Exam 1 Flashcards
Baby boomer years
1946-1964
What Federally funded program that covers hospital and physician services?
Medicare (1960)
What does “asses rich and cash poor” mean
Have money locked up in assets (houses, property, cars), but no spending money (cash) in the bank.
1/2 of women and widowed
Understand elderly abuse
Elderly abuse must be reported 
Types of elder abuse 
Physical
sexual
psychological
emotional
financial and material
abandonment
neglect
serious loss of dignity and respect
Self neglect
Understand the difference between dementia and delirium
Dementia: Does not go away, and can be helped with medication. It has a gradual onset that progresses with time
Delirium: can be fixed/cured
What act was responsible for the growth of nursing homes?
Hill– Burton act
What is the hierarchy of resident needs?
Similar to Maslow hierarchy, the need at the bottom must be met first. In this case, hygiene:
Healing: Before healing can occur, hygiene in a hole ism need to be fulfilled. Healing does not imply a cure but, rather, the establishment of a meaningful and purposeful life. Using illness as an opportunity for self discovery, and deepening spiritual awareness and growth, and transcending the physical being
holism: Psychological, social, and spiritual aspects are considered. Finding balance on my mind, body, and spirit, individuals need to exercise individual rights, and assume responsibility for self-care to the fullest extent
hygiene: Encompasses most basic needs including physiological needs, assurance of safety of the human and physical environment, treatment of medical conditions, and restoration and or stabilization of physical and mental health. 
What is Creutzfeldt-Jakob disease
This disease is under the umbrella of Alzheimer’s, but kills within one year
Who do we notify if there is elder abuse?
APS; adult protective services
What agency protect the privacy of the client 
HIPPA
Family member roles
Dependent: Individuals who rely on other members of the family for economic or caregiving assistance
Victim: A person who forfeit his or her legitimate rights and maybe physically, emotionally, socially, or economically abused by the family
caregiver: A person who provides direct services, Luxe after, or assist the personal care and home management other family member
scapegoat :
decision maker: The person who is granted or assumes responsibility for making important decisions or is called on in times of crisis. May not be geographically close or involved in daily activities but is consulted for problem-solving
Deviant: The problem child or nonconformist who has strayed from family norms. They may be a family scapegoat or may provide a sense of purpose for family members who rescue or compensate for the individual 
What are ethnocentric beliefs? 
Ethnocentrism; the belief that one’s beliefs are superior than others.
Nurses need to put their biases aside in order to work with patients
Restraint use
A restraint is anything that physically or mentally restricts a patient movement; protective vests, trays on wheelchairs, safety belts, geriatric chairs, side rails, and medication’s.
We want to find the least invasive measures possible. For example, finding a sitter, alarm doors, alarm pads, beds and chairs close to floor can be used instead of restraints. The use of restraints must be ordered by a doctor.
Improper use of restraints can violate regulations and result in litigation for false imprisonment and negligence.
Omnibus budget reconciliation act (OBRA) - Heightened awareness and impose trick standards on the use of restraints in long-term care facilities.
Stereotyping
A widely held but fixed oversimplification image or idea of a particular person or group that is not based on fact.
This could be cultural, race, gender, age, etc
Factors leading to elder abuse
Caregiver burnout
caregiver stress
impairment of the dependent elder
What are housing options that offers the privacy of an apartment? 
Nursing homes and assisted living
What is a DNR And advanced directive
DNR; Do not resuscitate
Advance directive; a written statement of a persons wishes regarding their medical treatment often includes a living will 
Good to talk with the patient about this upon admission
What led to the emphasis on extensive documentation
CYOA; making sure that you have the proper documentation can help cover you as a nurse if anything goes wrong with the patient.
Also, extensive documentation can help the whole healthcare team treat the patient in the best way
What is the pharmacological management of moderate to severe Alzheimer’s disease?
Aricept
Alzheimer’s disease
Most common form of dementia
60-80% of all dementias are Alzheimer’s.
Two changes in the brain:
1) presence of neurotic plaques
2) brain change in neuifibrillary tangles in the cortex.
Work to orient the patient. Offer good hygiene and verify their breathing is OK
Know how a nurse should address substance-abuse with a client
Look for subtle cues and use the elder mistreatment assessment instrument
What prescriptions are used for palliative care?
Morphine
List safety risks for an older adult client
Fall
infection
UTI
pressure ulcer
Understand the role of an advocate
Be there for the patient and being their guard
Understand role of defiant behavior
Subacute care
Level of care in which continued management of acute condition along with assistance with basic care is needed and provided in a long-term care facility.
In the past, patients had to stay in the hospital. Today nursing homes are establishing subacute care units to help patients as they rehabilitate
Defense mechanisms regarding chronic conditions
Denial
anger
depression
regression
Signs of possible abuse
Delay in seeking necessary medical care
malnutrition
dehydration
unexplained bruises
poor hygiene and grooming
urine odor, urine stained clothing/linens
inappropriate administration of medication’s
repeated infection, injuries, or preventable complication from existing diseases
unsafe living environment
social isolation
anxiety, suspiciousness, and depression
