heart failure
- where the heart cant meet the bodies need of how fast to pump
- usually the left side fails first and as a result the right side
100
what are the s/s of left sided HF
LEFT= LUNGS
tachycardia, wheezing, dyspnea, and crackles, anxious, pale
101
what are the s/s of right sided HF
RIGHT=rest of the body
- jugular vein distension causing pressure in the vessels
- rest of the body also has ton of pressure and fluid buildup causing edema
- weight gain
- low urine output
102
cardiovascular system changes in the older adult
- how much the heart pumps and the amount of blood it pumps decreases (stroke volume and cardiac output)
- so it takes longer for the heart to pump and return to its resting state as you get older
103
location of the brainstem and list the parts
Located between the cerebrum and the spinal cord
Consists of the
o Midbrain (located at the top of the brainstem and controls motor movement like your hands or moving your face when you hear a noise)
o Pons (located between the midbrain and the medulla oblongata controls facial movement like blinking, chewing, or facial expressions)
o Medulla oblongata (lowest part connect to the spinal cord controls autonomic functions like breathing and heartrate)
104
the capacity one has for movement within the immediate and larger-scale environment is definition of what
definition of mobility
how much and how well someone can move within their daily lives
105
what are the changes in the musculoskeletal system?
- reduced height because vertebral disk thin bc of dehydration
- weaker bones (because of bone mineral density (BMD)
- kyphosis (stooped posture) bc the bones get weak and start curving
- movement becomes limited
- wear and tear to the muscles that aren't being moved around (atrophy of muscles)
106
why do older adults move more slowly and with caution
slower reaction time so they take extra precautions when moving around
107
as the nurse what do you do when a client tells you they're about to fall?
- help them down to the floor as safely as you can without hurting yourself or the patient
- stabilize the patient and don't move them
- do a quick head to toe ax.
108
an event that results in a person coming to rest in the ground or other lower level is the definition of what
fall
109
what are some things that could contribute to a fall
- environment
- foot wear or lack of grippy socks
- visual impairment lack of aids like walker or clean glasses
- lack of cognitive abilities not understanding that wet floor sign is placed their for a reason
- medications can cause a sedative effect
- age -> poor balance, weak bones, higher risk of fractures
110
most common cause of nonfatal injuries and hospital admissions for trauma
a. lack of aids
b. medications
c. falls
C, is also leading cause of death in older adults older than 65
111
112
musculoskeletal osteoporosis
- bone (osteo), pore (por), disease (osis) = osteoporosis
- more at risk for fractures because pores causes bones to be weaker
- common sites at forearm, pelvis, humerus, forearm, hip, vertebrae
- women are more likey to get this
113
what are the 3 fall risk assessment tests that are used as early interventions
- hendrich II fall risk model
- morse falls scale
- the berg balance scale
114
what is the test that's a part of the hendrich fall risk model, where you assess how well an older adult can sit in a chair
get up and go
115
which of the following assessments...
take gender, mental and emotional health into consideration
a. hendrich II fall risk model
b. morse falls scale
c. the berg balance scale
A
116
which of the following assessments...
rapid and simple method of assessing ones likeliness to fall, based on their history of falls
a. hendrich II fall risk model
b. morse falls scale
c. the berg balance scale
B
117
which of the following assessments...
assess performance of functional tasks, good assessment for those who have had a stoke
a. hendrich II fall risk model
b. morse falls scale
c. the berg balance scale
C
118
What is the minimum score that indicates a high fall risk in the Hendrich II Fall Risk Model?
