Chapter 14: Older Adults Flashcards
___________ often has little relation to the reality of aging for an older adult.
Chronological age
What is a factors that contributes to the projected increase in the number of older adults are the aging of the baby-boom generation and the growth of the population segment over age 85?
Older adults will increase to 72.1 million
Older adults also vary widely in their levels of _______ ability. Including inability to perform ______, confusion, becoming withdrawn, and inability to make decisions regarding _____.
ADLs
Functional
Needs
Aging does not inevitably lead to ________ and _________. Most older people remain functionally independent despite the increasing prevalence of _______ disease.
disability
dependence
chronic
This part of the nursing process provides valuable clues to the effects of a disease or illness on a patient’s functional status.
Nursing assessment
Chronic conditions add to the _______ of assessment and care of the older adult. Most older persons have at least one ______ condition, and many have multiple conditions.
complexity
chronic
Although the interaction of these physical and psychosocial factors is often serious, do not ______ that all older adults have signs, symptoms, or behaviors representing _______ and _______ or that these are the only factors you need to ________.
assume
disease and decline
assess
Some people ________ older adults as ill, disabled, and physically unattractive.
stereotype
Although many older adults have chronic conditions or have at least one disability that limits their performance of activities of daily living (ADLs), What percent of noninstitutionalized older adults assess their health as excellent or very good?
39.1%
What is a word that is synonymous with people believing that older adults are forgetful, confused, rigid, bored, and unfriendly and that they are unable to understand and learn new information.
Ageism
Although changes in vision or hearing and reduced energy and endurance sometimes affect the process of learning, older adults are _______.
Lifelong learners
Specialists in the field of gerontology view _______, the oldest of the old, as having an optimistic outlook on life, good memories, broad social contacts and interests, and tolerance for others.
centenarian
Use teaching techniques to compensate for _______ changes, provide additional ____ for remembering and responding, and present _______ rather than abstract material to facilitate learning by older adults.
Sensory
Time
Concrete
Other effective teaching techniques draw on the older adult’s past _______ and correspond to his or her identified ________ rather than to the content areas that the ____________ believes are important.
experiences
interests
health care professional
In a society that values attractiveness, energy, and youth, these myths and stereotypes lead to the ________ of older adults.
Undervaluing
Some people equate worth with ________; therefore they think that older adults become _________ after they leave the workforce. Others consider their knowledge and experience too outdated to have any _________ value. These ideas demonstrate ________, which is
discrimination against people because of ___________ age, just as people who are racists and sexists discriminate because of skin color and gender.
Productivity Worthless Current Ageism Increasing
According to experts in the field of gerontology, ________ ageism has the potential to undermine the ________ of older adults, limit their access to care, and distort caregivers’ understanding of the _________ of each older adult. Older adults who have a positive image about aging actually live ______ years longer than those with a negative image. Nurses can help promote a positive ________ regarding the aging process when working with these patients.
unopposed self-confidence uniqueness 7.5 perception
Many older adults lived through or were born during the ________ of 1929. They also experienced two world wars and wars in Korea, Vietnam, and the Persian Gulf and are now experiencing the war on terrorism. Older adults have seen changes in health care as the era of the family physician gave way to the age of ________. After witnessing the government initiatives establishing the Social Security
system, Medicare, and Medicaid, older adults are currently living with the changes imposed by _______ and the uncertainty of the future of Social Security and Medicare. Living through
all of these events and changes, they have stories and examples of ______ to share.
Great Depression
specialization
health care reform
coping with change
It is critical for you to learn to respect older adults and actively _______ them in care decisions and activities.
involve
The time has come for nurses to recognize and address ageism by ______ prevailing negative attitudes and stereotypes and _______ the realities of aging as they care for older adults in all care settings.
questioning
reinforcing
This biological theories of aging view aging as the result of random cellular damage that occurs over time. The accumulated damage
leads to the physical changes that are recognized as characteristic of the aging process.
Stochastic theory
This biological theories of aging views aging as the
result of genetically programmed physiological mechanisms within the body that control the process of aging.
