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quizlet final Flashcards

1
Q

Sub categories of older adults

A

young-old: 65-74
middle-old: 75-84
old-old: 85-99
centenarians: 100+

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2
Q

do men or women live longer?

A

women

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3
Q

what are the leading causes of death in older adults?

A
  • cancer
  • CVD / stroke
  • chronic lung disease
  • diabetes
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4
Q

what does the term “ageism” refer to?

A

thinking about older persons based on negative attitudes and stereotypes about aging

and

failing to structure society for the needs of older people

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5
Q

ethnogeriatrics

A

cultural diversity of the older adult population

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6
Q

primary aging

A

physiological aging related to time, also called senescence

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7
Q

secondary aging

A

changes related to trauma or disease process

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8
Q

healthy aging

A

positive or optimal aging

not the absence of sickness but rather the optimal possible health conditions that individuals adapt to their aging process

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9
Q

what contributes to healthy aging?

A

resilience, hope, injury prevention, lifestyle choices, healthy weight maintenance, adequate nutrition, sleep

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10
Q

what are the three levels of prevention with examples

A
  1. PRIMARY: vaccinations, lifestyle choices, education
  2. SECONDARY: screening for early detection
  3. TERTIARY: prevention and prophylaxis from reoccurrence (medications, exercise)
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11
Q

normal changes in aging: body composition

A

decreased muscle mass (sarcopenia), skeletal mass, total body water, & creatine production.

increased adipose tissue

leading to: decreased strength/function, increased drug levels

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12
Q

normal changes in aging: cells

A

decreased: DNA repair capacity

increased: DNA damage, cell senescence, lipofuscin accumulation, fibrosis

leading to: cancer, inflammation risk, infection

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13
Q

normal changes in aging: CNS

A

decreased: dopamine receptors, connectivity/nerve conduction, brain mass, nerve endings

increased: adrenergic responses

leading to: increased muscle tone, sensitivity to environment, increased response time, delayed reaction time, sleep changes, balance chances

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14
Q

normal changes in aging: endocrine system

A

decreased: estrogen, progesterone, testosterone, growth hormone, vit D

increased: glucose intolerance, insulin resistance, thyroid abnormalities, bone mineral loss, ADH secretion

leading to: diabetes, fractures, low muscle/bone mass, vaginal dryness, water intoxication

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15
Q

normal changes in aging: auditory / ears

A

thickening of tympanic membrane, stiffening of ear structures, increased production of cerumen

leading to: loss of hearing, decreased ability to recognize speech, unsteadiness, vertigo

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16
Q

normal changes in aging: visual / eyes

A

decreased: lens flexibility, ciliary muscle, tear production, pupil size

increased: time for pupillary reflexes

leading to: sensitivity to light, decreased visual acuity, cataracts risk, poor depth perception, glaucoma, diabetic retinopathy, dry eyes, presbyopia (decreased visual acuity)

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17
Q

normal changes in aging: GI tract

A

decreased: visceral blood flow, digestive uses, saliva production, thirst mechanism, motility

increased: food transit time, pH

leading to: constipation, diarrhea, aspiration, gastric irritation, GERD, diverticulitis

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18
Q

normal changes in aging: cardiovascular

A

decreased: elasticity of vessels, pacer cells, heart rate, diastolic reaction

increased: atrioventricular conduction time

leading to: a-fib, diastolic dysfunction risk, decreased antibody response

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19
Q

normal changes in aging: musculoskeletal & joints

A

decreased: cartilage, muscle mass, strength, bone density, elasticity

leading to: falls, osteoarthritis, osteoporosis

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20
Q

normal changes in aging: liver

A

decreased: hepatic mass, hepatic blood flow, CYP 450

leading to: decreased metabolism, fat absorption, metabolism of meds

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21
Q

normal changes in aging: urinary system

A

decreased: renal blood flow, volume, filtration, renal reabsorption, bladder capacity, creatinine production

increased: urea nitrogen

leading to: dehydration, retention, low output, incontinence

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22
Q

normal changes in aging: sensory

A

decreased: taste buds, sense of smell, nerve conduction

leading to: decreased taste, appetite, pain sensitivity, risk of smoke poisoning

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23
Q

normal changes in aging: respiratory system

A

decreased: functional capacity, elasticity, gas exchange, cilia

increased: residual volume, mucous production, stiffness

leading to: SOB, mental changes, cough, exercise intolerance, pneumonia, respiratory failure risk

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24
Q

normal changes in aging: skin

A

decreased: elasticity, moisture, sweat glands, oil, subcutaneous fat tissue

increased: dryness

leading to: hyperthermia, hypothermia, skin breadown, delayed healing

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25
Q

presbycusis

A

age related hearing loss

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26
Q

DASH diet

A

dietary approach to stop hypertension

high fruits, vegetables, and plant proteins, low sodium and plant protein

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27
Q

importance of orodental health

A

risk factor for dehydration, malnutrition & systemic diseases (pneumonia, joint infections, cardiovascular disease, poor glycemic control)

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28
Q

what is the most common theme across all theories of aging?

A

change

change is considered development in early life, and aging in later life

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29
Q

life expectancy factors

A

heredity, disease processes, medical procedures, lifestyle choices, nutrition

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30
Q

senescence

A

aging-related changes that lead to a decreased ability for adjustment and survival

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31
Q

programmed theories (non-stochastic)

A

aging has a biological timetable or internal biological clock

aging is predetermined, timed phenomena

(programmed senescence, gene theory, endocrine theory, immunologic theory, nutritional theory)

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32
Q

damage/error theories (stochastic)

A

aging is a result of internal and external assaults that damage cells; random processes accumulate overtime and inflict damage

(wear & tear, cross-linking, free radicals, somatic mutation, environmental theory)

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33
Q

programmed senescence

A

cells natural loss of function overtime

(eg. “Hayflick’s Limits”: fibroblasts can only divide a certain amount of times)

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34
Q

gene theory

A

aging is programmed due to one or more harmful genes within each organism

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35
Q

endocrine theory

A

biological clocks act through hormones to control the pace of aging

dysfunction in the hypothalamus causes age-related changes

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36
Q

immunologic theory

A

aging is due to decreased T cells and causes increased susceptibility to diseases

decline in immune system

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37
Q

nutritional theory

A

diet affects aging

quality of diet is important due to vitamin and nutrient deficiencies

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38
Q

wear and tear theory

A

internal and external stressors damage body components over time

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39
Q

cross-linking theory

A

DNA/proteins cross link with sugars, become stiff and inhibit normal metabolic activities

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40
Q

free radicals

A

accumulation of toxins damages the cell membrane; anti-oxidants neutralize toxins

