Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

Nur 333 fundamentals 2 > Wk 4: older adults/ pain and comfort > Flashcards

Wk 4: older adults/ pain and comfort Flashcards

(87 cards)

Start Studying
1
Q

what age does old age start at ?

A

65+

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

what has lead to the increase in the aging population?

A

longer life span, baby boomers getting to this age group, better diagnostic testing

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

what are some universal signs of aging when looking at a patient

A

facial wrinkles, grey hair, BMI changes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

physiological changes of aging: neurological system

A

degeneration of nerve cells
decrease in neurotransmitters
decreased impulse conduction
slower voluntary reflexes
less ability to respond to multiple stimuli
alterations in sleep

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

physiological changes of aging: facial features and vision

A

loss of SQ fat and skin
visual acuity declines
presbyopia
difficulty adjusting to light changes
yellowing of eyes lens
altered color perception
sensitivity to glare
smaller pupils (react slower)
Dz: cataract, macular degeneration, diabetic retinopathy, retinal detachment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

physiological changes of aging: hearing

A

changes subtle
presbycusis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

physiological changes of aging: taste

A

salivary secretion reduced
taste bud atrophy
difficult to recognize between salt/sweet/sour
health conditions and meds can alter taste

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

physiological changes of aging: smell

A

loss of smell
this causes nutritional issues

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

physiological changes of aging: heart and vascular

A

decreased cardiac output d/t low contractile strength of myocardium
slight cardiomegaly
stiffening heart wall
HR changes (lower)
heart valves thicken/stiffer
lower extremity pulses weaker but palpable (less perfusion)
HTN (not nml)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

physiological changes of aging: lungs

A

lung strength and expansion decreases (cough not as effective)
more susceptible to PNA/infections
AP diameter increases
decreased # of alveoli and cilia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

physiological changes of aging: thorax

A

kyphosis
calcification of costal cartilage (causing decreased mobility of ribs)
chest wall stiffens/ less recoil

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

severe kyphosis can lead to what?

A

respiratory issues
pain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

physiological changes of aging: GI and abdomen

A

increased fatty tissue
protuberant abd
slowed peristalsis
decreased production of saliva and digestive enzymes
delayed gastric emptying
less tolerant of foods

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

physiological changes of aging: urinary system

A

BPH causing urinary retention, frequency, incontinence, UTI’s
decreased bladder capacity
urinary incontinence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

women are more susceptible to what kind of incontinence?

A

stress incontinence (when coughing, sneezing, laughing or lifting objects)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

what are some risk factors for urinary incontinence?

A

age
menopause
DM
hysterectomy
stroke
obesity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

physiological changes of aging: skin

A

decreased turgor / SQ fat/ connective tissue
loss of resilience & moisture
thinning of epithelial tissue
wrinkles

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

what happens to hair and nails with age

A

hair thins and grays, sparse distribution
nails grow slow and thicken

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

senile lentigo

A

age spot / liver spot

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

who is at higher risk for developing osteoporosis

A

postmenopausal women

they should take in more calcium

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

physiological changes of aging: female reproductive system

A

reduce estrogen and progesterone
vaginal drying, pain with intercourse, decreased libido

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

physiological changes of aging: male reproductive system

A

weaker erection, weaker ejaculation
less testosterone
decreased libido
no definite cessation of fertility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

physiological changes of aging: breasts

A

lower estrogen
tissue firmer
lower muscle mass/ tone/ elasticity
gynecomastia in males
men and women at risk for breast cancer

