Nursing Care Older Adults (Final)

Question 1

Developmental Tasks for Older Adults

Answer 1

Adjusting to Changes in health and physical strength

Retirement and reduced or fixed income

Death of loved ones

Acceptance of themselves as they age

New living environments

Redefining relationhips

Question 2

Placement Decisions: Postive things to look for

Answer 2

1. Does not feel like a hospital. Personal room with privacy
2. Medicare and Medicaid certified
3. Adequate and qualified staff who pass background checks
4. Quality of care and recreational activities
5. Quality of food and mealtime choices
6. Staff encouragement of family involvement

Question 2

How can nurses help with placement decisions

Answer 2

-Encourage collaborative involvement

-Answer questions

Educate on options

-Medicare website that helps determine quality

Question 3

Acute Care: Pay special Attention to the patients

Answer 3

-Needs of comfort

-Safety

-Nutrition/hydration

-Skin integrity

Question 4

Common of complications in Acute Care

Answer 4

-Delirium

-Malnutrition and Dehydration

-HAI’s

-Urinary Incontinence

-Falls

Question 5

Delirium: Related to nursing care

Answer 5

Multiple reasons for increased risk

-Encourage family visits

-Provide memory cues

-Compensate for sensory deficits

-use reality orientation techniques

Question 6

Acute care setting pose increased risk for these adverse events

Answer 6

Health care associated infections

Urinary continence

Falls

Question 7

Restorative Care

Answer 7

Types of ongoing care:

-Continues recovery from acute illness

-Support of chronic conditions that affect daily functioning

Both types take place in private homes and long-term care settings

Question 7

Goal of Restorative Care

Answer 7

To regain or improve prior level of independence, ADLs, instrumental activities of daily living (IADLS)

Question 8

Leading cause of fatal injury

Answer 8

FALLS

Question 9

Health Concerns of Older Adults

Answer 9

-Heart Disease (HTN and CAD)

-Cancer (Screening and mimimize risk factors)

-Chronic Lung Disease (Stop smoking or decrease smoking)

-Stoke

-Smoking (Risk factor for 4 most common deaths. First 4)

-Alcohol Abuse

Question 9

More Health Concerns

Answer 9

SLIDE

Question 10

Pain

Answer 10

Not an normal part of aging

Question 11

Nutritional recommendation for Older Adults

Answer 11

-Increase intake of certain vitamins

-D, B12, E, Folate, Fiber, calcium

Take a multivitamin

Increase fluid intake if it is not contraindicated

Limit bad foods

Question 11

Medications

Answer 11

One of the biggest problems. Polypharmacy

Question 11

Recommendations to improve nutritional intake in healthcare setting

Answer 11

-Eat with others

-Ensure food is accessible during day

-Ensure patient is comfortable

-Hygiene

-Environment

-Promote activity

Question 12

Risk Factors for falls in Older Adults: Intrinsic

Answer 12

-History of fall

-Fear of fall

-Muscle weakness

-Imparied vision

-Posturla hypotension

-Problems with balance and gain

-Adverse medication reaction

-chronic conditions

Question 13

Risk factors for falls in Older Adults: Extrinsic

Answer 13

Poor lighting

Lack of handrails

Poor stairwell design

-ETC

Question 14

Illness Indictors in Older Adults

Answer 14

Changes in mental status, occurrence and reason for falls, dehydration, decrease in appetite, loss of function, dizziness, and incontinence

Question 14

Polypharmacy

Answer 14

Concurrent use of medications by patient

-Affects about 40% of older adults

-One HCP should prescribe manage all medications

Question 14

Assessing the Needs of Older Adults

Answer 14

-Obtain a complete assessment takes time

-May need to make adjustments based on changes

-It is important to recognize early indicators of acute illness in older adults

Question 14

Disease Presentation in Older Adults

Answer 14

PP slide on Second Voice over

Question 14

What can you do to prevent falls

Answer 14

-Talk to doctor

-Check eyes

-Make home safer

-Keep moving

-Speak up

Question 14

Confusion =

Answer 14

Some type of illness or infection

Question 15

Altered Presentation of Illness in Different Settings: Hospital

Answer 15

Confusion: Look for acute illness, neurological events, new meds, risk factors fo delirum Chronic Dehydration: Exacerbated by acute illness is common Infection: May not have a fever, look for increase in RR, falls, incontinence, confusion

Question 15

Altered Presentation of Illness in Different Setting: Home care

Answer 15

-Investigate all falls, balance and gait issues -Loss of appetite with late-stage heart disease is early symptom of impending failure

Question 15

Altered Presentation of Illness in Different Settings

Answer 15

-Under-treatment of pain: Look for nonverbal cues -Decline in function -Watch for drug toxicity -New intontience

Question 15

Altered Presentation of Illness in Different Settings: Ambulatory Care

Answer 15

SLide

Question 16

Early indicators of Acute ilness in older adults

Answer 16

-Mental Status changes -Falls -Dehydration -Decrease in appetite -Loss of functions -Dizziness -Incontinence

Question 17

General Preventive measures to recommend to older adutls:

Answer 17

-Participation in screening activities -Regular exercise -Weight reduction if overweight -Eating a low-fat, well balance diet -Moderate alcohol use -Smoking cessation

Question 18

Elder Mistreatment

Answer 18

Intentional act or failure to act that causes or creates a risk for harm to an older adult

Question 19

Psychosocial health interventions

Answer 19

-Therapeutic Communication -Touch -Reality orientation -Validation therapy -Reminiscence -Body image interventions

Question 20

Teaching Older Adults

Answer 20

-Assess readiness to learn -Speak clean, slowly with a normal tone while they can read your lips -Present 1 idea at a time -Allow for extra time to process information -Minimize environmental distraction -Utilize teach back method

Question 21

Teaching Older Adults with Hearing Deficit

Answer 21

-Get attention -Reduce background noise -Speak clearly and loudly -Repeat yourself -Have good lighting