a) 3
b) 4
c) 5
d) 6
C, score of 5 or higher = higher risk of falls
119
true or false siding rails are only considered a restraint if all 4 side rails are up
true
120
falls reduction interventions
- exercise
- adjust environmental factors like clutter or lighting
- assistive devices
- temp affects mobility as well cold temp = stiff bones adn muscles
- ensure proper foot wear
121
122
which one is the cushioning
a) bones
b) cartilage
c) tendons
d) ligaments
B, supported around the joints and helps moves bones smoothly
123
which one is the hard tissue makes up most of our skeletal system
a) bones
b) cartilage
c) tendons
d) ligaments
A
124
which one is the one that connects bone to cartilage also a strong and flexible band like a resistances band at the gym
a) bones
b) cartilage
c) tendons
d) ligaments
D
125
which one is the one that connects bones to bones
a) bones
b) cartilage
c) tendons
d) ligaments
C
126
what condition is this where the more you use your body it breaks down and bones start to rub together,
- major site of this condition is the knees but could also be at the hands and hips
- big loss of cartilage, and intense pain
S&S:
- pain when moving, stiffness, limited movement, swelling of the joints
osteoarthritis
127
what are some NI for osteoarthritis
- patient teach about osteoarthritis
- ROM exercises
- pain assessments \ management
- encourage rest between activities and schedule activities around your peak time like after taking pain medications
- provide heat or cold packs
- provide aids like walkers to keep pressure off joints
- weight management to not put pressure on joints
128
what condition is this a autoimmune chronic progressive inflammatory diseases that can affect multiple joints at once causing joints to swell up with fluid and inflamed synovial tissues (joints become all swollen like a bouncy ball), happens bilaterally
S&S:
morning stiffness lasting more than 1 hour, joint changes ate symmetrical so happen on both sides of the body, organs can be affected and inflamed as well.
rheumatoid arthritis
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what are some NI for rheumatoid arthritis
- body image is impacted because of the swelling in the joints -> provide emotional support
- allow patient time to get up and do ADL's slowly because of the stiffness -> assess how ADL's are affected
- provide aspirin or NSAID's anti-inflammatory medications (to reduce the pain with swelling between the joints)-> pain assessment and management
- pt will be scared of pain so limited movement will be present -> support patient through their fears and anxiety about this condition by teaching them
130
a patient with a UTI is advised to drink 35 ml/kg of body weight daily to help flu sh out bacteria, the patient weights 132 lbs. How much should the patient drink each day?
2.1 liters or 2100 mL
131
age related changes in the neurological system CNS adn PNS
- decrease in brain weight and size
- dendrites "wear out" affecting memory, reaction time, and learning
- loss of sensations and tactile senses (bc there's a loss of nerve endings)
132
what is the progressive degenerative disorder of the basal ganglia called where over time loss of movement, coordination and tremors occur.
- men are more likely to develop this condition than women
a. parkinson's
b. dementia
parkinsons
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what are the s/s of parkinsons disease and medical treatments
- bradykinesia, tremors, rigidity
- shuffling
- monotone voice and lack of facial expressions
- changes in handwriting
medication
- levodopa-carbidopa (senemet)
physical therapy for gait retraining
134
what are the 2 types of CVA's called
ischemic and hemorrhagic
135
what are some NI for someone with a fall risk
- provide assistive devices like walkers so they could make their way around with out losing balance
- make sure their space is clutter free
- make sure they have proper foot wear or at least grippy socks at might if they want to go to bed
- medication review some medications could make you drowsy
- exercise to promote balance
136
an obstruction or blockage of blood vessel caused by plaque buildup in the blood vessels or clot
is called what
a. ischemic
b. TIA
A
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rupturing blood vessel in the brain that causes increase pressure in the brain
a. hemorrhagic
b. ischemic
hemorrhagic
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- is called a mini stoke
- symptoms usually leave within 24 hours with no permanent damage
- temporary blockage of blood vessels to the brain
is what type of stroke
TIA
139
what are stoke risk factors non-modifiable and modifiable
non-modifiable
- age
- gender
- genetics
- race
are all things you cant change
modifiable
- lifestyle changes like diet, exercise
- smoking and drinking
- stress management
140
s/s of a stroke
FAST
face; ask patient to smile and see if one side of face is drooping
arms; ask patient to raise both arms up
speech; is patients speech slurred
time; call or get help
stiffness of the neck, loss of consciousness, vomiting, and seizures
141
- language disorder that affects the patients ability to speak, read, write, or understand language
- many types like global, receptive, or broca's
a. aphasia
b. dysarthria
c. dyspraxia
A
142
difficulty swallowing
a. aphagia
b. dyspraxia
c. dysphagia
C
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brain has trouble communicating the motor movements
a. dyspraxia