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

physiological changes of aging: immune system

A

slowed response and healing
reduced production of B&T cells
decreased body temp
decreased stress response
decreased response to immunizations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
what does the functional changes in older people refer to?
the capacity and safe performance of ADL and IADL's PT/OT can help in assessment
26
physiological changes of aging: cognitive changes
reduction of brain cells and changes in neurotransmitter levels. misconceptions: confused, disoriented, forgetful, loss of language skills, poor judgement
27
psychosocial changes of aging
retirement social isolation sexuality housing and environment death
28
what are some nursing considerations for elderly ?
developmental tasks setting in which you are caring for the older adult variability of older adults health considerations disease presentation in older adults health promotion psychosocial concerns of the older adult
29
how can nurses help with placement decisions
encourage collaborative involvement answer questions educate on options encourage to visit facility to determine quality
30
what are some things to look for when finding a placement home for elders ?
does not feel like a hospital personal room with privacy medicare & medicaid certified qualified staff with background checks quality of care & activities quality of food staff encourage family involvement
31
what are some acute care considerations for elderly
basic needs of comfort nutrition/ hydration skin integrity identify and treat cause promote independence include them in care
32
what are some complications of acute care with elderly
delirium malnutrition/ dehydration HAI's urinary incontinence falls
33
what are some nursing care interventions for an elderly patient with delerium?
encourage family visits memory cues compensate for sensory deficits reality orientation
34
what is the goal of restorative care for elderly ?
the regain or improve prior level for independence , ADL, instrumental activities for daily living (IADL)
35
what is the leading cause of death?
heart disease (including HTN and CVD)
36
what are the factors affecting nutrition in older adults?
lifelong eating habits, tradition, cultural habits, preferences, religious beliefs, situational factors, chronic illnesses, medications
37
some overall nutritional recommendations for elderly
increase vitamins (D,B12,E, folate, fiber, Ca) increase fluid intake limit sodium / fat/ refined sugar/ alcohol
38
how to improve nutritional intake when an elderly person is hospitalized
eat with others ensure food is accessible during the day pt is comfortable good hygiene environment dietician consult promote activity
39
intrinsic risk factors for falls in older adults
H/o falls fear of falling Wk vision issues postural hypotension balance /gait issues medication reaction chronic conditions (stroke, DM, dementia, arthritis)
40
extrinsic risk factors for falls in older adults
poor lighting no handrails poorly designed stairs no grab bars or nonslip surfaces hazards / obstacles slippery / uneven ground improper use of assistive devices inappropriate footwear
41
what are some illness indicators in elderly
metal status changes occurrence / reasoning behind falls dehydration decreased appetite loss of function dizzy incontinence anxious
42
if an elderly adult that is staying in the hospital starts to act acutely confused, what are some possible sources of it?
acute illness neurological event (stroke?) new medications risk factors for delirium
43
if an elderly adult that is staying in the hospital obtains an infection, how would it present
may not have a fever tachypnea falls/ increase in falls incontinence confusion
44
loss of appetite with late stage heart disease is an early symptom of what ?
impending failure
45
what is a large concern when checking an older adults EMR and seeing multiple providers involved in their care?
polypharmacy drug-drug interactions drug-food interactions
46
what are some generalized preventative measures that the nurse should recommend to older adults
frequent screenings exercise regularly weight reduction as needed low fat, well balanced diet moderate alcohol smoking cessation stress management socialization good hand washing regular checkups with HCP immunizations
47
when teaching older adults be sure to..
assess readiness to learn speak clear / slow/ normal tone one idea at a time allow time to process info minimal environmental distractions teach back method
48
teaching older adults with hearing deficits
get their attention reduce background noise speak clearly speak loudly repeat yourself good lighting
49
which is not a description of pain A. pain is objective B. pain is an individual experience C. pain is often misunderstood and inadequately treated D. pain is an individual experience
A. rationale: pain is a purely subjective experience only the person experiencing it rate
50
nociception
observable activity in the nervous system in response to an adequate stimulus pain
