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Undeleted > Caring for the Older Adult > Flashcards

Caring for the Older Adult Flashcards

1
Q

barriers to working with older adults

A
  • faced with mortality
  • ageism (senility/unteachable NOT TRUE)
  • “why bother?”
  • distrust, fear
  • loss of independence
  • purpose questioning
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2
Q

erikson’s stage of psychosocial development

A

ego integrity vs despair

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3
Q

nursing implications of integumentary system changes

A
  • temperature sensitivity
  • slower healing
  • fragility of skin
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4
Q

nursing implications of cardiovascular system changes

A
  • lower tolerance for activity
  • loss of conditioning
  • lower blood flow to kidneys, liver, brain, muscle (every system!)
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5
Q

nursing implications of respiratory system changes

A
  • decreased thoracic expansion
  • impairment in oxygen exchange (effects seen in other systems)
  • impaired defense of airway
  • reduced efficiency
  • INCREASED RISK of pneumonia
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6
Q

nursing implications of musculoskeletal system changes

A
  • loss of flexibility
  • loss of glycogen reserve for activity
  • vulnerable to osteoporosis
  • risk for fractures

decrease in both, but GENERALLY ADIPOSE > MUSCLE

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7
Q

nursing implications of gastrointestinal system changes

A
  • malabsorption and nutritional deficiencies (decrease in absorption in small bowel)
  • difficulties eating
  • constipation
  • changes in metabolism and excretion of MEDS
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8
Q

B12 deficiency

A

can contribute to dementia

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9
Q

nursing implications of endocrine system changes

A
  • stress response not as good as it used to be
  • lower basal metabolic rate
  • diabetes
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10
Q

nursing implications of immune system changes

A
  • greater susceptibility to infections
  • diminished inflammatory response = delayed healing
  • proliferation of abnormal cells
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11
Q

nursing implications of genitourinary system changes

A
  • decline in renal function
  • slowed excretion of MEDS
  • urinary urgency, incontinence, infections (SOCIAL STIGMA)
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12
Q

nursing implications of central nervous system changes

A
  • mild gait disturbances thus RISK for fall/injury
  • decreased perception of smell/taste
  • sleep disturbances
  • depression
  • risk for cognitive illness
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13
Q

1 cause of systemic infection in older adults

A

urinary tract infection

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14
Q

most common cause of toxic meds in older adults

A

decreased kidney filtering

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15
Q

nursing implications of sensory system changes

A
  • confusion
  • poor nutrition
  • isolation
  • RISK FOR INJURY
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16
Q

nursing implications of psychological aspects of aging

A
  • adjustment of teaching methods and time allowed
17
Q

psychological aspects of aging

A
  • 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)
18
Q

psychiatric disorders in older adults

A

3 Ds: dementia, delirium, depression

sleep disorders = 50-66% of disorders

19
Q

4 shared risk factors of geriatric syndromes

A
  1. older age
  2. baseline cognitive impairment
  3. baseline functional impairment
  4. impaired mobility
20
Q

geriatric syndromes result from…

A
  • psychological changes that occur with age
  • multiple co-morbidities
  • adverse effects of interventions
21
Q

geriatric syndromes result in…

A
  • frailty
  • hospitalization (and longer, too)
  • increased mortality
22
Q

Screening for “classic” geri syndromes: SPICES

A 
S leep disturbances
P roblems eating/feeding
I ncontinence
C onfusion
E vidence of falls
S kin breakdown
23
Q

delirium

A
  • acute confusion, biological stressor must be present
  • transient disturbance of consciousness
  • rapid onset
  • fluctuating levels of consciousness
  • multiple risk factors/causes
24
Q

delirium assessment

A
  1. acute assessment, fluctuating course? *
  2. poor attention/inattention *
  3. disorganized thinking?
  4. altered LOC?
  • 1 & 2 necessary
    3 or 4
25
Q

delirium causes

A
  1. UTI
  2. dehydration (fluid/electrolyte imbalance)
  3. medication withdrawal
26
Q

relocation stress syndrome - definition

A

physiological and/or psychological distress following transfer from one environment to another

27
Q

relocation stress syndrome - S&S

A

increased somatic complaints
sleep difficulty
anger, anxiety, withdrawal, depression

28
Q

relocation stress syndrome - nursing interventions

A
  • reorient! (should be doing that anyway)
  • explain procedures/routines
  • partner in decision making
  • familiar objects
  • family visits
  • avoid too much change
29
Q

polypharmacy

A

use of multiple drugs

30
Q

pharmacology in older adults nursing considerations

A
  • drug interactions
  • sub-therapeutic plasma levels
  • typical dosages may be toxic
  • paradoxical reactions to sedative/hypnotics

START LOW, GO SLOW

31
Q

effects on pharmacology in older adults: DAME

A

D istribution: lower plasma concentration, higher tissue conc
A bsorption: potentially affected
M etabolism: increased plasma concentrations; lower blood flow, decreased efficacy
E xcretion: slowed

32
Q

neglect and abuse: percentage

A

10% of > 65yo are victims

33
Q

indicators of psychological abuse

A

depression, withdrawal, anxiety, agitation, sleep disorders, confusion

34
Q

indicators of physical abuse

A

burns, bruises, welts, lacerations, evidence of hair pulling, dislocations, fractures

DON’T JUMP TO CONCLUSIONS - some of these are signs of aging

35
Q

indicators of financial abuse

A
  • disparity between assets and living conditions

- complaints of insufficient funds for daily living

36
Q

completed suicide: percentage

A

20% of ALL completed suicides are in > 65 yo

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