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Exam 1 Flashcards

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1
Q

Define gerontology

A

The scientific study of the effects of time on human development

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2
Q

What is a super-centenarian?

A

Person at 110 years of age

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3
Q

What is a centenarian?

A

Person between 100 & 109 years

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4
Q

What is a typical centenarian?

A

White female living in urban south

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5
Q

What is survivorship?

A

Remaining life expectancy - for persons who have reached a particular age

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6
Q

What is the wellness-based model?

A

Encompasses the idea that health is composed of multiple dimensions; more than just the absence of disease

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7
Q

What is the flower model?

A

Wellness is expressed in 7 dimensions of human experience within the context of culture

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8
Q

What are the 7 dimensions in the flower model?

A

Functional
Environmental
Intellectual
Psychological
Spiritual
Social
Biological

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9
Q

What is the wellness-based model for healthy aging?

A
  • Health is viewed on a continuum, and health promoting strategies are important to achieving highest level of wellness
  • Healthy aging must be viewed from the prenatal period to death
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10
Q

What are primary, secondary, and tertiary prevention strategies?

A

Primary - prevent illness before it occurs
Secondary - early detection of problem that has already developed
Tertiary - slowing disease or limiting complications

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11
Q

Why is the wellness model better than the biomedical model of aging?

A

Wellness model is more holistic (focuses on the whole person)

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12
Q

Certification hospitals can get that is designed to improve outcomes for hospitalized older adults

A

NICHE
(Nurses Improving Care of Health System Elders)

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13
Q

What does NICHE especially focus on in older adults?

A

Iatrogenic complications

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14
Q

Why are older people more vulnerable to poor outcomes due to having complex problems?

A

They require care from multiple settings which makes them more vulnerable to poor outcomes during transition

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15
Q

Factors contributing to poor transitional care outcomes after discharge from the hospital

A

Fragmented system of care
Poor communication
Patient-related factors (unable to follow instructions or lack of follow up care)
*Medication discrepancies (most prevalent adverse event)

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16
Q

What is the goal behind hospital readmission reduction program (HRRP)

A

Fixing the way pts are prepared and educated for discharge to prevent readmission
(Nurses role to help prepare pts for release)

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17
Q

Learned values, beliefs, expectations, and behaviors of a group of people

A

Culture

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18
Q

Guides our thinking and helps us know what is appropriate when interacting with family and friends

A

Culture

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19
Q

Cultural beliefs passed down from one generation to another

A

Enculturation

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20
Q

A process where persons from one culture adapt to another culture

A

Acculturation

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21
Q

Existence of more than one group with differing values and perspectives

A

Diversity

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22
Q

Differences in health outcomes between groups

A

Health disparity

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23
Q

Social status, economic status, and health status of older women

A

Social - differs by culture (some more, some less respected)
Economic - disadvantaged
Health - live longer, greater number of chronic diseases

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24
Q

Social status, economic status, and health status of older men

A

Social - usually higher
Economic - usually higher
Health - black men = shortest lifespan