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41
Q

somatic mutation

A

DNA damage (telomeres) leads to chromosome abnormalities

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42
Q

environmental theory

A

number of environmental factors are known to threaten health

ingestion of lead, arsenic, pesticides, second hand smoke, & air pollution

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43
Q

role theory

A

as people evolve through life stages, their roles evolve as well

adaptability is a predictor of adjustment to aging

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44
Q

person-environment fit theory

A

changes in competencies and needs due to aging influence ability to deal with environment

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45
Q

activity theory

A

activity is necessary to maintain life satisfaction and positive self-concept

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46
Q

continuity theory

A

maintain a consistent pattern of behaviour, continuation of life roles slows aging

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47
Q

disengagement theory

A

no longer supported

natural seperation of old people from society to transfer power to younger generations

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48
Q

age stratification

A

society consists of cohorts that age collectively and influence each other, and are influenced by significant events

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49
Q

selective optimisation with compensation theory

A

individuals develop strategies to manage and cope with losses of function that occur over time

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50
Q

gerotranscendence

A

spirituality has a greater role in life and in acceptance of death

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51
Q

Maslow’s hierarchy of needs

A

higher level needs (self-actualization, esteem, love/belonging) cannot be met before meeting basic needs (safety, physiological)

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52
Q

Jung’s theory of individualism

A

self-realization is the goal of personality development

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53
Q

Erickson’s eight stages of life

A

ego-integrity vs despair

psychological development and tasks that one needs to master in a step-wise fashion

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54
Q

Peck’s integrity

A

new identity and new meanings beyond self-centerdness

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55
Q

Havinghurst’s theory

A

adjustment and adaptation tasks for late life changes

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56
Q

functional consequences theory

A

environmental and biopsychosocial consequences of aging impact functioning

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57
Q

theory of thriving

A

environment is an important contributor to how people age

people thrive when they are in harmony with environment and personal relationships

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58
Q

theory of successful aging

A

successful aging as a process of adaptation

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59
Q

age-related changes

A

inevitable, progressive, and irreversible changes that occur during later adulthood

typically degenerative physiologically

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60
Q

macular degeneration

A

chronic eye disease marked by deterioration of the macula (tissue layer inside the back wall of the retina)

number one cause of vision loss in Canada

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61
Q

xerostomia

A

reduced saliva production

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62
Q

sarcopenia

A

decrease in muscle mass, strength, and endurance

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63
Q

what are the normal vital sign changes in older adults

A

TEMP: lower
HR: no change
RESP: no change
BP: systolic increases

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64
Q

prebyopia

A

impairment of vision as a result of old age

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65
Q

lentigos

A

a brown macule resembling a freckle usually caused by sun exposure

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66
Q

what are the 4 “I’s” warning red flags of atypical presentation in older adults?

A

INSTABILITY
INCONTINENCE
IMMOBILITY
INTELLECTUAL IMPAIRMENT

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67
Q

what are common atypical presentations of illness in the older adult?

A

CONFUSION*, anorexia, absence of fever, lethargy, agitation, incontinence, falls, weakness, dizziness.

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68
Q

goals of care for the older adult

A
  1. maintain self care
  2. prevent complications of aging
  3. delay decline
  4. achieve the highest possible quality of life
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69
Q

gerontology

A

the study of aging

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70
Q

responsive behaviours / protective behaviours

A

indicate unmet needs

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71
Q

gentle persuasive approaches (GPA)

A
  1. BODY CONTAINMENT STRATEGIES: learning about brain changes that lead to responsive behaviours
  2. PERSONHOOD: focus on the person behind the disease
  3. UNMET NEEDS: learning how to interpret aggressive behaviour as a response to unmet needs
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72
Q

body containment strategies

A

STOP & GO
when the person is resistive to care, stop, pause & reapproach.

MANIPULATE ENVIRONMENT
remove potential hazards, reduce stimuli, provide natural light, provide diversion

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73
Q

GPA care tips

A
  • provide what makes them happy
  • concentrate on the person, not task
  • be calm
  • allow space & time
  • identify triggers & unmet needs
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74
Q

neurogenic reflex grab

A

person with dementia instinctively grabbing on when someone is in close contact

neurological reflex response

do not pull away

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75
Q

the eden alternative

A

utilizes children, plants, and animals to fight loneliness, helplessness and boredom experienced by elderly in care facilities

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76
Q

the GRACE model

A

Geriatric Resources & Care of Elders

a support team & multidisciplinary team who assess and develop an individualized care plan while working with the patient, and family

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77
Q

chronic care model

A

nurses provide patient-centered, cost-effective care to patients with chronic conditions through in home assessments, self-management strategies and access to resources to reduce hospital admissions

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78
Q

how to reduce hospitalization in the older adult

A
  • standardize transition plans, procedures, forms
  • send discharge summaries directly to primary care provider
  • easy to understand discharge plans
  • ensure timely follow up and coordination of support
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79
Q

validation therapy

A

approach for those with cognitive impairment and dementia

help resolve past unfinished issues through validation, empathy, and listening

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80
Q

what are three validation techniques that can be used for dementia patients?

A
  1. REPHRASE
  2. UTILIZE THE VISUAL
  3. REMINISCING
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81
Q

P.I.E.C.E.S Model

A

enhance ability of long-term care home staff to meet the care requirements of individuals with complex physical and cognitive needs

Physical
Intellectual
Emotional
Capabilities
Environment
Social & Cultural

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82
Q

Teepa Snow’s positive approach

A

SUPPORTIVE communication techniques:
- give examples
- use gestures & pointing
- acknowledge and accept emotions
- empathy & validation
- use familiar phrases or known interests
- avoid the negative

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83
Q

48/6 Assessment model of care

A

acute care settings in BC require 6 areas to be assessed within 48 hrs

  1. BOWEL & BLADDER
  2. COGNITION
  3. FUNCTIONAL MOBILITY
  4. MEDICATION MANAGEMENT
  5. NUTRITION & HYDRATION
  6. PAIN MANAGEMENT
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84
Q

Fulmer SPICES screening

A

geriatric syndrome screening tool

S - Sleep disorders
P - problems with eating or feeding
I - incontinence
C - confusion
E - evidence of falls
S - skin breakdown

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85
Q

what is a medication reconciliation form

A

medications are reviewed to ensure accuracy and they are up to date

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86
Q

what may a low prealbumin level point to?

A

malnutrition

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87
Q

what blood tests can detect inflammation?

A

ESR & CRP

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88
Q

IADLs

A

activities needed to live independently (housework, preparing meals, medication adherence, managing finances, using a phone)

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89
Q

what tools are used to assess cognition?

