Chapter 1 Flashcards
holistic improvement of health including physical, medical, emotional and spiritual well being
gerontology
what is the nursing goal of gerontology
live longer and live better
young-old
ages 65-74
middle-old
ages 75-84
old-old
ages 85+
changes in lungs
maximum breathing capacity may decline by 40% between ages 40-70
primary prevention/health promotion
educate about health lifestyle, injury prevention, nutritional assessment, avoid tobacco, moderate alcohol, limit carcinogens
secondary prevention AKA
early dx & tx
examples of secondary prevention
screening & assessment, referrals for further testing, disease cure and tx to prevent progression
tertiary prevention AKA
restoration & rehab
examples of tertiary prevention
multidisciplinary rehab, short-term placement in rehab facility, aids/services to increase independence (walker, cane, home health aid)
do men or women live longer
women
are men or women more likely to be widowed
women
do more women or more men live in poverty
women
why do women live longer
men are exposed to more risk factors (tobacco, alcohol, occupational hazards)
2 highest causes of death
heart disease & malignant neoplasms
what causes more than 2/3 of all deaths each year (5)
heart disease, cancer, stroke, COPD, diabetes
being old means being sick, older people are set in their ways/cannot learn new things, health is wasted on older people, older adults do not pull their own weight and are a drain on societal resources, older people are isolated & lonely, older people have no interest in sex
myths of aging
a range of nursing functions that are differentiated according to the level of practice, the role of the nurse, and the work setting
ANA scope of practice
purpose of the scope/standards of practice
evaluate and guide practice
the 3 elements of the scope of practice
quality, safety, evidence
the formal process by which clinical competence is validated in a specialty area of practice
certification
advanced practice nurses have what degree
master’s
the nurse should use what when establishing goals of care
measurable verbs
medicaid supports who
low income individuals
medicaid is based off of what
financial income and number of people living in home
medicare supports who
the elderly and younger people with disabilities
part A medicare covers
hospitalizations & hospice
part B medicare covers
office visits, labs, durable equipment
part D medicare covers
prescriptions
a multidimensional pattern of self-initiated actions and perceptions that serve to maintain or enhance the level of wellness, self-actualization and fulfillment of the individual
health promotion
variables affecting holistic geriatric assessment
- evaluation of environment
- accuracy of health hx
- social hx
- psychological hx
- home environment
- culture & education
what method of pain mgmt should be used first
least invasive
what to do if pt experiences breakthrough pain
notify provider
nonopioid analgesics
NSAIDS, acetaminophen, tramadol
doses of acetaminophen should not exceed
3000 mg per day
NSAIDS
aspirin & ibuprofen
cox-2 inhibitors are a class of what
NSAIDs
cox-2 inhibitors are associated with what
adverse CV events
opioid analgesics
morphine, fentanyl
how long does it take for fentanyl patch to work
24-36 hours
opioid analgesics that are not used
meperidine and propoxyphene
constipation, sedation, respiratory depression, N/V, myoclonus, pruritis all examples of what
adverse effects of pain meds
sedation should subside in how long
24-48 hours
ways to tell if someone with dementia is in pain
facial expression, verbalization/vocalization, body movements, changes in interactions, changes in activity/routines, mental status changes
ARMD
age related macular degeneration
leading cause of blindness in adults >65
ARMD
affects central vision
scotoma (ARMD)
require more light
ARMD and cataracts
dark spot in center of visual field
ARMD
tx for ARMD
laser therapy, injections, dietary changes
age above 50, ciggs, family hx, increased exposure to UV lights, caucasian, light colored eyes, HTN, CV disease, lack of dietary intake of antioxidants and zinc
risk factors for ARMD
lack of intake of antioxidants and zinc
risk factor for ARMD
having light colored eyes and being caucasian puts you at a higher risk for what
ARMD
opacities of the lens of the eye
cataracts
a decrease in light filtration and vision causing blurry vision and halos
cataracts
halos are seen in what
cataracts
difficulty contrasting colors
cataracts
increased age, smoking & alcohol, obesity, diabetes, HTN, high cholesterol, trauma to the eye, previous eye surgery, exposure to the sun, long term corticosteroid use, caucasian
risk factors for cataracts
long term corticosteroid use may lead to what
cataracts
tx of cataracts
surgery
encourage what in cataract pt
antioxidants, vitamins E & C
optic nerve damage secondary to increased IOP
glaucoma
increased IOP, older than 60, family hx, personal history of myopia, diabetes, HTN, migraines, AA
risk factors for glaucoma
tx of glaucoma
meds to decrease IOP, laser surgery
teach these pts how to administer eyedrops properly
glaucoma pts
damage to ocular microvascular system
diabetic retinopathy
prevention of diabetic retinopathy
monitor glucose, BP, cholesterol; educate about diabetes, nutrition, and exercise
tx of diabetic retinopathy
laser therapy
hypogeusia
diminished sense of taste
xerostomia
dryness of the mouth, distorts taste sensation
assess for taste disturbances
mucous membranes (dryness, ulcers, yeast), teeth/dentures (fit), foods they enjoy
how to prevent dry mouth
sugar free candy, mints, gum, oral lubricants, encourage fluids
conductive hearing loss
r/t problem in the middle or external ear, tympanic membrane, or bones in the ear
conductive hearing loss can be result of
ear infection, impacted cerumen, benign tumor, FB, perforation of TM
sensorineural hearing loss
problems within the inner ear
sensorineural hearing loss can be result of
damage to ear drum due to excessive noise, tumors, and infections
hyposmia
diminished sense of smell caused by a reduced number of sensory cells & neurotransmitters/injury to mucosa
is a dysfunction in taste or smell more common
smell
9 D’s of wt loss
dementia, depression, disease, dysfunction, dysphagia, dentition problems, diarrhea, drugs, dysgeusia
failure to thrive is AKA
cachexia
unintentional wt loss is defined as
5% wt loss in 1 month of 10% in 6 months
3 categories of wt loss
insufficient intake, iatrogenic practices (from meds, NPO, certain diets), nutrient losses (during absorption or metabolism, fever, alcohol)
SENSE pneumonic
S: safety maintained at all times
E: environment allows for independence
N: nursing process used
S: stigmas can be dangerous, treat pts as individuals w/ unique needs
E: etiology of a condition that the elder believes is normal may be detected during assessment
