Caring for the Older Adult Flashcards
barriers to working with older adults
- faced with mortality
- ageism (senility/unteachable NOT TRUE)
- “why bother?”
- distrust, fear
- loss of independence
- purpose questioning
erikson’s stage of psychosocial development
ego integrity vs despair
nursing implications of integumentary system changes
- temperature sensitivity
- slower healing
- fragility of skin
nursing implications of cardiovascular system changes
- lower tolerance for activity
- loss of conditioning
- lower blood flow to kidneys, liver, brain, muscle (every system!)
nursing implications of respiratory system changes
- decreased thoracic expansion
- impairment in oxygen exchange (effects seen in other systems)
- impaired defense of airway
- reduced efficiency
- INCREASED RISK of pneumonia
nursing implications of musculoskeletal system changes
- loss of flexibility
- loss of glycogen reserve for activity
- vulnerable to osteoporosis
- risk for fractures
decrease in both, but GENERALLY ADIPOSE > MUSCLE
nursing implications of gastrointestinal system changes
- malabsorption and nutritional deficiencies (decrease in absorption in small bowel)
- difficulties eating
- constipation
- changes in metabolism and excretion of MEDS
B12 deficiency
can contribute to dementia
nursing implications of endocrine system changes
- stress response not as good as it used to be
- lower basal metabolic rate
- diabetes
nursing implications of immune system changes
- greater susceptibility to infections
- diminished inflammatory response = delayed healing
- proliferation of abnormal cells
nursing implications of genitourinary system changes
- decline in renal function
- slowed excretion of MEDS
- urinary urgency, incontinence, infections (SOCIAL STIGMA)
nursing implications of central nervous system changes
- mild gait disturbances thus RISK for fall/injury
- decreased perception of smell/taste
- sleep disturbances
- depression
- risk for cognitive illness
1 cause of systemic infection in older adults
urinary tract infection
most common cause of toxic meds in older adults
decreased kidney filtering
nursing implications of sensory system changes
- confusion
- poor nutrition
- isolation
- RISK FOR INJURY
nursing implications of psychological aspects of aging
- adjustment of teaching methods and time allowed
psychological aspects of aging
- short-term memory deteriorates (but everyone experiences decline)
- longterm memory in HEALTHY individual DOES NOT DISSIPATE
- intellectual functioning DOES NOT DECLINE
- learning ability DOES NOT DIMINISH (though slower reaction time)
psychiatric disorders in older adults
3 Ds: dementia, delirium, depression
sleep disorders = 50-66% of disorders
4 shared risk factors of geriatric syndromes
- older age
- baseline cognitive impairment
- baseline functional impairment
- impaired mobility
geriatric syndromes result from…
- psychological changes that occur with age
- multiple co-morbidities
- adverse effects of interventions
geriatric syndromes result in…
- frailty
- hospitalization (and longer, too)
- increased mortality
Screening for “classic” geri syndromes: SPICES
S leep disturbances P roblems eating/feeding I ncontinence C onfusion E vidence of falls S kin breakdown
delirium
- acute confusion, biological stressor must be present
- transient disturbance of consciousness
- rapid onset
- fluctuating levels of consciousness
- multiple risk factors/causes
delirium assessment
- acute assessment, fluctuating course? *
- poor attention/inattention *
- disorganized thinking?
- altered LOC?
- 1 & 2 necessary
3 or 4