A

MMSE, MoCA, CDT (clock drawing test), CAM

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90
Q

Global Deterioration Scale

A

measures clinical characteristics at 7 levels based on the progressive stages of Alzheimer’s disease

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91
Q

agitation chart

A

a tool that allows staff to plot when an individual is calm and agitated, and assists staff in identifying patterns

has a column to chart PRNs and effectiveness

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92
Q

ABC Assessment

A

Antecedent, Behaviour, Consequence

identifying triggers and effectiveness of interventions

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93
Q

movement chart

A

helpful when tracking movements for individuals with Parkinson’s disease

movement prior and following administration of medications

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94
Q

assessment tools for nutrition

A
  • weight records
  • intake sheets
  • calorie counts
  • MNA (Mini Nutritional Assessment)
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95
Q

dysphagia screening

A

sitting upright a pt is asked to drink a 90 mL cup of water in single sips with a breath in between

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96
Q

SBAR

A

Situation
Background
Assessment
Recommendation

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97
Q

triage risk screening tool

A

detects geriatric risk profile

  1. presence of cognitive decline
  2. living alone
  3. reduced mobility/fall in past 6 months
  4. hospitalized in past 3 months
  5. polypharmacy
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98
Q

what is the ‘brown bag test’?

A

taking ALL of a patients over the counter, prescription and herbal supplements to the doctor

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99
Q

delirium

A

an acute, fluctuating syndrome of altered attention, awareness, and cognition

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100
Q

diagnostic criteria for delirium

A

disturbance in ATTENTION and AWARENESS

sudden onset, change in baseline and tends to fluctuate in severity during the course of a day

physiological consequence

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101
Q

hypoactive delirium

A

most prevalent

“quiet” delirium

lethargic, drowsy, quiet, withdrawn

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102
Q

hyperactive delirium

A

agitated, combative, disoriented, psychotic features

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103
Q

how to distinguish a psychiatric disorder from delirium?

A

a psychotic disorder almost always LACKS the disorientation, memory loss, and cognitive impairment

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104
Q

PRISM-E (underlying causes of delirium)

A

Pain
Restraint / Retention
Infection
Sensory impairment / Sleeplessness
Medication
Emotional / Environment

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105
Q

CAM

A

confusion assessment method

  1. evidence of acute change in mental status
  2. inattention, difficulty focusing attention, or keeping on track
  3. disorganized thinking
  4. altered LOC
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106
Q

what should you do when you suspect delirium?

A
  • vital signs
  • blood work
  • urine
  • hydrate
  • bowel/bladder function
  • unrelieved chronic/acute pain
  • trauma
  • blood sugars
  • chest sounds
  • med history
  • MSE
  • change in ADLs
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107
Q

treatment goals for delirium

A
  • establish routine, provide comfortable surroundings
  • encourage family/friends to stay
  • reassurance and emotional support
  • reduce sensory stimulation
  • promote rest & orientation
  • ensure adequate nutrition & fluids
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108
Q

delirium prevention triad

A
  1. prevent sleep deprivation
  2. monitor hydration / prevent dehydration
  3. prevent stimuli deprivation / ensure vision & hearing
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109
Q

use the NICE & EASY approach when working with delirious clients

A

Name
Introduce yourself every time
Contact
Eye contact

Explain what you are doing BEFORE doing it
Avoid arguments
Smile
You are in control

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110
Q

mild cognitive impairment

A

cognitive decline beyond that normally expected in a person of the same age with preservation of function

cognitive impairment is NOT normal in old age

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111
Q

dementia

A

a slowly progressive decline in mental abilities, including memory, thinking, and judgment, that is often accompanied by personality changes

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112
Q

what are the key features of dementia

A
  • insidious onset (months to years)
  • persistent disorientation
  • symptoms depend on the area of brain affected by the disease
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113
Q

anosognosia

A

lack of insight

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114
Q

amnesia

A

loss of memory

last thing learned is first thing lost

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115
Q

apathy

A

loss of initiation

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116
Q

agnosia

A

loss of recognition

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117
Q

apraxia

A

loss of purposeful movement

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118
Q

aphasia

A

loss of language skills

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119
Q

altered perception

A

loss of depth perception, illusions, delusions, hallucinations

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120
Q

attention deficit

A

difficulty maintaining and is easily distracted

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121
Q

alzheimer’s disease

A

most common form of dementia

memory loss, mood and behaviour progressive changes

caused by neuritic (senile) plaques and neurofibrillary tangles in the brain

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122
Q

vascular dementia

A

due to interrupted blood supply to the brain (post-stroke)

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123
Q

Lewy body dementia

A

protein deposits, called Lewy bodies are found in deteriorating nerve cells

marked by fluctuating cognitive ability and often accompanied by visual hallucinations

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124
Q

frontotemporal dementia

A

cells in the frontal and temporal lobes of the brain shrink, die, or swell

frontal lobe regulates behaviours

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125
Q

responsive behaviours (BPSD)

A

indicate an unmet need

[ABC method: Antecedent, behaviour, consequence]

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126
Q

pharmacological treatment for BPSD

A

citalopram & sertraline: controlling irritability

risperidone: tx of aggression/psychosis

quetiapine & haldol: aggression

trazodone: sleep aid

carbamazepine, gabapentin: impulsivity

cyproterone: hyper-sexuality

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127
Q

sun-downing

A

increase in behavioural problems that begin at dusk and last into the night

(d/t end of day exhaustion, upset in internal body clock, shadows, disorientation lack of activity)

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128
Q

pharmacological treatment for alzheimer’s?

A
  • Cholinesterase Inhibitors
  • Memantine
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129
Q

Aricept (donepezil)

A

health warning d/t possible rhabdomyolysis & NMS

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130
Q

ADUCANUMAB

A

recommended for mild cognitive impairment or early alzheimer’s disease

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131
Q

symptoms of late life depression

A

low energy, motivation, anhedonia, hopelessness, increased dependency, poor grooming, difficulty completing ADLs, withdrawal from people, decreased sexual interest, “giving up”, preoccupation with death

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132
Q

typical presentation of depression in an older adult

A

typically present for physical complaints rather than a mood disorder

early morning awakening, anorexia, weight loss, substance use, exaggerated of pre-morbid personality traits, violent suicide attempts, thinking problems

memory difficulties may be the chief complaint and get mistaken for early signs of dementia

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133
Q

pseudodementia

A

behavioral disorder resembling dementia but is not caused by brain tissue abnormalities

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134
Q

psychotic depression

A

depression accompanied by psychotic thought content

delusions of self-depreciation of often seen, eg. describing themselves as “unworthy, ugly, foul smelling”

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135
Q

SIGECAPS depression

A

Sleep disorders or problems
Interest decreased
Guilt
Energy decreased
Concentration difficulties
Appetite disturbance
Psychomotor retardation or agitation
Suicidality

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136
Q

what older adult populations are at highest risk for suicide?

A

male, caucasian/first nations, 65-85, single, alcohol, isolation, suffering from chronic disease etc..