51
the four phases of pain pathophysiology
transduction transmission perception modulation
52
acute pain
protective mechanism short duration (3-6Mo) limited damage can progress to chronic pain VS changes
53
chronic pain
not protective not same outwards Sx as acute pain lasts longer than 3-6 months
54
what is the goal of treatment for someone with chronic pain ?
to improve functional status
55
is chronic pain and cancer pain the same?
no cancer pain arises from damaged pain nerves r/t cancer care
56
what are some observable signs of acute pain ?
BP change increased HR increased RR dilated pupils diaphoresis
57
why dont people with chronic pain have observable signs of pain?
d/t loss of adaption mechanisms
58
nociceptive pain
aching gnawing, pounding pain arises from pain receptors
59
neuropathic pain
injury to nerves or abnormal sensory output burning, shooting, electrical, abnormal sensations
60
what are some examples of neuropathic pain ?
spinal cord pain DM neuropathy phantom limb pain
61
what are the three kinds of nociceptive pain?
1. somatic: bones/joint/muscles/connective tissue 2. visceral: internal organs (often referred) 3.cutaneous: in skin or SQ tissue
62
what are two types of well localized pains?
somatic cutaneous
63
idiopathic pain
chronic, unknown cause "idiot" hard to treat exceeds typical pain levels
64
acute pain activates which nervous system?
sympathetic fight or flight Sx: tachycardia, HTN, anxiety, diaphoresis, muscle tension
65
what are some symptoms of chronic pain?
fatigue depression decreased level of functioning
66
Which statement about pain is true: A. chronic pain is psychological B. pain is what the patient says it is and we must assess and treat it as such C. patients who abuse substances overreact to discomfort D. administering analgesics regularly leads to drug addiction E.psychogenetic pain is not real
B
67
what are some factors that influence pain experiences
age fatigue genes cognitive/neurologic function previous pain experiences support systems/ coping mechanisms spirituality anxiety/ fear
68
cultural aspects of pain
P&P box 44.4
69
what are some aspects in a persons life that pain can impact ?
quality of life self-care work social support (family/friends)
70
what are some ways to measure a patients pain?
vertical and horizontal pain scale visual analogy scale simple descriptive pain intensity face scale (3 y/o or up)
71
PQRSTU
provocative / palliative quality/ quantity region/ radiation severity timing/ treatment understanding
72
what are some non-pharmacologic measures for pain management (4)
relaxation and guided imagery distraction music cutaneous stimulation
73
if a patient is opioid naive, what is the best course of action when administering their medications
start with the lowest dose or lest intense medication and gradually increase as needed
74
what are the three main types of pharmacological treatments for pain
non-opioids opioids adjuvants
75
what are some considerations for acetaminophen?
safest MOA unknown analgesic, anti-pyretic NOT antiinflammatory watch for liver toxicity ceiling effect
76
considerations for NSAIDS
ceiling effects watch for GI bleeds
77
do opioids have a ceiling effect?
no
78
if opioids lead to respiratory depression, what are some nursing implications?
naloxone (may need multiple doses or a drip) administer O2 maintain airway **critical to know baseline respiratory assessment
79
why would around the clock dosing be utilized ?
to maximize pain relief potentially decreases opioid use
80
if a patient is using ATC (around the clock) opioids for pain management, what can be used for breakthrough pain?
non-opioids, usually ibuprofen d/t most opioid already having acetaminophen in them
81
range order medications
orders where a dose varies over a prescribed range to provide flexibility Ex: Morphine 2-6mg IV q2h PRN for pain nurse responsible to know patient and follow orders appropriately
82
if a patient has a range order for Tylenol that is: Tylenol 500-1000 mg q4h PRN for pain what are some considerations to administering this?
whatever dose is given, you have to count/tally what is given and chart it so you do not go over the daily limit of 4g
83
PCA (patient controlled analgesia)
always IV starts with loading dose patient then BOLUS meds as needed there is a frequency and limit
84
epidural anesthesia
regional anesthesia must be preservative free can be PCA or continuous
85
what are some side effects of epidural anesthesia
hypotension, N/V, urinary retention, constipation, respiratory depression, pruritus
86
nursing care for epidural anesthesia
monitor site placement monitor infection/ bleeding may need urinary catheter may not be able to walk, fall risk monitor coags
87
what is the difference between tolerance and dependence ?
tolerance is not a sign of addiction. dependence can also cause withdrawal symptoms if drug is not gradually decreased. both tolerance and dependence an occur after repeated exposure to opioids

Nur 333 fundamentals 2 (7 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions