ch, 14 Flashcards
Ageism
discrimination against people because if increasing age.
Geronlogical nursing
requires creative approches for managing the potential of older adults
identify common myths and stereotypes in older adults
- ill, disabled and physically unattractive
- forgetful
- confused
- rigid and bored
- unfriendly
Describe common development tasks for older adults
Adjusting to:
- decrease health and physical strength
- retirement and reduced or fixed income
- death of a spouse, children, sibling &friend
- accepting self as an aging person
- maintaining satisfactory living arrangements
- redefining relationships with adult children & siblings
- find ways to maintain quality of life
Common physiological changes with aging at a glance.
next couple cards
- integumentary
- respiratory
- cardiovascular
- GI
- musculoskeletal
- neuro
- sensory
- genitourinary
- reproductive
- endocrine
- immune system
INTEGUMENTARY
- loss of elasticity
- pigmentation changes
- glandular atrophy
- thinning and gray hair( women increase in hair ,men decrease)
- slower nail growth
- atrophy of epidermal arterioles
Respiratory
- decrease in cough reflex & cilia
- increase: anterior-posterior chest diameter, chest wall rigidity.
- fewer alevoli
- increase airway resistance and risk of infection
Cardiovascular
- Thick blood vessels walls, narrow vessel lumen
- loss of vessel elasticity
- low CO, number of of heart muscle fibers
- decreased elasticity & calcification of heart valves, baroreceptor sensitivity
- decreased eff. of venous valves
- increased systolic bp
- decreased peripheral circulation
GI
- periodontal disease;
- decrease saliva, gastric secretions and pancreatic enzymes
- smooth muscle changes due to decrease peristalsis & small intestinal motility
- gastric atrophy
- decreased intrinsic factor
- inc stomach pH
- loss of smooth muscle; hemorrhoids, rectal prolapse, impaired rectal sensation
Musculoskeletal
- decrease muscle mass & strength
- decalcification of bones, degenerative joint changes
- dehydration of intervertabal disks
- increase in fat tissue
Neuro
- degenerative of nerve cells
- decrease in neurotransmitters
- decrease in rate of conduction of impulses.
sensory
Eyes: decreased near/far vision (presbyopia), difficulty adjusting from light to dark, yellow of lens, altered color perception, increased sensitivity to glare, smaller pupils
EARS: loss of high frequency tones(presbycusis), thick tympanic membrane, sclerosis of inner ear, cerumen
TASTE: diminished, fewer taste buds
SMELL: often diminished
TOUCH: decreased skin receptors
PROPRIOCEPTION: decreased awareness of body positioning
Genitourinary
-fewer nephrons, decrease renal blood flow by age 80
- decrease bladder capacity
Male: enlargement of prostate
Female: reduced sphincter tone
Reproductive
Male: sperm count diminished, smaller testes, erections less firm and slow
Female: decreased estrogen production, degeneration of ovaries, atrophy of vagina, uterus and breast
Endocrine
GENERAL: hormone alterations, decrease ability to respond to stress.
Thyroid: diminished secretions
cortisol:increased anti-inflammatory hormone
Pancreas: increased fibrosis, decreased secretion of enzymes and hormones, decreased sensitivity to insulin
Immune System
- thymus decreased in size and volume
- T-cell function decrease
- core temp elevation is lowered.
Delirium
acute confusional state that is potentially reversible cognitive impairment that has physiological cause.
- pneumonia and UTI, SLEEP deprivation
- older adult in acute care setting
onset: hours less than a month
Course: short, worst at night, in darkeness
Progression: abrupt
Consciusness: reduced
Alertness: fluctuate; legarthic
Assesment: distracted from task; munerous errors
Dementia
Deciline in ability to perfrom basc ADL’s and IADL’s
- gradual progressive, irreversible cerebral dysfunction
-ALZHEIMERS
Duration: months to years
Behavior: apraxia
Thinking:difficulty with with abstraction, diminished thoughts, difficult to find words
Depression
- NOT a normal part of aging
- most common in older adults
- associated: stroke, diabetes, DEMENTIA, PARKINSONS DISEASE, Arthritis.
- Treatment: psycho therapy, ECT
Issues with psychological changes
- social isolations
- sexuality
- housing and environment
- death
cont…
- heart disease; hypertension silent killer and cornonary artery disease - Cancer: malignant neoplasms Chronic lung disease: COPD, - stroke: 4th leading cause - smoking; Alcohol abuse: due to depression, loneliness and lack of social support. repeated falls and accidents - nutrition
Patient teaching; adapting instruction for older adults with health literacy limitations
OBJ - patient verbalizes understanding - they will demonstrate psychomotor skill TEACHINF STRATEGIES - schedule sessions in midmorning - no med term - give patient time to process info - speak slowly -minimize distraction Evaluation - validate understanding by teach back technique before proceeding - make sure patient is able to demonstrate and do psychomotor skills independently
Risk factors for falls in older adults
Intrinsic
-history of previous fall
-impaired vision’
postural hypotension or syncope
- Arthritis, lower extremity muscle weakness, foot problems
- bladder incontinence and frequency, nocturia
-confusion
-med reactions; sedatives, hypnotics, opioids
slowed reaction times
- deconditioning
Extrinsic factors
- enviromental hazards outside and within home; lighting, wet floor, items on floor
- inappropriate footwear
- improper use of assistive devices
Elder mistreatment
- complex and multifacted and encompasses a broad range of abuses.
“ intentional actions that cause harm or create serious risk of harm for elder done by someone close to them”
physical abuse
hitting
- beating
- pushing
- slapping
Psychosocial/emotional abuse
- insults
- threats
- humiliation
- intimidation
- harassment
- social isolation
Financial exploitation
- illegal taking, misuse or concealment of funds or property
- cashing checks without permission, stealing money
- forging signature
sexual abuse
- unwanted touching, rape, sodomy or forced watching of pornography
caregiver neglect
- refusal or failure to provide basic necessities such as food or water, clothing shelter
Abandonment
-desertion at hospital, nursing facility pr public location
Self-neglect
refusal or failure to provide oneself with basic necessities such as food, water, clothing and etc.
Therapeutic communication
enables you to perceive and respectbtge older adults uniqueness.
- attentive listening
- eye to eye
Touch
- therapeutic tool used to help comfort patient
- gentle touch is used when providing any type of procedure
Reality orientation
- communication technique that makes an older adult more aware of time, place and person.
- purpose is to restore a sense of reality , improve level of awareness, promote socialization, independence and minimize confusion.
Validation Therapy
- Alternative approach that accepts the description of time and place as stated by the older adult.
- do not challenge or argue with older adults statements, accept them.
Reminiscene
- recalling the past
- recollection of the past to bring meaning and understanding to present and resolve current conflicts.
Body image intervention
- older adult becomes self conscious about image
- helping them with their image, combing hair and etc
interventions
promote indepence in ADL’s