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137
Q

IS PATH WARM

A

Ideation
Substance use

Purposelessness
Anxiety
Trapped
Hopelessness

Withdrawal
Anger
Recklessness
Mood changes

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138
Q

CBT

A

thoughts or interpretation of a situation evokes emotions that drives our behaviours

thoughts - feelings - physical symptoms - behaviours

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139
Q

steps in CBT

A
  1. therapeutic relationship
  2. generate a problem list
  3. turn problems into goals
  4. behavioural action
  5. thought testing
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140
Q

selective optimisation with compensation

A

to achieve goals in spite of losses

find a new way to do things, practice makes perfect, make the best out of it

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141
Q

wisdom enhancement

A

past experiences and lessons learned can guide present challenges

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142
Q

timelines

A

review a person’s life without getting stuck on the past

focus on coping and resilience

143
Q

acute vs chronic illness

A

ACUTE: sudden, without warning, treated aggressively for short period of time, may quickly lead to death in later life

CHRONIC: insidious onset, continues indefinitely, periods of exacerbation & remission

144
Q

what are the most common chronic conditions of the elderly in Canada?

A
  1. arthritis
  2. hypertension
  3. glaucoma
  4. heart disease
  5. diabetes
  6. COPD
145
Q

what are the 8 stages of the chronic illness trajectory model?

A
  1. PRE-TRAJECTORY: no s/s
  2. TRAJECTORY ONSET: s/s present
  3. CRISIS: life threatening
  4. ACUTE: acute illness & complications
  5. STABLE: symptoms controlled
  6. UNSTABLE: symptoms difficult to control
  7. DOWNWARD: progressive deterioration
  8. DYING
146
Q

shifting perspective model of chronic illness

A

clients can achieve wellness in spite of illness/disability; wellness is defined by the client

focused on maximizing function and quality of life

147
Q

nonfatal chronic illness

A

arthritis, vision impairment

148
Q

serious, potentially fatal chronic illness

A

cancer, stroke, dementia, diabetes

149
Q

fraility

A

health state related to multiple bodily systems gradually losing their built-in reserves (weakness) leading to severe functional impairment

at greater risk for catastrophic outcomes

40% of people over 80 years old area affected

150
Q

risk factors for frailty

A

smoking, poor diet, inactivity, impaired immune system

151
Q

frailty causes & symptoms

A
  1. CHRONIC MALNUTRITION –> weight loss
  2. SARCOPENIA –> weakness
  3. DIMINISHED STRENGTH –> chronic fatigue
  4. SLOW GAIT –> falls
  5. DECLINE IN ACTIVITY –> immobility
  6. SENSORY DEPRIVATION –> low mood/depression
  7. COGNITIVE IMPAIRMENT –> dependency/isolation
152
Q

geriatric syndrome

A

common health conditions of older adults that don’t fit into specific disease categories

falls, functional decline, cognitive impairment (3 Ds), incontinence, susceptibility to adverse reactions to meds, pressure ulcers

153
Q

contributing factors to development of geriatric syndromes

A
  • chronic inflammation
  • autonomic dysregulation
  • immune system deficiency
  • hormonal/vitamin deficiencies
  • sarcopenia
  • atherosclerosis
154
Q

PRISMA - 7 Questionnaire

A

identifying frailty
3 or more “yes” answers require further review

  1. Over 85 yrs?
  2. Male?
  3. Health problems that limit your activities?
  4. Do you require help on a regular basis?
  5. Health problems that require you to stay at home?
  6. Support?
  7. Mobility aid?
155
Q

gait speed test

A

average gait speed of longer than 5 seconds to walk 4 meters is an indication of frailty

156
Q

failure to thrive (dwindles)

A

state of progressive functional decline, progressive apathy, and a loss of willingness to eat or drink

characterized by nutritional abnormalities with no obvious explanation of these symptoms

IS NOT A NORMAL CONSEQUENCE OF AGING

157
Q

four domains critical to the development of failure to thrive

A
  1. impaired physical function (abnormal sensory impairment)
  2. malnutrition (diminished smell/taste, cost of food, meds)
  3. depression (r/t post stroke, Parkinson’s, early dementia)
  4. cognitive impairment
158
Q

etiology of failure to thrive - 11Ds

A

Diseases
Dementia
Delirium
Drinking alcohol
Drugs/medication
Dysphagia
Deafness, blindness, other sensory deficits
Depression
Desertion by family, social isolation
Destitution (poverty)
Despair (giving up)

159
Q

what are the signature consequences of failure to thrive?

A
  • weight loss
  • dehydration
  • low cholesterol and albumin
  • increased infection rate
  • fractures
  • pressure ulcers
  • increased mortality
160
Q

internal vulnerability factors of FTT

A

older age, female, medical comorbidities, substance abuse, mental illness, cognitive impairment, sensory impairment, impairment in ADLs, malnutrition

161
Q

external vulnerability factors of FTT

A

lack of social network, dependence on care provider, living alone, lack of community resources, inadequate housing, unsanitary living conditions, high-crime, adverse life events, poverty

162
Q

what are some red flags indicating elderly vulnerability?

A
  • repeated ER/hospital admissions
  • neglect of medical problems
  • noncompliance with medication
  • acute deterioration in ADLs
  • unexplained weight loss
  • poor grooming/hygiene
  • refusal of needed assistance
  • threat of eviction
163
Q

what are the 4 areas of assessment to determine a client’s vulnerability for developing frailty?

A
  1. FALLS
  2. WEIGHT
  3. INCONTINENCE
  4. CONFUSION
  5. MOBILITY
164
Q

stress urinary incontinence

A

leakage of urine when coughing, sneezing, straining, exercise or any other type of exertion

165
Q

urge incontinence

A

leakage of urine associated with the urge to void that cannot be delayed

166
Q

overflow incontinence

A

constant leaking or dribbling from a full bladder suggesting normal urination is impossible

167
Q

functional incontinence

A

incontinence related to causes outside of the urinary system such as physical barriers, lack of mobility, anxiety, depression etc.

168
Q

Parkinson’s disease etiology

A

degeneration of neurons in the basal ganglia leading to a dopamine deficiency

severity of disease is associated with the degree of neuron loss and reduction of dopamine receptors in the basal ganglia

169
Q

cardinal symptoms of Parkinson’s disease

A

tremor*, muscle rigidity, slow movements (bradykinesia), shuffling gait, mask-like face, muffled speech

170
Q

risk factors for Parkinson’s disease

A
  • advancing age, more oftenly affecting men
  • head trauma
  • exposure to toxins (heavy metals and carbon monoxide)
  • declining estrogen levels, vitamin B12, & folate
171
Q

what are the two types of Parkinson’s disease

A

PRIMARY (idopathic) - cause is not known

SECONDARY - d/t another disorder causing loss of dopamine in the basal ganglia

172
Q

“shuffling gait”

A

Parkinson’s disease

arm-swing impaired, tendency to fall forward which results in the steps becoming fast to catch up (festination)

173
Q

hypophonia

A

soft speech, may be seen in Parkinson’s disease

174
Q

micrographia

A

small handwriting, seen in Parkinson’s disease

175
Q

what does a clinical diagnosis of Parkinsonism require?

