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N133 > adulthood > Flashcards

adulthood Flashcards

1
Q

What age range is young adult?

A

20-40yo

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2
Q

What age range is middle adult?

A

40-60yo

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3
Q

What age range is older adult?

A

65 and on

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4
Q

What stage is the young adult in according to Erikson?

A

Intimacy Vs Isolation:

Has intimate relationships, stable positive feelings about self, experiences successful role transitions & increased responsibilities. Has strong sense of personal identity if progressed through previous stages.

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5
Q

What stage is the middle adult in according to Erikson?

A

Generativity vs. self-absorption – accepts changes in appearance & physical endurance, reassesses life goals. Shows contentment with aging.

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6
Q

What stage is the older adult in according to Erikson?

A
  • Ego integrity vs despair – feels positive about own life & its meaning, is interested in providing a legacy for the next generation. Final stage of life, look back with satisfaction in accomplishments, few regrets. Despair – failure to accept one’s life as meaningful, leads to bitterness and emotional desolation.

Wisdom – practical (good judgment and complex problem solving) and transcendent wisdom (self-knowledge that allows person to transcend subjectivity, bias and self-centeredness, share understanding of life.

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7
Q

What are the physical changes to occur in young adulthood?

A
  • complete growth by 20yo
  • active: prime physical year
  • fewer illnesses than older adults
  • minimal physical changes unless pregnancy
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8
Q

What are the cognitive changes to occur in young adulthood?

A
  • Variation in reason and thinking
  • ^ critical thinking
  • choosing career is major
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9
Q

what stage according to Piaget is the young adult in?

A

Formal Operations: relates values and norms to social group

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10
Q

What psychosocial changes are likely to occur between 23-28yo?

A

refine self perception & capacity for intimacy

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11
Q

What psychosocial changes are likely to occur between 29-34yo?

A

focus on achieving personal & occupational goals, money!

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12
Q

What is Erasure?

A

– describes how sexual minorities are erased in the system that only allows binary gender (male/female

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13
Q

what stage according to Kohlberg what is the young adult in?

A

Kohlberg – preconventional (punishment & obedience) - egocentric; conventional - societal focus; postconventional – understands human rights & acceptable norms, laws can be changed to what is right (principled reasoning), universal focus.

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14
Q

What does Gilligan say about the young adult stage?

A

Gendered view

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15
Q

what is the 2nd leading cause in young adults?

A

suicide

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16
Q

what is the peak age for mental health issues?

A

15-24yo

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17
Q

What is the recomended exercise for a young adult?

A

moderate to vigorous high intensity bouts of 10min or more - min of 150 min per week

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18
Q

What kind of physical changes occur in middle adulthood?

A
  • Appearance ( hair thins, grey, decrease skin turgor & moisture, sc fat = wrinkles, fat to abd. area;
  • MSS (decrease in muscle bulk, ROM, height, bones; CVS (blood vessels loss elasticity & thicken = harder to pump through);
  • senses (decline in vision, hearing and taste)
  • metabolism (slows down = wt. gain);
  • GI (decrease in tone = constipation);
  • Urinary (GRF decreases d/t loss of nephrons);
  • sexuality (decline in sexual function).
  • Men & women experience a decrease in hormone production =
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19
Q

What age range does menopause occur and for how long?

A

40-65 for 1 yr

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20
Q

What is climacteric and when does it occur?

A

In men 40-65yo

andropause, decrease in sexual activity, less firm erections & ejaculations

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21
Q

What psychosocial changes occur in middle adulthood?

A
  • Sandwich generation

- Midlife crisis

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22
Q

According to Erikson, what stage is the middle adult in?

A

Generativity vs. self-absorption and stagnation: willingness to care for & guide others

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23
Q

What are the 9 life choices to get through a tough time?

A

intention, accountability/responsibility, identification, centrality, recasting, options, appreciation, giving (without expectation of return), truthfulness (honesty with self and others).

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24
Q

Functional Age vs. Chronological Age:

A

– refers to functional fitness level compared to others of same age and gender, physiological, emotional and mental ages

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25
Q

What era are the baby boomers from?

A

1946-1964

26
Q

Zoomers:

A

Zoomers – older adults who are informed on health care and technology.

27
Q

What is frailty generally caused from?

