Exam 1 Flashcards
gerontological nursing
the study of the role of nursing in meeting the bio-psycho-social needs of older adults
gerontology
concerned with physical, mental, and social aspects and implications of aging. how time affects the body
geriatrics
medical specialty focused on care and treatment of older persons
gerontological nursing
nurses collaboration with older adults, their families, and communities to support health aging, maximum functioning, and quality of life
senescence
condition of process of deterioration with age, loss of cell’s power of division and growth. a period of life in which aging changes are noticeable
senility
showing decline or deterioration of physical strength or mental functioning due to old age or disease especially short-term memory and alertness
elderhood
span of 40 or more years
super-centenarians
people that live at least 110 years
the centenarians
people that live 100-109 years
ageism
prejudgement about a person based only on age
what are examples of ageism?
elders don’t know technology, they can’t do their jobs like they once could, assume they can’t hear so you talk louder
gerontophobia
abnormal fear of being around elderly people or abnormal fear of one’s own aging/becoming old
what best applies to a patient who is terminally ill with end-stage cancer?
the patient has the right to define wellness for themselves
primary prevention
to prevent them from getting a disease
secondary prevention
detecting a disease early and preventing it from worsening
tertiary prevention
improve quality of life and reduce symptoms of disease
the concept of compressed morbidity
- reducing length of time patient is sick or disabled
- providing them resources
- it is the goal of healthy aging
- maximize # of years a person spends in wellness
- minimize # of years a person spends in illness
what is the leading cause of death globally?
ischemic heart disease
what age qualifies patients for medicaid?
those born in 1957 or 65 years
U.S. life expectancy
- 76.6 years in 2021
- 77.3 years in 2020
- 78.8 years in 2019
is the gap narrowing significantly between white americans age and black americans age?
yes
what are some demographics to think about concerning patients?
their education, employment, income, diversity
chronologic age
just the number they are
biologic age
measurement of age based on different bio markers
discuss biologic free radical theory
- unstable molecules within cells called ROS (Reactive Oxygen Species) can be helpful or can cause damage
- use vitamin C and E
- eat healthy
- there is an association between oxidative stress and various degenerative disease process
diseases associated with excessive inflammation (cytokines)
- dementia
- parkinson’s disease
- atherosclerosis
- diabetes type 2
- sarcopenia
- RA
- osteoporosis
- osteoarthritis
- frailty syndrome
- high risk of morbidity and mortality
what are shortened telomeres associated with?
- decreased longevity
- chronic disease such as CV disease, HTN, diabetes, and dementia
- oxidative stress and inflammation
what can be done to reduce cellular damage?
- avoid environmental pollutants and unnecessary radiation
- watch for research on use and presence of antioxidants
- avoid stress
- minimize potential infection
role theory
- defined by person’s role in society
- over one’s lifetime, one must adapt to changes in roles
activity theory
successful aging dependent on being active and productive
disengagement theory
unsuccessful aging = elders withdraw from former roles, activities and from society
continuity theory
- late life roles and activities are reflection of continuation of life patterns
- continue previous behaviors and roles or find suitable replacements
- similar to activity theory
gerotranscendence theory
self-reflection, exploration of inner self, contemplation of meaning of life
explain ego integrity in erikson’s developmental theory
- feel whole, complete, and satisfied with their achievements
- adapted skills to deal with triumphs and disappointments
- capacity to view one’s life in the larger context
acculturation
adapting to another culture
ethnocentrism
the attitude that one’s own group, ethnicity, or nationality is superior to others
the LEARN model
Listen
Explain
Acknowledge
Recommend
Negotiate
- helps provide individualized care
explain elderspeak
form of ageism, assumptions, similar to “baby talk”, infantilizes adults
what are the four communication tools for older adults?