A

presence of at least 2/4 of the cardinal signs

lack of specific diagnostic test

176
Q

Tx for Parkinson’s Disease

A
  • treatment of symptoms (anticholinergics, dopamine agonists)
  • MED: Levodopa and Carbidopa (dopamine replacement)
  • deep brain stimulation (brain pacemaker implanted to improve tremor)
  • transplantation of stem cells into the substantia nigra
  • rehab (PT, OT, ST)

*NEW: non-contact boxing

177
Q

what surgeries can be used to reduce tremors of Parkinson’s?

A
  1. Pallidotomy (globus pallidus, reduces tremors & stiffness)
  2. Thalamotomy (thalamus, controls involuntary movements)
178
Q

nursing considerations for Parkinson’s Disease

A
  • risk of falls & choking
  • monitor orthostatic hypotension
  • assess mood * risk of depression
  • prevent infection
  • sleep hygiene
  • promote cognitive stimulation & communication
179
Q

etiology of shingles/herpes zoster virus

A

varicella zoster virus acquired as chicken pox and stays dormant until reactivated due to compromised immunity

180
Q

who can acquire shingles? and it is part of normal aging?

A

YES, it is part of normal aging but only for those who have previously had chicken pox

181
Q

what serious complications are associated with shingles?

A

postherpetic neuralgia, ocular involvement, and CNS disease

182
Q

S/S of shingles

A

EARLY SYMPTOMS: fever, weakness, pain/burning or tingling sensation over an area on one side of body or face

RASH STAGE: unilateral lesions (vesicles filled with fluid) which eventually crust over

POST: post herpetic neuralgia (severe pain)

183
Q

what is post herpetic neuralgia?

A

pain that stays with the patient after the rash has healed (could last months or years). Increased sensitivity to touch/light is also very common. Treat with antiviral (acyclovir)

184
Q

why does shingles cause a unilateral rash?

A

it occurs in the dermatome (area of the skin) supplied by a single spinal nerve

185
Q

most common site of shingles

A

ophthalmic division of the trigeminal nerve and mid-thoracic sensory roots

186
Q

herpes zoster ophthalmicus

A

singles affecting the eye, can have potential vision-threatening complications

187
Q

client teaching for shingles

A
  • wear rubber gloves when applying tx cream
  • trim fingernails short, clean hands
  • wash sores and skin with soft washcloth and mild soap
  • wear a clean undershirt everyday
  • wash soiled linens in hot water and soap
188
Q

TX for shingles

A

antiviral medications

Zovirex, Valtrex, Famvir

  • within 72 hrs of rash appearing
189
Q

transmission of shingles

A

only those who have had chickenpox can get shingles, if someone with shingles infects someone without previously having chickenpox they will likely get chickenpox

190
Q

goal of tx for shingles

A

control pain and restore function and quality of life

191
Q

osteoporosis

A

skeletal disorder characterized by compromised bone strength predisposing to an increased risk of fracture

“silent thief”

192
Q

how is osteoporosis diagnosed

A

DEXA scan

Dual-Energy X ray Absorptiometry

low energy x-rays

193
Q

T-score measurements

A

+1 to -1 SDs = NORMAL

-1 to -2.5 = OSTEOPENIA

below -2.5 = OSTEOPOROSIS

below -2.5 with 2 fragility fractures = SEVERE OSTEOPOROSIS

194
Q

risk factors of osteoporosis

A
  • family hx
  • osteopenia
  • low body weight
  • low calcium diet
  • low physical activity
  • ovaries removed or early menopause
  • post-menopausal
  • vitamin D deficiency
  • smoking
  • caffeine intake
  • race (caucasian, asian)
  • excessive alcohol intake
195
Q

TX goal of osteoporosis

A

PREVENTION OF FRACTURES & FALLS

  • adequate calcium and vitamin D
  • mobility exercises
196
Q

medications used for osteoporosis

A
  • Alendronate (Fosamax)
  • Risedronate (Actonel)
  • Ibandronate (Bonvia)
  • Zoledronic acid
197
Q

what is the most common complication of osteoporosis?

A

vertebral compression fracture

198
Q

S/S of osteoporosis

A

height loss, spinal deformity, chronic back pain, impaired breathing

199
Q

what is Calcitonin?

A

a hormone produced by the thyroid gland that slows bone loss and reduces risk of spinal fractures

200
Q

arthritis

A

inflammation of a joint

consists of more than 100 related conditions ranging from tendinitis to rheumatoid arthritis

201
Q

rheumatoid arthritis

A

autoimmune condition that causes chronic inflammation

painful and deformed swelling of the joints

TX: NSAIDS; disease-modifying antirheumatic drugs (DMARDs)

202
Q

osteoarthritis

A

cartilage breaks down and wears away which causes bones to rub together

most prevalent type of arthritis

203
Q

treatment for osteoarthritis

A

CANNOT BE “CURED” W/O JOINT REPLACEMENT

  • pain management (hot & cold, medications)
  • steroid injections into the joint
  • acupuncture
  • music
  • glucosamine & chondroitin sulphate
204
Q

etiology of gout

A

inflammatory arthritis that occurs due to raised uric acid levels in the blood which may lead to the accumulation of urate crystals in joints, soft tissues and kidneys

205
Q

what is uric acid?

A

waste product secreted when the body breaks down purines (protein)

206
Q

S/S of gout

A

joint inflammation, pain, tophi (large and gritty deposits of uric acid d/t chronic hyperuricemia)

207
Q

tophi

A

clusters of urate crystals that form deposits in joints, cartilage, bones, kidneys or soft tissues

typically 10-12 years after onset of symptoms

may break through the skin and appear white or yellowish-white chalky nodules

208
Q

risk factors for gout

A
  • male sex
  • high intake of foods high in protein and alcohol
  • obesity
  • those taking diuretics, aspirin, ciclosporin & kidney disease
  • hypertension
  • diabetes
  • CVD
  • CKD
  • metabolic syndrome
209
Q

what foods should those with gout avoid?

A

PURINE FOODS
- red meats
- anchovies, herring, mackerel, sardines, trout, caviar
- seafood
- meat and yeast extracts
- sweetened soft drinks
- highly processed foods

210
Q

protective foods for gout

A

low fat dairy, high vitamin C, sour cherries or cherry juice

211
Q

treatment for gout

A

NSAIDS for approx 2 weeks

may alternately be prescribed glucocorticoids or Colchicine

allopurinol used for repeated attacks

212
Q

why is insomnia common among the elderly?