Non-stochastic Theory
The psychosocial theories of aging, developed during the 1960s, explain changes in behavior, roles, and relationships that come with aging. These theories reflect the values that the theorist and society held at the time the theory was developed. Name the four theories?
Disengagement Theory
Continuity Theory
Gerotranscendence
Activity Theory
This is the oldest psychosocial theory, it states that aging individuals withdraw from customary roles and engage in more introspective, self-focused activities. What psychosocial theory of aging is this?
Disengagement theory
This theory considers the continuation of activities performed during middle age as necessary for successful aging. What psychosocial theory of aging is this?
Activity Theory
This theory suggests that personality remains stable and behavior becomes more predictable as people age. The personality and behavior patterns developed during a lifetime determine the degree
of engagement and activity in older adulthood. What psychosocial theory of aging is this?
Continuity Theory aka Developmental Theory
The more recent theory of proposes that the older adult experiences a shift in perspective with age. The person moves from a materialistic and national view of the world to a more cosmic and transcendent one, causing an increase in overall life satisfaction. What psychosocial theory of aging is this?
Gerotranscendence Theory
The more common _______ related to old age are of health, significant others, a sense of being useful, socialization, income, and independent living. How older adults adjust to the changes of aging is highly __________. For some adaptation and adjustment are relatively _____. For others coping with aging changes requires the _________ of family, friends, and health care professionals. Be ________ to the effect of losses on older adults and their families and be prepared to offer __________.
Losses individualized easy assistance sensitive support
Adjusting to decreasing health and physical strength
Adjusting to retirement and reduced or fixed income
Adjusting to death of a spouse, children, siblings, friends
Accepting self as aging person
Maintaining satisfactory living arrangements
Redefining relationships with adult children and siblings
Finding ways to maintain quality of life
What are these examples of?
Developmental tasks for older adults
The extent and timing of aging changes vary from
individual to individual; but, as body systems age, changes in _______ and ________ occur. These changes are not associated with a disease; they’re _______. The presence of ______ sometimes alters the timing of the changes or their impact on daily life.
appearance
functioning
normal
disease
Some people find it ______ to accept their aging. This is apparent when they ________ their ages when asked, adopt ________ styles of clothing, or attempt to hide physical evidence of aging with ________. Acceptance of personal aging does not mean ______ into inactivity, but it does require a __________ review of strengths and limitations.
Difficult understate younger cosmetics Retreat Realistic
Others elders deny their aging in ways that are potentially ________. Some older adults deny functional _______ and refuse to ask for help with tasks that place their safety at great ________. Others _______ activities designed for
their benefit such as senior citizens’ centers and senior health promotion activities and thus do not receive the _______ these programs offer.
problematic declines risk avoid benefits
Older adults retired from employment outside the home have to cope with the loss of a _________. Older adults who worked at home and the spouses of those who worked outside the home also
face _______.
work role
role changes
Some may ________ retirement as a time to pursue new interests and hobbies, volunteer in their community, continue their education, or start a new career. Retirement plans for others may include changing residence by moving to a different city or state or to a different type of ________ within the same area. Reasons other than retirement also lead to changes of _______.
Ex. physical impairments may require relocation to a smaller, single-level home or __________.
welcome
housing
residence
Nursing home
A change in living arrangements for the older adult usually requires an extended period of _______, during which assistance and support from health care professionals, friends, and family members are necessary.
adjustment
Deaths represent both _______ and reminders of personal _______. Coming to terms with them
is often difficult. By assisting older adults through the _______ process, you help them resolve the issues posed by these deaths.
losses
mortality
grieving
A variety of issues sometimes occur when the part child roles are reversed in old age, including but not limited to _______ of decision making, dependence, ________, guilt, and loss. How these issues surface in situations and how they are resolved depend in part on the ______relationship between the older adult and their adult children. All
the involved parties have past experiences and powerful emotions.
