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Gero 1 Flashcards

(62 cards)

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1
Q

Defining Aging

A
  • described since birth
  • old is 65; qualifies for retirement benefits
  • biological aging based on cellular decline
  • sociological aging is based on changes in roles and relationship
  • psychological aging is based on aging as a developmental stage fo through
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2
Q

marital status

A
  • 70% of people 65 and older are married
  • older men are more likely to be married than older women
  • women outlive men
  • marital status impacts income, mobility, housing, intimacy, and social interaction
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3
Q

struggles of elderly women

A
  • twice as likely to be poor
  • pay inequity, occupational differnces
  • rising health care cost
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4
Q

Financial status

A
  • major source of income: social security
  • half of older adults had less than 24,224 in yearly income
  • poverty is major issue
  • poverty: gender and race
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5
Q

Health concerns

A
  • 80% of older adults have at least 1 chronic condition
  • leading cause of death among older adults: heart disease, cancer, chronic lower res. disease, stroke, Alzheimer’s disease, and diabetes
  • most common health concerns: arthritis and hypertension
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6
Q

comorbidities

A

more than 1 chronic diseases

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7
Q

cultural groups

A
  • the largest growth in older adults is Hispanic pop
  • united states is rich w diversity
  • immigrant pop growing
  • intergenerational conflict
  • adaptation to institutional norms
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8
Q

ageism

A
  • prejudice against older adults
  • media portrayal of aging
  • one’s attitude towards aging depends on culture and history
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9
Q

ADLS

A

activities of daily living

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10
Q

IADLs

A

instrumental activities of daily living

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11
Q

aging in place

A

remain were they live- own home

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12
Q

acute care

A

acute conditions with chronic issues (comorbidities)
Dangers- drug reactions, falls, immobility, confusion
Other issues- sepsis, nutritional status, never events/ wounds
Nursing care- promotion of safety, assessment of baseline function, goal is to max independence, and enhance functioning

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13
Q

Subacute care

A

pt are stable but still actue, do not need daily physician visits, services like rehab, IV therapy

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14
Q

Rehab units

A

located in hospital, subacute care, SNF
- goal is rehab to return to original place

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15
Q

community-based residential facility (CBRF)

A

a place where 5 or more unrelated people live together in a community setting
services provided include room and board, supervision, support services, and may include up to 3 hours of nursing care per week

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16
Q

Residential care apartment complexes (RCAC)

A

independent apartment units in which the following services are provided: room and board, up to 28 hours per week of supportive care, personal care and nursing services

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17
Q

Adult family home (AFH)

A

3-4 adults reside and receive care, treatment, or services that are above the level of room and board

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18
Q

SNF

A

the decision to move in depends on pt physical/cognitive needs, support system, community resources
emphasis on quality of life and residents rights

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19
Q

Resident assessments

A

RAI- ongoing comprehensive assessment of the resident, focusing on functional abilities - long term
- hearing & speech, vision, cognition, mood, behavior, routines, functional status (incontinence), bladder and bowel, active disease, oral health, skin, nutrition, meds

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20
Q

Home care

A

multiple services or just a few
criteria: must have skilled care needed, person must be homebound, require intermittent care
must have physicians statement supporting need for homecare

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21
Q

OASIS

A

-outcome and assessment info set
- mandated by CMS for performance improvement in home care