A

melatonin, cortisol and growth hormone production drops dramatically with age

213
Q

changes in sleep with aging

A
  • sleep reduced
  • takes longer to fall asleep
  • disorders occur earlier in men, common in men 65+
214
Q

insomnia in the older adult

A

more common in women

causes mood changes, memory deficits, diminished concentration, poor judgement, impaired performance, and immune system changes

215
Q

sleep apnea

A

cessation of respirations for more than 10 seconds

treated with either a dental appliance or CPAP therapy

216
Q

restless leg syndrome

A

uncomfortable sensation in legs causing movement, numbness and loss of sleep

cause unknown, may be d/t some medications such as antidepressants and caffeine

217
Q

REM behavioural sleep disorder

A

loss of voluntary sleep atonia (core muscle relaxation) during REM sleep

complex behaviours while dreaming

mean age 60 years

more common in males

218
Q

what can adverse reactions related to dopamine agonists cause?

A

impulse-control disorders (eg. gambling or sex addiction)

219
Q

why is benztropine used with caution in pts with Parkinson’s?

A

may cause serious side effects that include hallucinations and urinary retention

220
Q

paternalism

A

withholding information and not offering certain options, impending the patient’s ability to act upon their wishes

221
Q

justification of limiting autonomy

A

lack of capacity/competency
potential harm to self
potential harm to others

but, they must be the least invasive or restrictive and no more than is necessary to accomplish the purpose

222
Q

what are the 3 risk assessment rules?

A

1: never based on convenience or gratification

#2: negotiating risk involves minimal use of power to attain max benefit and minimum infringement on client’s liberty
#3: the more grave consequences, the greater obligation to intervene

223
Q

encumbered client

A

whose judgement and decision making ability are hindered by distorting factors, impaired emotional state, undue influence and inadequate/partial information

224
Q

unecumbered client

A

competent and not subjected to distorting factors

225
Q

substituted judgement

A

making a decision for a patient based off his/her own values

226
Q

best interest judgement

A

what a reasonable person, in the patient’s position would want with consideration

227
Q

life prolongation vs futility of treatment

A

circumstance under which life-sustaining treatment can be suspended

there is irreversible progression of disease, tx will be harmful and ineffective, life with be shortened regardless of tx, non-tx will allow greater comfort

228
Q

withholding vs withdrawing treatment

A

morally equivalent

229
Q

moral distress

A

when we know what is the right/ethical action but cannot act upon it

230
Q

Adult guardianship laws

A
  • health care (consent) and care facility (admission) act
  • representation agreement act
  • adult guardianship act
  • public guardianship and trustee act
231
Q

consent to health care

A

voluntary decision made by a capable adult in BC to accept or refuse an offer of medically appropriate health care tx

232
Q

when is an adult’s consent NOT required?

A
  • when urgent or emergency health care is required
  • when involuntary psych tx is needed
  • preliminary examinations such as triage and assessment
  • when communicable diseases are involved
233
Q

Two types of substitute decision makers

A
  1. FORMAL: pt has a duly appointed committee of person or representative
  2. TEMPORARY: pt does not have a committee of person or representative, a decision maker is chosen by the HCP
234
Q

committee of person

A

personal guardian whose formal name is committee of person

if an incapable adult did not make a representation agreement or AD while capable

235
Q

Public Guardian and Trustee of BC

A

protects the legal and financial interests of children under the age of 19 years, and adults who require assistance in decision making

administers the estates of deceased and missing people

236
Q

advance directive

A

written instructions telling medical providers what treatments a person does or does not want

may be detailed or as vague as desired

237
Q

representation agreement

A

document in which a capable adult names their representative to make health care and other decisions on his/her behalf

two types (section 7 & section 9)

238
Q

what is the list in order for temporary substitute decision maker?

A
  1. SPOUSE
  2. CHILD
  3. PARENT
  4. BROTHER or SISTER
  5. GRANDPARENT
  6. GRANDCHILD
  7. RELATED BY BIRTH OR ADOPTION
  8. CLOSE FRIEND
  9. PERSON RELATED BY MARRIAGE
239
Q

advance care plan

A

written summary of the capable adult’s wishes or instructions to guide a substitute decision maker if that person is asked to make tx decisions on their behalf

240
Q

instructional directives

A

state what or how health care decisions ar to be made when they are unable to make them themselves

“living will”

241
Q

proxy directives

A

specific person who will make decisions for the pt when they are unable too

242
Q

section 7

A

routine financial management, personal care, and some health care decisions

DOES NOT allow person to accept or refuse life support

243
Q

section 9

A

personal care and other health care decisions as well as ACCEPTANCE or REFUSAL of life support

244
Q

enduring power of attorney

A

decisions in relation to financial affairs, business and property

NO HEALTH CARE DECISIONS

245
Q

MAID

A

Medical Assistance in Dying

competent adult consents to termination of life

246
Q

EOL care

A

End of Life Care

term used by those in health care when referring to care provided to individuals in their last weeks to days of life

247
Q

SPEAK - EOL decisions

A

S- substitute decision maker
P - preferred treatment options
E - expressed wishes
A - advanced directives
K - knowledge of benefits and tx prognosis

248
Q

MOST

A

Medical Orders for Scope of Treatment

M3 - full treatment
M2 - transfer only when comfort measures cannot be achieved
M1 - comfort measures only

C2 - intubation
C1 - no intubation

249
Q

palliative care

A

care designed to improve the quality of life, prevent and relieve suffering, optimize function and provide opportunities for personal growth

can occur at anytime in a chronic declining condition

250
Q

hospice care

A

holistic and compassionate care given to terminal patients in their last stage of life

251
Q

how is death pronounced?

