healthy aging

Question 1

continuing care

Answer 1

home care = make regular visits to their home to assist with hygiene and other needs
supportive living = allow them to still be independent while providing some types of care
long term care = provide more specialized care
hospice or end of life care
other services = adult day programs, rehabilitative or restorative care, medical assistance program

Question 2

communicating with older adults

Answer 2

attentive listening 
authentic presence
non-judgmental attitude
cultural competence
clarifying 
giving information 
seeking validation of understanding 
keeping focus 
using open-ended questions

Question 3

inappropriate or ineffective communication

Answer 3

associated with multiple negative outcomes
decreased function 
miscommunication 
depression 
falls 
loss of self-esteem 
safety risks 
cognitive decline

Question 4

what to avoid when communicating

Answer 4

offering cliche responses 
giving advice 
answering your own questions 
giving excessive praise or reprimands
defending against a complaint 
using parenting approaches or behaviours 
elderspeak

Question 5

foundational nursing interventions

Answer 5

learn more about ageism and discrimination
examine own values and beliefs around aging
identify and speak up on myths and misinformation
build intergenerational bridges to promote understanding
learn more about healthy active aging
listen to older adults who have experienced ageism

Question 6

cognitive abilities and aging: formal operations

Answer 6

perception = ability to interpret the environment, depends on acuteness of senses, effect of changes in cognitive structures unknown, importance of lifelong mental activity
cognitive agility = change in speed, abilities remain
memory = retrieval from long term memory increased, most change in short term memory
language = additional time required, motivation is important

Question 7

developmental tasks of older adults: integrity vs despair

Answer 7

discover and participate in fulfilling activities to fill their time
sustain a sense of usefulness, doing something worthwhile
adjust to multiple losses
reflection, retrospection/life review
contemplating, facing own morbidity/mortality
success = fulfillment and enjoyment
failure = regret, bitterness and despair

Question 8

nurses must consider

Answer 8

hearing impairment
visual impairment
neurological impairment
cognitive impairment

Question 9

hearing impairment strategies for communication

Answer 9

hearing aids = personal amplifying system
cochlear implants = surgically implanted in the mastoid bone behind the ear, electrically stimulated the cochlea, setting the cilia in motion, transmitting impulses along the auditory nerve to the brain’s hearing centre
assisted listening devices = enhance face-to-face communication, understanding of speech in large rooms
tone and level (shouting increases pitch, moderate speech speed), positioning (face individual at their level, determine side of hearing impairment), environment (reduce background noise, lighting), non verbal (gestures, pictures, written material), verify (clarifying questions, pausing)

Question 10

vision impairment strategies for communication

Answer 10

insulin delivery systems, talking clocks/watches, large-print books, magnifiers, telescopes (handheld or mounted), electronic magnification through closed-circuit television or computer software, software that converts text into artificial voice output (talking books)
tone and level (identify self, moderate speech speed/tone), positioning (face individual at their level), environment (reduce background noise, lighting to eliminate glare, room arrangement), printed material (large dark print)

Question 11

neurological impairment strategies for communication: APHASIA

Answer 11

explain situations and treatments, avoid patronizing and childish phrases, be patient, allow plenty of time to communicate in a quiet environment, speak naturally/slowly/ask one question at a time and wait for a response, include the person in social gatherings and conversations, ask questions that can be answered with a nod or the blink of an eye, use close-ended questions, responses written on paper, be honest, speak of things familiar to and of interest to the person, use visual cues/objects/pictures/gestures/touch as well as words, Wernicke’s aphasia = listen and watch for the bits of information that emerge from the words/facial expressions/gestures, ignore the non words, encourage all speech, use augmentative communication devices, consistent care

Question 12

nursing interventions

Answer 12

nutrition and oral care
constipation 
hydration and continence
skin and feet 
mobility/fall prevention 
grief and loss 
medication
abuse and neglect 
caregivers

Question 13

nutrition and oral care

Answer 13

swallowing, assistive devices, feeding assistance (manual), denture care and teeth, environment, teaching, nutritional assessment, collaboration with interprofessional team
dysphagia = supervision at meals, food consistency, positioning during meals and after, dentures, cueing, suctioning equipment available

Question 14

constipation

Answer 14

medication review, diet (fibre, fluid intake), exercise, positioning during defecation, stool chart, bowel routine (promote regularity), medications (laxatives, stool softeners, bulking agents, osmotic laxatives, stimulant laxatives, saline laxatives), enemas (NS/tap H2O, oil retention), fecal impaction removal

Question 15

bowel incontinence

Answer 15

environment, diet, bowel schedule, stool chart, mobility, sphincter-training exercises, skin care, medications, surgery

Question 16

hydration

Answer 16

calculate a daily fluid goal, compare current intake to fluid goal to evaluate hydration status, perform fluid regulation and documentation, provide fluids consistently throughout the day, plan for at-risk individuals

Question 17

skin and feet

Answer 17

goals = eliminate friction and irritation, reduce moisture, displace body weight to facilitate circulation
fungal infections = limit the conditions that encourage growth, clean and dry, prompt management of incontinent episodes, avoid incontinence products
pressure ulcers = positions and transferring (friction/shear), protective barriers, appropriate dressings, documentation and assessment tools, clean and dry, prompt management of incontinent episodes
foot care = toenails, footwear

Question 18

mobility/fall prevention

Answer 18

exercise, diet, environmental modifications, medication review, behaviour and educational programs, assistive devices, restraints, side rails, assessment tools
post fall = immediate care, assessment, revise and implement individualized risk-reduction interventions

Question 19

grief and loss

Answer 19

anticipatory guidance = must consider grief, loss, illness trajectory, SEDoHs
advanced care planning
post mortem care

Question 20

end of life care/nursing interventions families have found helpful

Answer 20

end of life care/nursing interventions families have found helpful = kept them informed, asked how they were doing and offered support, put an arm around them when they cried, brought them food, knew their name, cried with them, brought a bed and encouraged them to stay in the room with their dying spouse, told them to hold their dying spouses hand, held their hand, got the chaplain for them, let them take care of their spouse, stayed with them after their shift was over

Question 21

medication

Answer 21

pharmacokinetics = absorption, distribution, metabolism, excretion
polypharmacy = concurrent use of several different medications, medication interactions (medications may potentiate each other, more effective or less effective), adverse drug reactions (unwanted pharmacological effect)
review all medications (prescriptions, over the counter, vitamins, herbal supplements), complete a medication reconciliation
patient education = identify key people, environment, time, communication, reinforce, evaluate, safety

Question 22

beers criteria = 3 categories of medications

Answer 22

potentially inappropriate medications and classes to avoid in older adults

• potentially inappropriate medications and classes to avoid in older adults with certain diseases and syndromes that the drugs listed can exacerbate
  
  • medications to be used with caution in older adults

Question 23

abuse and neglect

Answer 23

nurses must be vigilant in their sensitivity to the potential for abuse, observe for signs and symptoms in all interactions with older adults
comprehensive assessment = safety of the victim, desires of the victim (if competent)

Question 24

caregivers

Answer 24

goals = to reduce caregiver burnout, increase overall well-being of the caregiver, increase knowledge of the caregiver
assessment tools, psychoeducational, supportive, respite, psychotherapy, multicomponent