- the life story
- reminiscing
- storytelling
- life review
what is reminiscing good for?
it provides cognitive stimulation and improves socialization
if a patient is experiencing sensory overload, what should you do?
give them time to adapt to the change, it has an impact on mental/physical function
FANCAPES
- used for assessment in the older adult if the full assessment isn’t available
- Fluids ~ factors affecting hydration
- Aeration ~ adequate oxygen exchange
- Nutrition ~ mechanical or psych factors
- Communication ~ any needs
- Activity ~ participate in enjoyable activities
- Pain ~ any pain
- Elimination ~ incontinent
- Socialization ~ can they function in society
what does the functional assessment assess?
their ability to carry out basic tasks for self-care
top 3 common chronic conditions in adults
hypertension, high cholesterol, arthritis
chronic illness trajectory
- pre-trajectory
- trajectory onset
- stable
- unstable
- acute
- crisis
- comeback
- downward
- dying
to be considered to have frailty, what must be evident?
(at least three of the following):
- unexplained weight loss
- self-reported exhaustion
- muscle weakness/weak grip strength
- slow walking speed
- low activity
what is frailty associated with?
- falls
- fractures
- hospitalization
- death
what is considered legally blind?
20/400
ptosis
upper lid droops over eye (loses elasticity)
ectropian
lower eyelid turns or sages outward, away from eye (can cause dryness, excessive tearing, and irritation
entropian
eyelid turns inward so eyelashes and skin rub against eye surface (causes irritation and discomfort)
when do age-related eye changes begin?
in patients’ 40s
arcus senilis
gray or white arc visible above and below outer part of cornea
what retinal changes occur?
color perception, light transmission decreases, peripheral vision, visual acuity
presbyopia
loss of accomodation
accomodation
ability of eye to focus from distant to near objects
explain what occurs in cataracts
light scatters which leads to glare, increase in blurred vision, appearance of halos around objects, night vision and color perception decrease
explain what happens in glaucoma
increase in IOP which leads to damage of the optic nerve which is irreversible; it is the 2nd leading cause of blindness in the U.S.
who is more at risk for glaucoma?
- those with family history
- age 60+
- hispanics - 4x more common than whites
- blacks - 5x more common than whites and can develop at a young age
- type 2 diabetes - 82% higher risk
- smoking
- long term glucocorticoids
- trauma to eye
if someone has glaucoma, how often should they be screened?
every 6 months
signs and symptoms in primary open-angle glaucoma (POAG)
- decrease in peripheral vision (tunnel vision)
- headaches
- increased sensitivity to glare
- “tired eyes”
is acute angle-closure glaucoma a medical emergency?
yes! IOP rises rapidly and leads to blindness in two days
talk about diabetic retinopathy
- caused by chronically elevated BG
- created microaneurysms in retinal capillaries that leads to lower O2 and nutrient delivery to eyes
- treatment is laser therapy
talk about macular degeneration (AMD)
- degenerative eye disease that affects macula
- central vision is affected (eyesight is “fuzzy” in middle)
- more common in whites and asians
- only peripheral vision intact
another name for dry eye
xerophthalmia
what kind of medications can cause dry eyes
antihistamines, anticholinergics, beta blockers, diuretics
to maintain healthy eyes, what should a nurse teach a patient to do?
use soft light with adequate illumination
presbycusis
loss of high frequency sounds
conductive hearing loss
passage of sound is blocked in either the ear canal or middle ear, blockages or damaged anatomical structures
sensorineural hearing loss
related to inner ear changes with aging (presbycusis)
how is absorption affect in older adults?
- gastric pH increases so meds sit in stomach longer which causes more absorption and could lead to toxicity
- overall, little change except for delayed onset of peak of action
how is distribution affected in older adults?
- they have less serum albumin levels so those high protein drugs may become toxic as they won’t bind to serum albumin
- they have less water and this can lead to increased toxic levels
how is metabolism affected in older adults?
their metabolism is unpredictable so it could stay in their body for longer and lead to toxic levels
pharmacodynamics vs. pharmacokinetics
pharmacodynamics vs. pharmacokinetics
- dynamics = what drug does to the body
- kinetics = what body does to the drug
MASTER
- used to help older adults with medication teaching
Minimize the number of drugs
Alternatives (consider)
Start low; go slow
Titrate therapy
Educate client
Review regularly
brown bag gold standard
ask patients to bring a bag in of all of their medications they take