b. aphagia
c. hemiplegia
A
144
brain can still form words but speech is altered due to weakness of the muscles
speech is slurred or slowed
a. aphasia
b. dysarthria
B
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paralysis of one side
a. quadriplegia
b. paralysis
c. hemiplegia
C
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vision related changes
- keratoconjuntivitis sicca = eyes dont produce tears
artifical tears or eye drops are used
- seen in women after menopause
- senile ptosis (eyelids start drooping)
- colour starts to fade as the colour clarity diminishes
- number of rods is reduced (meaning cant see at night time/ in the dark)
147
age related changes in hearing
- too much cerumen
- shape of the ear changes ear lobes sag and become longer
- ear hairs become thick and stiffer
- there is conductive (smt blocking the sound waves from entering like cerumen or fluid can be fixed or treated) and sensorineural hearing loss (damage to the inner ear happens (cochlea) usually from genetics or loud sounds this is permanent not fixable)
148
- increased intraocular pressure results in damage to the retina and optic nerve with loss of vision resulting in tunnel vision
- many types like open angle, cute angle
are all what type of vision changes
Glaucoma
149
what vision changes is where the lens becomes cloudy
cataracts
150
- loss of central vision peripheral vision still intact
- degenerative eye disease
s/s
- blurry spot in center vision
- difficulty to read and drive
- need bright light to see
risk factors
- excessive exposure to sunlight (wear sunnies)
- genetics and family history
- smoking
AMD (age-related macular degeneration)
151
It is characterized by ringing in the ear and may also manifest as buzzing, hissing, whistling, clicking, pulsating, or swishing sounds, sounds could be constant or intermittent
what hearing relation condition is this
tinnitus
152
tinnitus can be caused by
- loud noises
- excessive ear wax
- allergies
- medication side affects like with aspirin
153
what are the changes in the respiratory system
- reduced cilia meaning more waste enters the lungs higher chance of infections and respiratory diseases
- lungs lose their elastic recoil meaning some air is still trapped inside
- harder to expand the chest bc the chest wall is less flexible and stiff
- more resistance to the lungs causing them to be narrow and harder to breath
154
what 2 conditions make up COPD
- emphysema
- chronic bronchitis
155
what happens with COPD
where theres too much mucus, airways are trapped making it harder to breath "feels like their drowning in their own mucus"
smoking is the number one cause to COPD
156
chronic bronchitis and list s/s
- inflammation of the bronchi bc of increased production of mucus and chronic cough
caused by inhaled irritants like smoke, cigarettes
s/s
- productive cough
- wheezing
- SOBOE (trouble breathing while walking)
157
what is the most serious complication of COPD
cor pulmonale (right sided heart failure that happens secondary to the pulmonary disease)
158
what condition is this: airways become narrowed and inflamed making it harder to breath, its triggered by allergens or irritating products, reversable obstructive airway disorder.
some S&S include...
wheezing, tachycardia, tachypnea, dyspnea
medications to help are: bronchodilators, and anti-inflammatory drugs
asthma
159
what condition is this where the more you use your body it breaks down and bones start to rub together,
- major site of this condition is the knees but could also be at the hands and hips
- big loss of cartilage, and intense pain
S&S:
- pain when moving, stiffness, limited movement, swelling of the joints
osteoarthritis
160
NI for osteoarthritis
- ROM exercises
- encourage rest between activities
- provide heat or cold packs
- weight management to not have pressure on joints
- pain management
161
what is the most common form of arthritis
osteoarthritis
162
true or false arthritis is more common in men but more severe in women
true
163
what are the risk factors for arthritis
- family history
- obesity
- being on weight bearing joints over long period of time like knees, hips, spine reposition often q2h
164
age related changes in the immune system
- more infections could happen bc skin is thinner
- increase risk of UTI (common S&S for older adults is delirium)
- reduced cilia more changes of infections in the lungs and pneumonia
165
what biological theory is this
the body is like a machine the more we use it the more it wears out
wear and tear
166
what biological theory is this
the proteins in our body become "weak and dried out" making the skin less flexible, joints stiff, delay in wound healing. like dough first few days its soft and stretchy as it goes on gets hard and dried
cross-link
167
what biological theory is this
exposure to environmental pollutants that damage molecules in the cells, like smoke, radiation, air pollution
free-radicals/ oxidative
168
Which of the following is a true statement about dental health in older adults?
a. Most people can expect to lose most of their teeth by old age
b. Excessive saliva production is a common problem among older adults
c. Functional and cognitive limitations may contribute to poor oral hygiene
d. A little blood on the toothbrush is normal
C, because conditions like dementia will cause one to forget or make it harder to brush their teeth causing long term effects overall
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