A
  • no apical heart beat for 1 minute
  • no spontaneous respiration for 1 minute
  • pupils dilated and fixed
252
Q

what is meant by a “good death”

A
  • adequate pain and symptom management
  • avoiding a prolonged dying process
  • clear communication
  • a sense of control
  • spiritual or emotional sense of completion
  • strengthening relationships with loved ones
  • not being alone
253
Q

approaching death symptoms

A
  • decreased LOC
  • muscle relaxation/dysphagia
  • restlessness
  • congestion
  • breathing laboured/irregular/apnea/Cheyene-Stokes
  • incontinence/dark urine
  • mottling (red/purple marbled spots on skin)
  • non-reactive pupils
  • weak pulse, dropping BP
254
Q

nursing interventions for palliative comfort

A
  • pain control
  • reduce air hunger and anxiety
  • skin and mucous membrane care
  • choices
  • grooming/assistance with all ADLs
  • spirituality needs
255
Q

BATHE communication

A

Background information
Affect
Trouble
Handling things
Empathy

256
Q

acute grief

A

a crisis

manifests as somatic and psychological symptoms of distress

257
Q

anticipatory grief

A

the response to a real or perceived loss before it occurs

258
Q

ambiguous loss & grief

A

a person is physically present but psychologically absent

259
Q

disenfranchised grief

A

loss cannot be acknowledged or publicly mourned

(eg. health care workers in response to a pts death)

260
Q

chronic/dysfunctional grief

A

begins with normal grief but obstacles interfere with its normal evolution towards adjustment

261
Q

elder abuse

A

single or repeated act or lack of appropriate action, occurring within any relationship where there is an expectation of trust which causes harm or distress to an older person

262
Q

types of elder abuse

A

PHYSICAL
SEXUAL
EMOTIONAL / PSYCHOLOGICAL
MEDICAL
FINANCIAL * most common
NEGLECT
ABANDONMENT

263
Q

transgenerational violence

A

children who were abused when they were young and are now abusing their parents when caring for them

264
Q

risk factors for elder abuse

A
  • 80 years and older
  • female
  • disability
  • dementia/cognitive dysfunction
  • depression
  • social isolation
265
Q

more than ___ % of persons with dementia live at home with family members

A

70

266
Q

what does caregiver stress derive from?

A
  1. personal characteristics of caregiver
  2. needs of cared for persons
  3. challenges in accessing formal systems of care
267
Q

what are the two major trends responsible for family members assuming the caregiver role?

A
  1. SCARCE RESOURCES: efforts to reduce health care spending
  2. PHILOSOPHY OF CARE: care of aging individuals is best offered in community
268
Q

is relocation to a long term care facility looked forward to by the elderly

A

no, it is one of the most stressful kinds of relocation

269
Q

caregiver burden

A

commonly used to describe the financial, physical and psychosocial problems that family members experience when caring for older adults suffering from illness

270
Q

what type of stressor is caregiving considered?

A

a chronic stressor

d/t the persistent and often physically demanding caregiving tasks and emotional toll

271
Q

ambiguous loss

A

loss when a person with dementia is physically present, but psychologically absent

confuses relationships and prevents closure/moving on

272
Q

medication use concerns in older adults

A
  • differences in metabolism
  • overuse, underuse
  • polypharmacy
  • adverse drug reactions (ADRs)
  • drug interactions
273
Q

what age group is the largest users of OTC medications?

A

65 +

274
Q

pharmacokinetics

A

the study of the movement and action of a drug in the body

275
Q

what is the “golden rule” of prescribing drugs for older adults?

A

start low and go slow

276
Q

what are the four major pharmacokinetic processes in the body?

A

ABSORPTION: how it is taken in

DISTRIBUTION: where the drug is dispersed

METABOLISM: how it is broken down

EXCRETION: how the body gets rid of the drug

277
Q

effect of starvation on drug absorption

A

can reduce protein binding of drugs which will make levels of the free drug rise

278
Q

changes in distribution of drugs in the older adult

A

LOWER ALBUMIN LEVELS
needs lower dose of acidic protein bound drugs (digoxin, warfarin, diazepam)

INCREASED a1-acid glycoprotein & lipoproteins
needs higher dose of basic protein bound drug (propranolol, lidocaine)

LESS TOTAL BODY WATER
need lower dose of hydrophilic drugs (lithium, aminoglycosides)

HIGHER FAT CONTENT
caution in CNS drugs

LOWER LEAN MUSCLE MASS

279
Q

metabolism changes in the older adult

A

REDUCED HEPATIC BLOOD FLOW
increased bioavailability of the blood

REDUCED HEPATIC MASS

DECLINE IN OXIDATIVE METABOLISM

280
Q

excretory changes in the older adult

A

kidney function decreases, renal blood flow is reduced

prolongation of the half-life of medications providing the potential for toxicity

281
Q

what is the best indicator of renal function in the elderly?

A

creatinine clearance NOT serum creatinine

282
Q

pharmacodynamics

A

the physiological process between a drug and the body

283
Q

polypharmacy

A

an individuals use of multiple medications

284
Q

polypharmacy prevention: SAIL & TIDE

A

Simplify
Adverse effects
Indication
List

Time
Individualize
Drug interactions
Educate

285
Q

How much more common are ADRs in the elderly than the younger population?

A

7x

286
Q

causes of ADRs

A
  • improper dosages or drug
  • non-adherence
  • altered pharmacokinetics
  • multiple meds or prescribers
287
Q

common ADRs in elderly

A

falls, delirium, GI distress, incontinence, constipation, confusion, depression, anxiety

288
Q

akathisia

A

motor restlessness

may be mistaken for agitation

289
Q

tardive dyskinesia

A

movement disorder, worm like movements of the tongue or other facial movements

may be reversible if caught early, otherwise permanent

290
Q

risk factors for TD

A

elderly, asian/african, female, previous mood disorder, diabetes

291
Q

neuroleptic malignant syndrome

A

LIFE THREATENING

extreme rigidity, fever, autonomic disturbances, fluctuating level of consciousness

due to high serum creatinine kinase level

292
Q

severe cardiac dysrhythmias

A

antipsychotics pose this risk of a prolongation of the QT interval

ECG monitoring

293
Q

drug-drug interactions

A

more medications, greater risk of interactions

over 7 meds = 82% risk

294
Q

what foods should be avoided with use of MAOIs?

A

tyramine foods

aged cheese, wine, organ meats

cough syrup, cold medications

295
Q

serotonin syndrome

A

myoclonus (involuntary twitching), shivering, tachycardia, tremors, hyper/hypotension, seizures, delirium

296
Q

BEERS criteria

A

potentially inappropriate medications which should be avoided in persons 65 years + as they are ineffective or pose high risk

48 meds to avoid

297
Q

LR: What is ageism?

A

a way of thinking about older adults based on negative attitudes/stereotypes

298
Q

what are some barriers that older adults face in regards to accessing health care?

A
  1. cultural influences on understanding of mental health
  2. limited transportation accessibility
  3. lack of technology knowledge
  4. negative views towards HCPs
299
Q

All older adults do not want to participate in care. T/F

A

False

300
Q

what does genetic aging theory suggest?

A

there is a potential genetic predisposition for longevity of life

301
Q

what nursing implication promotes cognitive stimulation?

a. providing a balance between activity and rest
b. providing activities they enjoyed in the past
c. assessing the client’s memory on a daily basis

A

B - providing activities they enjoyed in the past

302
Q

which elevated plasma level is linked to healthy aging and longevity?

A

HDLs

303
Q

what are the 5 R’s of practicing reconciliation?