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22
Q

community programs and services

A

senior centers, adult day care, respite care, homemaker services

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23
Q

medicare

A

federal health insurance program

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24
Q

Medicaid

A

combo of state and federal funds to pay for SNF

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25
legal and ethical issues
common concerns: capacity and competence to make own decisions, identification of decision makers, conflict about care, disclosure of info, long-term care decisions, end of life, fraud
26
OBRA
omnibus Budget Reconciliation act of 1987 major reform of nursing facilities major parts: provision of services for nursing facilities, survey and certification process, enforcement of regulations resident empowerment and rights
27
quality of care
- focus on SNF - three major areas: reduce overuse of antipsychotics, reduce inappropriate use of restraints, reduce inappropriate use of indwelling urinary cath
28
resident rights
resident bill of rights
29
Older Americans Act (OAA)
directs states to provide various services for older adults
30
ombudsmen
a person to come in and speak up for residents of that facility
31
health insurance portability and accountability act of 1996 (HIPPA)
privacy and insurance coverage
32
abusive and protective servicies
- neglect - abuse - domestic- individual with a special relationship, institutional - facility caregiver, self-abuse -exploitation - mistreatment -physical, sexual, emotional
33
The nurse as an interviewer
communication techniques, attitude, respect, consider barriers, be aware of verbal and non- verbal communication
34
education
teaching the individual in a place that feels safe for them and assessing their personal needs to learn in an environment
35
components of the assessment
health history, physical assessment, specific assessments (functional, adl, fall, nutritional) factors that affect the norm - lab values, atypical presentation of illness, loss or decrease in compensatory reserve, and decrease immune response
36
Physical assessment
challenges with assessment - nonspecific signs and symptoms, reduced energy level, pain, sensory deficits, multiple health issues
37
sensory changes
can lead to anxiety causes of deprivation -reduced sensory capacities -restrictive, monotonous environments sensory overload -usually related to abrupt changes or hospital delirium
38
sensory changes 2
smell - decreased taste - modest decrease tactile - decreases skin changes, and decreased functioning of sensory neurons eyes and vision - cataracts, glaucoma, need for more light, yellowing of lenses, decreased color and clarity auditory - presbycusis
39
Integumentary
skin assessment - determine hydration status, potential for infection changes in older adults - decreased thickness, elasticity - dry skin - decrease vascular supply to skin and glands - decreased sweating - decreased sensation - decrease subq fat - body cooling system hair - melanin decreases (hair turns gray) hair loss men - increase hair in ears, nose, and eyebrows women- hair on face and chin (change in hormonal influences nails- brittle, flat
40
Benign skin conditions
uneven pigmentation - age spots seborrheic keratoses - think, brown raised lesions cherry angiomas - increased vascularity in the dermis skin tags - small flesh-colored tumors
41
dermatoporosis
chronic skin fragility 35% of older adults skin changes actinic purpura white pseudoscars
42
arterial ulcers
- pain w exercise or rest -cramping, burning, aching -cool, thin, shiny, dry - loss of hair - thick toenails - ulcers - well defined, outer ankle, feet, toes treatment - revascularization
43
venous ulcers
stasis ulcers brownish skin discoloration (accumulation of erythrocytes) medical aspect of lower leg flat, shallow, exudate treatment - prolonged elevation and compression therapy
44
diabetic lesions
neuropathy - risk factor foot inspection and care risk for amputation
45
pressure injury assessment
major risk factors -shearing -friction -moisture -nutritional status (protein deficiency)
46
Muscko
changes in stature and posture decrease bone density decrease joint movement vertebral disc height thins less flexibility sarcopenia - age-related changes to muscles -tissue mass decreases -decreased strength and stamina nursing implications - mobility; assisted devices - increase risk of falls
47
atherosclerosis
plac build-up , black stuff that builds up - not normal
48
arteriosclerosis
normal hardening of arterial walls
49
cardiovascular
arterial wall thickening and stiffening left ventricular and atrial hypertrophy sclerosis of atrial and mitral valves strong arterial pulses, diminished peripheral pulses, cool extremities decreased cardiac reserve and efficiency
50
respiratory
decreased respiratory muscle strength; stiffer chest wall diminished ciliary & macrophage activity, drier mucus membranes decreased cough reflex increase risk of aspiration decreased lung capacity
51
renal and urological
loss of nephrons, kidney mass, ability to concentrate urine, decreased kidney size and decreased blood flow to kidneys, decreased glomerular filtration rate (GFR), unable to tolerate dehydration or fluid overload as well as a younger adult, itching, edema, raised BP
52
digestion and nutrition
decreased sensitivity to insulin changes in dental health decreased taste buds and salivary secretions decreased digestive juices GERD decreased absorption of nutrients constipation is not a normal part of aging
53
Nervous system
most changes in aging are seen in CNS - decrease brain weight and size loss of deep sleep subtle changes in cognitive and motor functioning and balance slower PNS functioning, prolonged recovery increase risk of falls
54
reproductive system
women - menopause, structural changes typical of aging muscles and skin, vaginal dryness men - able to procreate entire lives following puberty, but structure changes may interfere with sperm motility. BPH (Benign prostatic hypertension) is another common issue
55
other changes
decrease antibodies slower healing reduce cellular immunity lean body mass declines and body water is lost temp regulation issues
56
SPICES
-sleep disorders -problems w eating or feeding -incontinence -confusion -evidence of falls -skin breakdown
57
functional assessment
- important because actual age does not reveal individual ability - hospitalized older adults are at risk for loss of function skills - loss of function is the major cause of institutionalization
58
goals of functional assessment
- restore/ improve health - monitor changes in health - enhance independence - identify disabilities - screen for issues needing further assessment and referral - evaluate need for community resources, equipment
59
components of the functional assessment
- environmental - physical - psychological - socio - economical
60
mobility
upper extremity -touch palms to back of head -reach up over the head -tough hands together behind waist lower extremity -get up and go test indications for therapy
61
fall risk assessment
tinettie balance and gait evaluation morse fall scale hendrich II scale
62
cognitive assessment
short portable mental status questionnaire mini-mental state exam mini-cog

Gero 1 (2 decks)

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