A

not a normal outcome of aging; general decline in physical functioning resulting in increased vulnerability to illness or disability. 3 or more of the following: muscle weakness, slow walking speed, exhaustion, low physical activity levels, or unintentional weight loss.

28
Q

What are good teaching strategies for the older adult?

A

Teaching strategies – quieter room, lip movements, glasses & hearing aids working, speak slowly & clearly, low tone voice, summarize & repeat key points, teach back & elicit questions, be culturally aware, integrate values, link to past experiences.

29
Q

what is ageism?

A

. Ageism is discrimination - describes negative societal attitudes towards aging or older adults. Undermines self-confidence of older persons.

Stereotyping common such as: unattractive, worthless, old-fashioned, senile, dependent, not changing, etc

30
Q

Gerontologial nursing vs geriatrics?

A

Geriatrics is medical care; gerontological is nursing practice specific to older persons – advocating and preventing

31
Q

What are the 7 developmental tasks for the older adult?

A

1) Adjust to decreased strength & health
2) Retirement & fixed lower income
3) Deaths (parents, spouse, friends)
4) Accepting one’s self as an aging person
5) Satisfactory Living Arrangements
6) Adult children relationships
7) Maintain Quality of life - Leisure time

32
Q

What things will a 75 and older person be adjusting to?

A 
75 and older adjusting to: 
Living alone
Safeguarding physical & mental health 
Moving into nursing home
Staying in touch with family, friends 
Finding meaning in life
Prospect of own death
33
Q

What are the differences between assisted living, long-term care, and complex continuing care or chronic continuing?

A

Levels of care include: assisted living (help with ADL’s), long-term care (require 24/7 care, can no longer function independently), complex continuing care or chronic continuing (specialized care, i.e. dementia units, tube feeds, mechanical ventilation etc.). Group home environment where residents share meals & activity areas.

34
Q

What is included in assessing needs of older persons?

A

1) Assess - strengths, recourses and limitations
2) Identify - needs and problems
3) Select interventions - to maintain physical abilities, pschosocial well-being, and spiritual well-being

35
Q

What are the expected changes to the integumentary system of an older adult?

A

dry skin, decrease elasticity, fragile (skin tears and shearing); hair loss & gray; nails thicken & brittle, grow slower; women – facial hair increases!; sagging and wrinkles of skin (chin, eyelids, earlobes); less subcutaneous fat – feeling colder; brown age spots appear; less sweaty!

36
Q

What are the expected changes to the respiratory system of an older adult?

A

respiratory efficiency reduces with age, respiratory muscles weaken, rib cage stiffens. Dyspnea occurs frequently with increase physical exertion, increased airway resistance, decreased alveoli & cilia. Decrease cough reflex therefore mucous collects increasing risk of resp infections, hence encourage yearly flu vaccines, quit smoking and wash hands!

37
Q

What are the expected changes to the cardiovascular system of an older adult?

A

heart rate stays the same. Slowing responses to stress (acceleration and deceleration), changes in heart wall/valves (rigidity). Arterial changes with reduced elasticity diminishes blood flow to periphery (calcium deposits, claudication), orthostatic hypotension (baroreceptors less sensitive). Hypertension – target B/P less than 140/90).

38
Q

What are the expected changes to the GI system of an older adult?

A

periodontal disease (changes diet intake), less saliva, decrease swallowing, motility, enzymes absorption (indigestion) and blood flow – constipation. Impaired rectal sensation, hemorrhoids, rectal prolapse.

39
Q

What are the expected changes to the MMS and Neuro system of an older adult?

A

reduction in speed and power of muscles (decrease in muscle fibres after 50). Activity slower pace; balance declines and endurance. Reaction times slow. Osteoporosis. Joint changes and supporting structures, stiffen and restrictive. Loss of height, bone mass. Ensure adequate Vit D, calcium, physical activity, nutrition, rest and pauses during exercise/activities. Kyphosis, osteoporosis, pathological fractures. Degeneration of nerves, ↓ in neuro transmitters, ↓ rate of conduction of impulses.

40
Q

What are the expected changes to the sensory and perceptual system of an older adult?

