Interpersonal Relationships

Question 1

High loyalty and closeness and high dependence

Answer 1

Disengaged Family

Question 2

Low to moderate closeness, some loyalty and interdependence with more dependence than independence

Answer 2

Seperated Family

Question 3

High closeness, loyalty and dependence

Answer 3

Enmeshed

Question 4

Loss of relationships bc of deaths as aging continues

Answer 4

The most common form of loss for adults

Question 5

Acute Confusion

Answer 5

Delerium

Question 6

Chronic Confusion

Answer 6

Dementia

Question 7

S(x) of cognitive impairment for older adults

Answer 7

Disorientation, loss of language skills, inability to calculate, poor judgement - NOT normal aging changes.

Question 8

Mini-Mental Status Exam (MMSE)

Answer 8

Tool used to examine patients’ mental status

Question 9

Older adults

most common problems that are undiagnosed

Answer 9

Depression and alcohol abuse/alcoholism

Question 10

Orientation phase

Answer 10

Pt felt and ID problem. Nurse responds, helps id problems, and uses resources.

Question 11

Identification Phase

Answer 11

Pt. feels belonging and capable to deal with issue. Decreases feeling of helplessness and hopelessness

Question 12

Exploitation Phase

Answer 12

Patient actively seeking and drawing help. Patient initated.

Question 13

Resolution Phase

Answer 13

Occurs after other phases are completed. Termination of relationship. Both nurse a client mature.

Question 14

Nurse theorist who believed that nurse and client should work together so both bcome mature and knowledgable.

Answer 14

Peplau

Question 15

Nursing care of older adults poses a special challenge due to…

Answer 15

The great variation in physiological, cognitive and psychosocial health.

Question 16

Positive aspects of care giving

Answer 16

• knowing that their loved one is receiving good care
• learning and mastering new skills
• finding opportunities for intimacy. The tasks involved in caregiving often provide opportunities for family members to gain greater insights into each other and strengthen their relationships.

Question 17

Caregiver Stressors

Answer 17

• Change in roles and relationships within family unit
• Lack of respite or relief from caregiving responsibilities
• Need to juggle day-to-day activities, decisions, and caregiving
• Change in living conditions to accommodate family member
• Conflict in the family unit related to decisions about caregiving
• Other people’s lack of understanding of the time and energy needed for caregiving
• Inability to meet personal self-care needs, such as socialization, sleep, eating, exercise, and rest
• Financial depletion of resources as a result of patient’s or caregiver’s inability to work
• Inadequate information or skills related to specific caregiving tasks such as bathing, drug administration, wound care

Question 18

Older Adult Men tendencies (vs women)

Answer 18

• More likely to be married and living with spouse or partner
• More likely to have health insurance
• Higher income after retirement
• Less likely to be involved in caregiving activities
• Generally have fewer chronic health conditions than women

Question 19

Older adult women tendencies (vs. men)

Answer 19

• More likely to live alone
• More likely to be widowed
• Less likely to have health insurance
• More likely to live in poverty
• Poverty rates highest among minority women
• More likely to lack formal work experience leading to lower income
• More likely to rely on Social Security as major source of income
• More likely to be caregiver of ill spouse or partner
• Have a higher incidence of chronic health conditions such as arthritis, hypertension, stroke, and diabetes

Question 20

Cognative skill that improves with aging

Answer 20

• Vocabulary and verbal reasoning

- Crystallized intelligence

Question 21

Cognative skill that declines during for middle age adults

Answer 21

• Mental performance speed
• Synthesis of new information
• Fluid intelligence

Question 22

Cognative skill, that declines during old age adults

Answer 22

-Short-term recall memory

Question 23

Cognative skills that remain constant (no changes with aging)

Answer 23

-Long-term recall memory

Question 24

Older adults and Internet use

Answer 24

Keep in mind that adults are more likely to accept what they read on the Internet as true. Teach patients how to assess the credibility of a website.

Question 25

When caring for older adult clients what are special considerations to follow?

Answer 25

• Identify older adults at risk for iatrogenesis (consequences of medical and/or surgical treatments).
• Consider discharge needs early in the hospital stay, especially assistance with ADLs, IADLs, and medications.
• Encourage the development and use of interprofessional teams, special care units, and individuals who focus on the special needs of older patients.
• Implement standard protocols to screen for at-risk conditions commonly present in the hospitalized older adult, such as urinary tract infection, falls, and delirium.
• Implement mobility programs to prevent functional decline such as “The bed is not your friend.”
• Monitor for and prevent skin integrity changes.
• Focus on safety (e.g., prevention of falls).
• Advocate for referral of the patient to appropriate community-based services.

ADLs, Activities of daily living; IADLs, instrumental activities of daily living.

Question 26

What are common causes of Med Erros by older adults?

Answer 26

• Decreased vision
• Forgetting to take drugs
• Use of nonprescription over-the-counter drugs
• Use of medications prescribed for someone else
• Lack of financial resources to obtain prescribed medication
• Failure to understand instructions or importance of drug treatment
• Refusal to take medication because of undesirable side effects

Question 27

What measures can be taken to help older adults to prevent med errors

Answer 27

377
• Assess cognitive function and monitor for changes.

• Attempt to reduce medication use that is not essential by consulting the HCP and pharmacist.
• Assess ability to self-administer medication and overall medication use, including prescription drugs; over-the-counter drugs; antihistamines; cough syrups; vitamins, minerals, and supplements; sleep remedies; and herbal remedies.
• Assess alcohol and illicit drug use.
• Encourage the use of written or electronic medication-reminder systems.
• Encourage the use of one pharmacy.
• Work with HCPs and pharmacists to establish routine drug profiles on all older adult patients.
• Advocate, with drug companies and/or social work services, for low-income prescription support services.

Question 28

How does birth affect the IPR between the mother and partner

Answer 28

Birth of children often raises issues about interpersonal intimacy.

Question 29

What factor can influence a woman’s postpartum adjustment?

Answer 29

The mother’s relationship to her parents.

Question 30

What knowledge do nurses who work with older adults requried to possess?

Answer 30

Knowledge about normal aging, drug interactions and chronic disease.

Question 31

Mental health/cognitive nurses need to be skilled in what areas?

Answer 31

Effective communication, behavioral intervention and recognition of how the care setting affects the older individual.

Question 32

What are important outcomes for birthing mothers/families?

Answer 32

• ID risk factors (ex. teen mothers who aren’t paying attention to the baby
• Verbalization of realistic exexpectation regarding his or her role
• if a question has answer choices between education and demonstration because it is both visual and audial learning