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25
Belief that one ethnic/cultural group is superior to another
Ethnocentrism
26
Application of limited knowledge of race, ethnicity, age, or culture to an individual (Assumptions about someone)
Stereotyping
27
Systematic elimination of the recognized culture
Cultural destructiveness
28
Belief that there are no differences
Cultural blindness
29
How to move toward cultural proficiency and healthy aging
Become familiar with own perspectives Examine own personal/professional behavior Remain open to different viewpoints/behaviors Appreciate worth of all people Develop skill of attending to both verbal & nonverbal communication Be sensitive to clues given by others Learn to negotiate rather than impose
30
Outward physical appearance
Phenotype
31
Phenotype as expressed in observable traits (esp skin tones)
Race
32
Cultural group with which one self-identifies
Ethnicity
33
What are the types of beliefs about health, illness, and treatment paradigms
Biomedical perspectives Magico-religious Naturalistic or holistic
34
What is the biomedical model?
Disease = result of abnormalities in structure/function of body or illness caused by pathogens
35
Drawback of biomedical model
Impersonal Focuses on part or disease vs. the whole person
36
What is the magico-religious model?
Illness is caused by actions of higher power (Health = blessing, illness = punishment) Uses prayer
37
What is the naturalistic/holistic model?
Balance of diet, exercise, food, sleep, evacuation (elimination), IPR (inner personal relationship), and forces in the universe
38
What is cultural proficiency?
Can easily work with all cultures and provide care that is respectful, compassionate, and relevant
39
Processing of one spoken language into another in a matter that preserves meaning
Interpretation
40
Exchange of one written language for another
Translation
41
What is the learn model used for?
Based on a negotiated plan of care, and guides nurses while interacting with elders of any ethnicity
42
What is the learn model?
Listen to what the pt has to say Explain your perception of the problem Acknowledge the similarities and differences of perception Recommend a plan of action that takes into account both perspectives Negotiate a plan that is mutually acceptable
43
The process of acquiring, storing, sharing, and using information
Cognition
44
Components of cognitive function
Language Thought Memory Executive function (decision making) Judgement Attention Perception
45
Why does the brain slow down with aging?
OA take longer to process constantly increasing amounts of information
46
Common cognitive function that declines with aging
Object naming
47
Brain’s ability to modify its connections or “retire” itself
Neuroplasticity
48
Refers to the strength of the connections in the brain
Cognitive reserve
49
Three components of memory
Immediate recall Short-term recall Remote or long term
50
Memory difficulties considered normal in light of a person’s age and education
Age-associated memory impairment (AAMI)
51
Brain exercises to include memory should be:
- new, unfamiliar, out of comfort zone - challenging and takes mental effort - fun and enjoying
52
Application of principles of adult learning theory to teach interventions for older adults
Geragogy
53
An intensely private soul-searching activity involving the process of putting one’s life in order
Life review
54
Physical assessment tools nurses should use
FANCAPES and spices
55
What does FANCAPES stand for?
Fluids Aeration Nutrition Communication Activity Pain Elimination Socialization
56
What does spices stand for?
Sleep disorders Problems eating Incontinence Confusion Evidence of falls Skin breakdown
57
What is a functional assessment used for?
To evaluate a person’s ability to carry out basic tasks for self-care and tacks needed to support independent living (Identifies areas of help and where to assess further)
58
What are IADLs measured by?
The Lawton scale
59
What is the functional independence measure used for?
To assess need for assistance with ADLs during inpatient hospital stays and for discharge planning, especially following a stroke
60
What does the Mini-Mental State Exam (MMSE) monitor for?
Cognition (Orientation, short term memory and attention, calculation ability, language, and construction)
61
What is the clock drawing test used to assess?
Cognitive function Can be helpful to rule out dementia
62
What is the mini-cog?
Combines test of short term memory in MMSE with clock drawing As accurate/reliable as MMSE, but less biased and more sensitive to dementia
63
What score on the Geriatric Depression Scale (GDS) indicates the potential for major depressive disorder?
5 or more
64
Gold standard of assessing mood in persons with dementia
Cornell scare for depression in dementia
65
What is the OARS and how is it scored?
Comprehensive geriatric assessment Most capable = 6 Total disability = 30
66
What is RAI?
Comprehensive geriatric assessment required for skilled nursing facilities
67
What is OASIS?
Comprehensive geriatric assessment required for skilled care from a home health agency Focuses on nursing interventions
68
How can the effect of lipophilic drugs differ in older adults?
May concentrate in increased fat in OA and increase effect
69
How does the effect of a hydrophilic drug differ in older adults?
Less TBW so drug may get too concentrated in blood and increase effect
70
How does lower albumin levels in older adults affect drugs?
Effects will be increased for drugs that bind to protein
71
How are drugs primarily excreted?
Through the kidneys
72
Why aren’t anticholinergic drugs good for OAs?
Risk of injury with BP changes Confusion Dizziness Dry mouth
73
Examples with strong anticholinergic and sedating side effects
Antihistamines Antimuscarinics Antispasmodics Benzodiazepines Antipsychotics Antidepressants Opioids
74
Potential side effects of drugs with strong anticholinergic and sedating properties
Constipation Dry mouth Blurred vision Dizziness Confusion Urinary retention Functional impairment Increased heart rate
75
What is poly pharmacy?
Use of 5 or more meds, meds that are medically unnecessary, or use of multiple meds for the same problem
76
3 most common errors when administering medications via enteral feeding tubes
Incompatible route Improper preparation (some meds cant be crushed, some cant be mixed together) Improper administration
77
Common culprits of adverse drug reactions
Anti-platelets Anti-coagulants Insulin Oral hypoglycemics Digoxin
78
Why are allergic reactions more common in older adults?
The immune system decreases in function
79
How should you minimize the likelihood of ADRs?
Start low, go slow, but go
80
What is the Beer’s criteria?
Potentially inappropriate meds (PIMS) associated with confusion, falls Identified to have higher than usual risk in older adults
81
Issues associated with antipsychotics
Neuroleptic malignant syndrome (high temp and liver damage) Movement disorders (extrapyramial syndrome (EPS))
82
Abnormal involuntary movement (mouth, face, tongue)
Acute dystopia
83
Compulsion to be in constant motion
Akathisia
84
Possible irreversible movement disorder from taking antipsychotics for 3-6 months
Tardive dyskinesia
85
What is the brown bag approach?
Asks the person to bring in all meds taken, including over the counters, herbals, and dietary supplements (Ask person how he or she actually takes meds rather than depending on label)
86
Most common intervention to promote medication adherence
Education
87
What is the prescribing cascade
Adding new meds without consideration of those to be discontinued

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