ch. 16 - promoting safety Flashcards
-Must Be Multifaceted And Individualized To The Areas Of Identified Risks
-Particularly Important For Older Adults Who Are At Risk For Falls And Is Recommended In Evidence-Based Protocols For Fall Risk Reduction
home safety assessment
- Exposed To Temperature Extremes In Dwellings Can Impose A Serious Risk To Older Persons With Declining Physical Health
-Older Individuals Are Vulnerable To Environmental Temperatures:
Thermoregulation
Hyperthermia
Hypothermia
environmental temps
- Neurosensory changes in thermoregulation delay or diminish the person’s awareness of temperature changes
- factors that bring impact:
Medications
Alcohol
Decreased ability to shiver or sweat
Inadequate fluid intake
Low socioeconomic status
Lack the functional ability to grab covers
thermoregulation
may be lower than your average 98.6. If their normal temp is 97.1, an increase of 1 degree is significant and could indicate infection.
A temp above 100.9 and greater is serious in the older adult. Ensure you get an accurate reading- do not guess
baseline temp in older adult
- Body temperature increases above normal ranges
- Risk factors: low fluid intake, diuretics (dehydration and fever increasing),
ppl w/ cardiovascular disease, diabetes, and PVD, and even certain meds are also at risk
- This is a medical emergency
hyperthermia
Prevention and education are priority nursing tasks to prevent deaths that are related to this condition
- Drink 2-3L of water a day
- Minimize exertion during the hottest time of the day (10-2)
- Stay in air conditioned rooms, use fans when possible
- Wear hats and loose fitting clothing
- Take tepid baths/showers
- Avoid alcohol
- Do a med-rec!
- Apply cool, wet compresses or immerse hands and feet in cool water
interventions and treatment for hyperthermia
- Exposure to cold environmental temperatures (core less than 95 degrees F)
- Medical emergency
- Must assess this patient’s respiratory and cardiovascular status
- Identify people at risk
- Confusion & disorientation could be the 1st signs in the older adult
- Heat is generated by shivering and increased muscle activity and then a rise in oxygen consumption occurs. Patients who are paralyzed or immobile and unable to generate enough heat through muscle activity is at risk for hypothermia, Someone who suffers from malnutrition and has very little body fat to provide insulation is at risk as well.
Someone who has surgery is at risk as well (cold OR room, anesthesia)
hypothermia
- affects the brain, making the victim unable to think clearly or move well. This makes hypothermia especially dangerous, because a person may not know that it’s happening and won’t be able to do anything about it.
- While hypothermia is most likely at very cold temperatures, it can occur even at cool temperatures (above 40°F) if a person becomes chilled from rain, sweat, or submersion in cold water.
body temp too low
who is at risk for hypothermia?
- Older adults with inadequate food, clothing, or heating
- Babies sleeping in cold bedrooms
- People who remain outdoors for long periods—the homeless, hikers, hunters, etc.
- People who drink alcohol or use illicit drugs.
- Shivering
- Exhaustion or feeling very tired
- Confusion
- Fumbling hands
- Memory loss
- Slurred speech
- Drowsiness
signs and symptoms of hypothermia
- OR: heated blankets, warm IV fluids
- Don’t let the temperature get below 65 degrees at home
- Have enough blankets & clothing (layer if needed)
- Wear a head covering
- Cover the patient when bathing to prevent from getting too cold
- Dry the patient quickly after bathing and cover with thick blankets
- Dry wet hair quickly- never let air dry
- use absorbent pads/briefs if they are incontinent
- Provide as much exercise as possible to generate heat from muscle activity
- Provide HOT, HIGH PROTEIN meals and snacks to sustain heat production throughout the day
prevention and management of hypothermia
- Older adults are very vulnerable during and after disasters!
- More likely to be isolated and not be able to seek supportive care
- Consider limited mobility, cognitively impaired, no family or friends
- We have to advocate for these patients in the community to make sure they are cared for!
- If you work at a nursing home, it is important to be prepared for any disasters that can potentially occur, so your residents are kept as safe as possible
vulnerability to natural disasters
Considered an IADL
Highly complex activity required mental, visual, and motor skills
Some older adults keep driving past when they should
driving as an older adult
To stop driving is a major loss for a patient:
- Leads to social isolation, depression, decreased quality of life, and increased risk for nursing home placement
- Older men tend to value driving more
- Patient education needs to be provided