A

Respect all worldviews

Reciprocity in all relationships

Relevance to holistic wellness

Responsibility for informed practice and pedagogy

Relationships grounded in safety and humility

304
Q

“Aboriginal” is an inclusive term referring to indigenous people across the world. T/F

A

False, “Indigenous” is the inclusive term

305
Q

Chronic health conditions of Indigenous peoples reported to be expressed in later life. T/F

A

False, they are experienced earlier in life

306
Q

Which psychiatric nursing care implications would you incorporate when working with older indigenous population?

a. speak louder
b. ask them about your culture
c. incorporate cultural safety into care
d. explain to them you don’t understand their culture
e. none of the above

A

C

307
Q

effects of vitamin D deficiency

A

osteoporosis, weak bones

308
Q

effects of vit b12 def

A

cognitive function altered, and decreased energy

309
Q

what is the recommended dose of vitamin D per day?

A

800-2000 IU

310
Q

what can help maintain bone mass in older adults?

A

regular weight bearing exercises/flexibility, balance exercises, calcium supplements

311
Q

recom diet for OA

A

plant based/mediterranean

312
Q

older adults are more susceptible to conditions like hypothermia and heat stroke than younger people. T/F

A

True, as we get older the body’s ability to regulate temperature decreases overtime

313
Q

physiological changes affecting thermoregulation in the older adult

A
  1. PERSPIRATORY CHANGES (less active sweat glands)
  2. CARDIOVASCULAR DECLINE
  3. DECREASED THERMORECEPTOR RESPONSE
  4. CHANGES IN BLOOD GLUCOSE
314
Q

psych & social contributions affecting thermoregulation in the older adult

A
  1. IMPAIRED FUNCTIONAL CAPACITY (adjusting for temp)
  2. HEALTH CONDITIONS
  3. IMPAIRED ABILITY TO SENSE THERMAL STATE
  4. ENVIRONMENTAL and FINANCIAL (unwilling to use air conditioning)
315
Q

which of the assessments below is the most important to include when working with older adults with impaired thermoregulation?

a. assessing the client’s urinary output
b. assessing the client’s pain status
c. assessing the client’s short term memory

A

A

316
Q

what are the most commonly misused substances among older adults?

A

benzos, alcohol, cannabis, opioids

317
Q

why is substance use rarely detected in older adults?

A

MOST screening & TX protocols are developed for younger population

318
Q

why OA at increased risk for SUD

A
  • increased health issues
  • chronic pain
  • psych stressors
319
Q

approved drugs to tx opiate misue in OA

A

buprenorphine, methadone, naltrexone

320
Q

1 example of physiological change in aging that may alter an OA perception of sexual intimacy

A

menopause

321
Q

sex orientation considered mental illnes until

A

1996

322
Q

to reduce stigma & discrimination, what interventions can be used in regads to sexuality & OA

A

trauma informed care, building rapport, education, assessmentof medications & sexual history

323
Q

what genre of music is best for sedation?

A

sedative

324
Q

why muscial interventions gaining more traction for OA

A

feasibility

325
Q

what is music reminiscence therapy

A

free intervention, recollection of life, and improves well being

326
Q

key aspect of nursing education in preventing aspiration penumonia in OA

A

provide tailored education on swallowing techniques

327
Q

what role do nurses play in antibiotic stewardship for UTIs in women?

A

educating patients on completing the antibiotic course as prescribed

328
Q

how do nurses contribute to collaborative care for older adults at risk of aspiration pneumonia?

A

coordinating care plans with interdisciplinary teams

329
Q

what is NOT a consequence of malnutrition?

a. increased life expectancy
b. delayed healing
c. longer hospital stays
d. anemia

A

A

330
Q

what vitamin do we give as a nutritional supplement?

A

vitamin D3

331
Q

what type of enriched foods should our older adult patients be eating?

A

protein

332
Q

physical activity is encouraged prior to bedtime to promote sleepiness. T/F

A

False, it should be encouraged in the day but avoided 4 hours prior to bedtime

333
Q

which sleep disorder is highly prevalent in the older adult?

A

insomnia (may be from nocturia or GERD)

334
Q

medications are used to treat sleep concerns but may also cause sleep disturbances. T/F

A

true

335
Q

what is incorrect regarding visual and auditory changes in old age?

a. increased risk of developing late-life depression and anxiety
b. hearing impairment can result in inaccurate MMSE scores
c. visual and hearing impairment decreases the risk of falls and prolonged hospitalization
d. many older adults underutilize visual or hearing assistive devices because of difficulties adapting to wearing or operating them

A

C

336
Q

older adults with visual and hearing impairments are at an increased risk of developing cognitive impairment. T/F

A

T

337
Q

what nursing interventions can be used for elderly individuals with visual and hearing impairments?

A

proper lighting, use visual/hearing aids, engage pt in oscially and mentally stimulating activities

338
Q

frailty is not associated with an increased risk for infection. T/F

A

false

339
Q

respiratory illness is associated with a greater loss of independence. T/F

A

t

340
Q

what is the main benefits of getting vaccinated for older adults?

A

it can prevent up to 70% of hospitalizations and 80% of deaths caused by influenza

341
Q

what lifestyle modifications can help prevent CVD in older adults?

A

adapting to a heart healthy diet, engaging in mild-moderate physical activity, smoking and ETOH management

342
Q

change in heart structure and function do not occur as a natural part of aging. T/F

A

False, changes in vessel structure and reduced elasticity are contributors

343
Q

which of the following is a risk factor for CVD?

a. a healthy lifestyle
b. increased sodium diet
c. medication adherence
d. none of the above

A

B

344
Q

there are higher incidence rates amongst older women compared to older males for cancer. T/F

A

false, in males

345
Q

leading cancer in older women

A

breast

346
Q

what is the recommended approach when caring for older adult patients with cancer?

A

timely assessments and interventions

347
Q

mineral significant to thyroid function

A

iodine

348
Q

what is the synthetic alternative used for thyroid hormone replacement in hypothyroidism?

A

levothyroxine

349
Q

which method is considered safe in the older population to identify thyroid cancers and distinguish between benign and malignant nodules?

A

Fine-Needle Aspiration Cytology (FNAC)

350
Q

which of the following is NOT a microvascular complication associated with chronic hyperglycemia in older adults?

a. diabetic retinopathy
b. diabetic nephropathy
c. peripheral artery disease
d. diabetic neuropathy

A

C - PAD macrovascular

351
Q

how does uncontrolled blood glucose levels affect older adults with diabetes in terms of macrovascular complications?

A

macrovascular complications such as hypertension and peripheral artery disease due to atherosclerosis

352
Q

what is a common symptom of GI disorders in the older adult?

A

constipation / diarrhea

353
Q

what is a common treatment for GI disorders

A

increase fluids & fibre

354
Q

what should you not do for a patient with a GI disorder?

A

restrict fluids

older adults (3 decks)

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