Control
Conflict
Past
When adult children become their parents’ caregivers, they have to find ways to ______ the demands of their own children and _______
with the many challenges of family caregiving. As adult children and aging parents ______ the aspects of changing roles, nurses are in the position to act as _______ to both the parents and the children. The aim is to help older adults find ways to maintain their __________.
balance careers negotiate counselors quality of life
Some family caregivers consider nursing center placement when in-home care becomes increasingly _______ or when _________ (recovery) from hospitalization requires more assistance than the family is able to provide. Although the decision to enter a nursing center is never final and a nursing center resident is sometimes discharged to home or another less-acute facility, many older adults may view the nursing center as their _______ residence.
difficult
convalescence
final
What is the best way to evaluate the quality of a nursing center in a community?
The patient and family to visit that facility and inspect it personally.
With _________ assessment information regarding strengths, limitations, and resources, the
nurse and the older adult identify _____ and ________. Together they select _________ to maintain the older adult’s ________ abilities and create an environment for ________ and ________ well-being. A _______ assessment requires the nurse to actively engage older adults and provide them enough _______ to share important information about their health.
Comprehensive Needs Problems Interventions Physical Psychosocial Spiritual Thorough Time
Nursing ______ takes into account five key points to ensure an age-specific approach:
(1) the interrelation between _______ and _______ aspects of aging,
(2) the effects of disease and disability on ________ status,
(3) the decreased efficiency of _______ mechanisms,
(4) the lack of standards for health and illness ______, and
(5) altered _______ and ________ to a specific disease.
assessment
- physical and psychosocial
- functional
- homeostatic
- norms
- presentation and response
A ________ assessment of an older adult takes more time than the assessment of a younger adult because of the longer life and medical history and the potential complexity of the history. During the physical examination allow _______ as needed or conduct the assessment in several _______ because of the reduced ______ and limited of some frail older adults. Remember to review both ________ and _______ carefully with the patient.
comprehensive rest periods sessions energy endurance prescribed and over-the-counter medications
Sensory changes also affect ______. Your choice of communication techniques depends on ____ or ______ impairments of the older adult. If older adults are unable to understand your
visual or auditory cues, assessment data may be _________. Ex, if an older adult has difficulty hearing a nurse’s questions, inappropriate _______ might lead the nurse to believe that the person is ________.
data gathering visual or hearing inaccurate or misleading responses confused
Sit or stand at ______, in front of the patient in full view.
Face the older adult while speaking; do not cover your ______.
Provide diffuse, bright, nonglare ________.
Encourage the older adult to use his or her familiar assistive devices such as _______.
These techniques help older adults with what type of impairment?
eye level mouth lighting glasses or magnifiers Visual Impairment
________ deficits, if present, affect the accuracy and completeness of an assessment.
Memory
Use tact when involving another person in the assessment interview. The additional person _______ the answers of the older adult with the consent of the older adult, but the older adult remains the ______ of the interview.
supplements
focus
During assessment use caution when interpreting the signs and symptoms of diseases and ________. Historically researchers have used ______ populations to establish these signs and norms. However, the classic signs and symptoms of diseases are sometimes absent, blunted, or atypical in older adults. This is especially true in the case of ________ infection, pain, acute ________ and ___________.
Laboratory Values Younger Bacterial Myocardial Infarction Heart Failure
The masquerading of disease is possibly caused by age-related changes in organ systems and ______ mechanisms, progressive loss of physiological and _____ reserves, or _______ acute or chronic conditions.
homeostatic
functional
coexisting
As a result the older adult with a urinary tract infection may present with _______, ________, and an elevation of __________ (within normal limits) instead of having fever, dysuria, frequency, or urgency as seen in younger adults.
confusion
incontinence
body temperature
Some older adults with pneumonia have ________, _________, and confusion with decreased _______
and functioning, ___________ the more common symptoms of fever pulmonary, renal, and metabolic function.
tachycardia
tachypnea
appetite
without
It is important to recognize _______ indicators of an acute illness in older adults. Note changes in _____ status, occurrence and reason for ______, _________, decrease in ________, loss of function,
_______, and incontinence because these may be indicators not presented in _______. A key principle of providing age-appropriate nursing care is timely detection of these _______ of illness so early treatment can begin.
early mental falls dehydration appetite dizziness younger adults cardinal signs
________Status changes changes commonly occur as a result of disease and psychological
issues. Some mental changes are often drug related, caused by drug ______ or ______ drug events. A _____ can be a common event for
an older adult and can be injury producing and costly.