A

5 senses become less efficient. Eyes – slower blink, eyelid tone and visual acuity, drier eyes. Presbyopia (40y near vision), cataracts, ↓ night vision. Hearing loss (presbycusis) after 65, more common in men. Reduced sense of taste & smell can affect appetite, also food gone bad and gas leaks. Touch sensations diminish to pain, heat and feeling thus risk of burns & other injuries. ↓ proprioception.

41
Q

What are the expected changes to the genitourinary system of an older adult?

A

– slowing down of excretion of waste products (possible accumulation of drugs - toxicity), less functioning nephrons, bladder capacity and emptying fully diminishes, nocturia, UTI’s, incontinence, prostate often enlarges in men leading to difficulty in starting flow, multiple births for women lose of tone. Drink water!

42
Q

What are the expected changes to genital and reproduction system of an older adult?

A

– men - libido decreases but still fully functional sexually but may take longer d/t blood flow, enlargement of prostate. Women – decrease in vaginal lubrication but still experience intensity of orgasm, estrogen.

43
Q

What are the expected immunocological changes of an older adult?

A

decrease immune responses to stress and immunization, less resistance to infection. Fewer antibodies, insulin resistance, cortisol levels can impair immune system’s ability to fight, T-cell function ↓, core temperature elevation is lowered (hence no fevers).

44
Q

What are the expected changes to the endocrine system of an older adult?

A

increased insulin resistance, decreased thyroid function, ↓ ability to respond to stress, ↑ anti-inflammatory hormone.

45
Q

What are the expected fxnl changes of an older adult?

A

– Declines in physical, psychological, cognitive & social function usually linked to illness or disease. Health promotion key! Functional status - ADL’s vitally important to maintain & assess, any sudden changes to abilities maybe significant.

46
Q

Is forgetfullness an expected consequence of aging?

A

no

47
Q

What are the 3 cognitive changes that may occur in the older adult?

A

Delirium
Dementia
Depression

48
Q

Delirium:

A

acute & reversible, new & sudden onset of disorientation, confusion. Usually caused by infections, medications (i.e. anesthetic) and dehydration. Lasts hours to days, fluctuates (cognitive & emotions), delusions, worse at night. CAM assessment!

49
Q

Dementia:

A

gradual & progressive decline in cognitive function that is not normal part of aging. Most common is Alzheimer’s disease. Occurs over months to years, irreversible, problems with memory, paranoia, delusions of theft, wandering, withdrawn, depressed, apathetic.

50
Q

Depression:

A

cluster of symptoms there most of the time (more than 2 weeks, not persons normal), worse in the morning, lack of appetite, lost interest in things, trouble sleeping, withdrawal, worthlessness. May lead to suicide. Some older adults may use alcohol to cope and interactions with other drugs or medications can cause overdose. Reversible with treatment.

51
Q

How can a nurse promote healthy ageing?

A

Promoting Healthy Aging – Nurse help to maintain physical & emotional health, avoid disease & injury, remain active & independent. Must be individualized! Comes down to genetics, chance, good health habits and preventative measures!

52
Q

What is the most common cause of death in older adults?

A

Cancer and hrt disease

53
Q

what is considered alcohol abuse?

A

5+ drinks a day for men

4+ drinks a day for women

54
Q

What are the leading cause of injury in older adults?

A

falls

55
Q

polypharmacy:

A

5 or more meds

56
Q

Are interventions the same for any age group?

A

yes

57
Q

How can you address health concerns with health promotion and maintenance?

A
  • Therapeutic communication
  • touch
  • cognitive stimulation
  • reminiscence: recalling the past, very important for finding meaning of life, resolving current conflicts, identity, self-esteem
  • body-image interventions
58
Q

What kind of risk is involved in an acute care setting?

A

risks of delirium so be aware of normal. Unfamiliar environment. Ensure proper eating, hydration, skin integrity, falls risk, infections, toilet, etc.

59
Q

What kind of care would be included in restorative care?

A

continuing (rehab), home care – care directed towards regaining and or improving functioning (ADL’s). Safety! Meals on wheels, volunteers etc

60
Q

What is the goal in palliative care?

A

EOL care, improve quality of what’s left of life. More next week!

61
Q

What are the nursing interventions for older adults?

A
  • prevent falls and injuries
  • prevent constipation
  • dementia and depression screening

N133 (8 decks)

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