Final Exam Flashcards

Question

Generalist's Resource to Integrate Driving (GRID)

Answer 1

Resource for generalists to assess the client's fitness to drive Includes client factors and contextual factors

Answer 2

Medical history such as seizures, neurological status, diabetes, etc. Driving history Insight Physical skills Visual skills Cognitive/perceptual skills - AMPS - Trail Making A - Trail Making B - Clock drawing - Brief cognitive assessment - MOCA - Snellgrove maze

Answer 3

Falls State guidelines Medical condition prognosis

Answer 4

Remediation of function Compensation for deficits Integration of skills - Visual motor skills - Speed of processing - Divided attention Educate on state laws

Answer 5

Clinical evaluation - 1.5 hours - Visual function (contrast sensitivity and binocular function_ - Reaction time - Motor and sensory assessmnet - Performance based test - Diagnosis specific assessments (ex. Dementia screen) Behind the wheel evaluation - 1.5 hours - Driver evaluation vehicle with instructor brake - Start in a low challenge environment - Increase demands to include use of executive function skills -> Ex. "Find and pull into a gas station" or "Drive me to a familiar location from here"

Answer 6

Specialized driver education Adaptive equipment training Compensatory strategies - Ex. Modifying a driving route to avoid left turns Communicate conclusions to family, client, and referring physician

Answer 7

Are you the only driver? Is the driver using a seat belt? Steering wheel tilt/head restraint device Distance between chest and steering wheel Line of sight above steering wheel (should be at least 3 inches) Positioning to gas pedal (should not need to reach with toes) Positioning to brake pedal (should not need to reach with toes) Mirror use Neck mobility for blind spot check Ignition key Operation of vehicle controls Driver walking around vehicle

Answer 8

At least 10 inches

Answer 9

At least 3 inches line of sight

Answer 10

Community based educational program by American Society on Aging with AAA, AARP, and AOTA Uses a 12-point checklist to help older drivers find out how well they currently fit their personal vehicle and helps to promote conversations about driver safety and community mobility Typically for drivers 55+ Events are set up by a coordinator in a big parking lot and each appointment takes 20 minutes to complete

Answer 11

Over 1/3 of participants have at least one critical issue 1/10 was seated too close to steering wheel 20% did not have line of sight at least 3" over steering wheel Older drivers are safer drivers but more likely to be killed or seriously injured when a crash occurs due to increased fragility Properly adjusting cars can increase the safety of older adults and other drivers

Answer 12

Facilitate check-in, check-up, and check-out

Answer 13

Train technicians, secure dates and locations, participate in and monitor CarFit events Communicate with the national organizations, AAA, AARP, and AOTA

Answer 14

Educate event coordinators

Answer 15

Address red flag concerns from 12 point checklist Begin conversation about vehicle fit Offer basic suggestions and demonstrate readily available devices Offer education and describe specialized resources and service

Answer 16

Decreased rate and amount of vaginal lubrication Decreased number of vaginal contractions Quicker return to pre-arousal stage Atrophy of labia, uterus, and reduction in expansion of vagina width Thinning of lining of vagina Low desire Difficulty with vaginal lubrication or inability to climax

Answer 17

Slower and less full erection Erection disappears quickly after orgasm Longer refractory period (12-24 hours) Testicles do not achieve full elevation and will not increase in size Decreased volume of sperm Ejaculatory control increases Ejaculation is less powerful and orgasm is less intense Decrease in ejaculatory testosterone

Answer 18

Fears in seeking out care Higher rates of physical limitations, weakened immune system, mental distress, and chronic disease Gay and bisexual men are twice as likely to live alone and have a higher risk of cancer and HIV Transgender older adults have higher rates of discrimination, victimization, mental distress, poor health, less support May identify with chosen family rather than biological family

Answer 19

51% of diagnosis of HIV/AIDS was among people over 50 and is diagnosed in later stages Older adults may have weaker immune systems to fight infections Important to teach safe sex CDC recommends annual chlamydia screening for all sexually active older women with risk factors Healthcare providers do not routinely discuss STDS with older adults and may misdiagnose signs Higher mid-life divorce Many older adults did not get sexual education Men may not want to wear condoms

Answer 20

23% of older adults are diagnosed with ED Individuals usually seek help from a personal physician Associated with disease conditions such as cardiac disease, diabetes, and neurogenic factors such as Parkinson's Medications should be prescribed with caution

Answer 21

Permission - Listen non-judgmentally, knowledgably, and relaxed as patient discusses sexual concerns Limited information - Educate the client about normal physiological changes with aging, psychosocial factors, and myths and stereotypes about the sexual health in the older adult population Specific suggestions - Provide patient specific suggestions to improve sexual functioning - Refer to a specialist Intensive therapy - Pelvic floor exercises (OT/PT) - Involves expertise of skilled social worker, psychologist, or psychiatrist

Answer 22

Experiment with different sexual positions and positioning aids for comfort Explore different adaptive equipment Educate on energy conservation techniques Encourage other forms of sexual expression Reassure person Discuss fears about sex Exercise to increaseor maintain ROM and muscle strength