Mental
toxicity
adverse
fall
Problems with the cardiac, respiratory, musculoskeletal, neurological, urological, and sensory body systems can present with a _____ as a chief symptom of a new-onset condition.
fall
_______ is common in older adults because of
decreased oral intake related to a ________ thirst response and less free _____ as a consequence of a decrease in ______ mass. When _____ and ______ accompany the onset of an acute illness, the older adult is at risk for further complications.
Dehydration reduced water muscle vomiting diarrhea
Decrease in ______ is a common symptom with the onset of pneumonia, heart failure, and urinary tract infection.
appetite
Loss of _______ ability occurs in a subtle fashion over a period of time; or it occurs suddenly, depending on the ________. nurses play an essential role in early identification, referral, and treatment of health problems.
functional
underlying cause
Thyroid disease, infection, cardiac or pulmonary conditions, metabolic disturbances, and anemia are common causes of _______ decline.
functional
Therefore older adults engaged in ADLs usually consider themselves _____; whereas those who have physical, emotional, or social impairments that limit their activities perceive themselves as _____.
healthy
ill
An initial inspection reveals if eye contact
and facial expression are _______ to the situation.
appropriate
Facial wrinkles, gray hair, loss of body mass
in the extremities, and an increase of body mass in the trunk. These are examples of what kind of aging changes?
universal aging changes
With aging the skin loses resilience
and ______. The epithelial layer thins, and elastic collagen fibers shrink and become _____. Wrinkles of the face and neck reflect lifelong patterns of muscle activity and facial expressions, the pull
of gravity on tissue, and diminished elasticity. Spots and lesions are often present on the skin. Smooth, brown, irregularly shaped spots
(age spots aka ________) initially appear on the backs of the hands and on forearms. Small, round, red or brown cherry ________ occur on the trunk. ___________ lesions or keratoses appear as
irregular, round or oval, brown, watery lesions.
You would look for these signs of aging when assessing what body system?
Moisture Rigid senile lentigo angiomas Seborrheic Integumentary
Years of sun exposure contribute to the aging of the skin and lead to premalignant and malignant lesions. You need to rule out these three malignan-
cies related to sun exposure when examining skin lesions?
Melanoma
Basal cell carcinoma
Squamous cell carcinoma
The facial features of the older adult may
become more pronounced from loss of _______ and skin elasticity. Facial features appear _______ because of missing
teeth or improperly fitting dentures. In addition, common vocal changes include a ____ in pitch and a ____ of power and range.
subcutaneous fat
asymmetrical
Rise
Loss
______ is the most prevalent risk factor for impaired hearing. Exposure earlier in life exacerbates hearing loss in old age.
Noise
________ attempts such as turning up the volume on televisions or avoiding social conversations.
Compensatory
A common age-related change in auditory acuity is _______. Before the nurse assumes presbycusis, it is necessary to inspect the external auditory canal for the presence of ________. Impacted cerumen, a common cause of diminished hearing _________, is easy to treat.
presbycusis
Cerumen
Acuity
_________ affects the ability to hear high-pitched sounds and sibilant
consonants such as s, sh, and ch.
Presbycusis
Salivary _______ is reduced, and taste buds ______ and lose
sensitivity. The sense of ______ also decreases, further reducing taste.
secretion
atrophy
smell
The older adult is less able to differentiate among what four tastes?
salty,
sweet,
sour,
bitter
Health conditions, treatments, and/or medications can alter _____. It is often a challenge to promote _____ in an older patient because of the loss of smell and changes in taste.
Taste
Optimal nutrition
Respiratory muscle strength begins to ________, and the anteropos-
terior diameter of the thorax __________. Vertebral changes caused
by _________ lead to dorsal _______, the curvature of the tho-
racic spine.
decrease
increases
Osteoporosis
Kyphosis