Answer 23

Older adults with rheumatoid arthritis are more likely to have concerns about sexual functioning than those with osteoarthritis Hip abduction contractures are the greatest obstacle to sexual functioning

Answer 24

Take a warm bath prior or use of mattress warmer during sex Use energy conservation techniques (rest prior, consider timing) Take pain medication prior Use a side by side position Change positions to decrease joint pressure Use pillows and bolsters for comfort and to support joints Communicate pain Encourage seeking physician guidance if pain occurs Reduce stress and fears related to sex

Answer 25

Critical 4-6 week period of precautions Do not bend hip more than 90 degrees Do not adduct hips Do not internally rotate hips

Answer 26

Sex in missionary position with client on bottom, hips abducted, feet pointed up and with knees in extension When lying on unaffected side, keep affected leg outside of midline of body by putting a pillow between legs or using their partner's legs for support

Answer 27

Do not kneel Do not squat Do not twist knee

Answer 28

Males - Side-lying - Cowgirl - Reverse cowgirl - Sitting on a chair Females - Missionary - Standing - Side-lying Gender neutral - Sitting in chair - Side-lying

Answer 29

Extreme anxiety and depression Link between cardiovascular disease and diabetes with sexual dysfunction Sexual activity can begin after acute phase of illness with average recovery time 8-16 weeks after physician approval Low risk - Patients with controlled hypertension can safely resume sex Medium risk - Patients with mild angina require further cardiac evaluation High risk - Patients with unstable angina or hypertension - Recommended to be stabilize condition before resuming sexual activity

Answer 30

Reassure person that heart attack is unlikely as a result of sex - Sexual activity causes 1% of all MI Promote physical activity Educate to stay away from extramarital affairs Encourage a gradual return to sexual activity to reduce anxiety Suggest grading sexual activity Discuss fears Consult with physician or pharmacist about possible medication side-effects Teach relaxation techniques Teach energy conservation - Ex. Rest before sexual activity

Answer 31

Shortness of breath Chest pain Excessive fatigue Continuous increase in blood pressure Heart palpitations lasting longer than 15 minutes after sex Medication side effects

Answer 32

Equal to mild to moderate exercise

Answer 33

Patient may have hyper or hyposensitivity to touch Perceptual changes Personality changes Executive function changes Hemiparesis/hemiplegia Changes in tone Decreased fatigue and endurance

Answer 34

Use of non-verbal communication such as touch Educate on effects of perceptual deficits on sexual functioning Teach energy conservation Use positions that require less efforts for motor deficits such as side lying and client on their back Experiment with different positions Encourage use of vibrator Use visual compensation with anesthesia Use warm water prior to sexual activity to decrease spasticity Do not overstimulate involved side of body if patient has hyperesthesia Minimize distractions for patients with cognitive deficits Use lubrication Lie on affected side to free "good" arm

Answer 35

Decreased libido due to psychosocial issues Pain Radiation therapy may cause erectile dysfunction Radiation therapy in women may lead to hormonal decline and a decrease in libido erection

Answer 36

Plan ahead of time Use positions that decreased pressure * Notify physican of use of lubricants Use energy conservation techniques Use pillows and bolsters to increase comfort

Answer 37

Neuropathy Decreased circulation Increased glucose levels Men - Erectile dysfunction - Retrograde ejaculation - Less ejaculation as semen enters the bladder instead of penis during orgasm Females - Decreased lubrication - Difficulty achieving orgasm - Increased risk of yeast infection

Answer 38

Use different positioning for increased comfort Female - Side-lying - Use pillows or bolsters - Incorporate stimulation during penetrative sex Pelvic exercises Adaptive equipment - Lubrication - Vacuum pump to increase erection - Talk to physician about oral medications

Answer 39

20-30% of couples with a spouse with dementia continue sexual activity Hypersexuality or inappropriate sexual behaviors Inappropriate behaviors involve a thorough assessment - With true cognitive incapacity, boundaries must be placed on person for inappropriate behavior - Programming and re-direction should be used

Answer 40

Person 18 or older who has a substantial mental or functional impairment - A substantial mental disorder is a disorder of thought, mood, perception, orientation, or memory that grossly impairs judgment, behavior, or ability to live independently or provide self-care Person whom a guardian has been appointed under the Nebraska Probate Code

Answer 41

Someone makes a report to DHHS Intake Investigation assessment Ongoing service coordination Case closure

Answer 42

Discontinue abuse of an vulnerable adult, promote self-care and independent living, and prevent further abuse Receiving and investigation reports of alleged abused Developing social service plans Arranging for medical care, mental health care, legal services, fiscal management, housing, home health Arrange for items such as food, clothing, or shelter Arrange or coordinate services for caregiverss

Answer 43

Financial abuse

Answer 44

Normal: 0-4 Mild depression: 5-8 Moderate depression: 9-11 Severe depression: 12-15

Final Exam Flashcards

(68 cards)