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Gero > Exam 1 > Flashcards

Exam 1 Flashcards

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
Q

Belief that one ethnic/cultural group is superior to another

A

Ethnocentrism

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26
Q

Application of limited knowledge of race, ethnicity, age, or culture to an individual
(Assumptions about someone)

A

Stereotyping

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27
Q

Systematic elimination of the recognized culture

A

Cultural destructiveness

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28
Q

Belief that there are no differences

A

Cultural blindness

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29
Q

How to move toward cultural proficiency and healthy aging

A

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

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30
Q

Outward physical appearance

A

Phenotype

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31
Q

Phenotype as expressed in observable traits (esp skin tones)

A

Race

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32
Q

Cultural group with which one self-identifies

A

Ethnicity

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33
Q

What are the types of beliefs about health, illness, and treatment paradigms

A

Biomedical perspectives
Magico-religious
Naturalistic or holistic

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34
Q

What is the biomedical model?

A

Disease = result of abnormalities in structure/function of body or illness caused by pathogens

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35
Q

Drawback of biomedical model

A

Impersonal
Focuses on part or disease vs. the whole person

36
Q

What is the magico-religious model?

A

Illness is caused by actions of higher power
(Health = blessing, illness = punishment)

Uses prayer

37
Q

What is the naturalistic/holistic model?

A

Balance of diet, exercise, food, sleep, evacuation (elimination), IPR (inner personal relationship), and forces in the universe

38
Q

What is cultural proficiency?

A

Can easily work with all cultures and provide care that is respectful, compassionate, and relevant

39
Q

Processing of one spoken language into another in a matter that preserves meaning

A

Interpretation

40
Q

Exchange of one written language for another

A

Translation

41
Q

What is the learn model used for?

A

Based on a negotiated plan of care, and guides nurses while interacting with elders of any ethnicity

42
Q

What is the learn model?

A

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
Q

The process of acquiring, storing, sharing, and using information

A

Cognition

44
Q

Components of cognitive function

A

Language
Thought
Memory
Executive function (decision making)
Judgement
Attention
Perception

45
Q

Why does the brain slow down with aging?

A

OA take longer to process constantly increasing amounts of information

46
Q

Common cognitive function that declines with aging

A

Object naming

47
Q

Brain’s ability to modify its connections or “retire” itself

A

Neuroplasticity

48
Q

Refers to the strength of the connections in the brain

A

Cognitive reserve

49
Q

Three components of memory

A

Immediate recall
Short-term recall
Remote or long term

50
Q

Memory difficulties considered normal in light of a person’s age and education

A

Age-associated memory impairment (AAMI)

51
Q

Brain exercises to include memory should be:

A
  • new, unfamiliar, out of comfort zone
  • challenging and takes mental effort
  • fun and enjoying
52
Q

Application of principles of adult learning theory to teach interventions for older adults

A

Geragogy

53
Q

An intensely private soul-searching activity involving the process of putting one’s life in order

A

Life review

54
Q

Physical assessment tools nurses should use

A

FANCAPES and spices

55
Q

What does FANCAPES stand for?

A

Fluids
Aeration
Nutrition
Communication
Activity
Pain
Elimination
Socialization

56
Q

What does spices stand for?

A

Sleep disorders
Problems eating
Incontinence
Confusion
Evidence of falls
Skin breakdown

57
Q

What is a functional assessment used for?

A

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
Q

What are IADLs measured by?

A

The Lawton scale

59
Q

What is the functional independence measure used for?

A

To assess need for assistance with ADLs during inpatient hospital stays and for discharge planning, especially following a stroke

60
Q

What does the Mini-Mental State Exam (MMSE) monitor for?

A

Cognition
(Orientation, short term memory and attention, calculation ability, language, and construction)

61
Q

What is the clock drawing test used to assess?

A

Cognitive function
Can be helpful to rule out dementia

62
Q

What is the mini-cog?

A

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
Q

What score on the Geriatric Depression Scale (GDS) indicates the potential for major depressive disorder?

A

5 or more

64
Q

Gold standard of assessing mood in persons with dementia

A

Cornell scare for depression in dementia

65
Q

What is the OARS and how is it scored?

A

Comprehensive geriatric assessment
Most capable = 6
Total disability = 30

66
Q

What is RAI?

A

Comprehensive geriatric assessment required for skilled nursing facilities

67
Q

What is OASIS?

A

Comprehensive geriatric assessment required for skilled care from a home health agency
Focuses on nursing interventions

68
Q

How can the effect of lipophilic drugs differ in older adults?

A

May concentrate in increased fat in OA and increase effect

69
Q

How does the effect of a hydrophilic drug differ in older adults?

A

Less TBW so drug may get too concentrated in blood and increase effect

70
Q

How does lower albumin levels in older adults affect drugs?

A

Effects will be increased for drugs that bind to protein

71
Q

How are drugs primarily excreted?

A

Through the kidneys

72
Q

Why aren’t anticholinergic drugs good for OAs?

A

Risk of injury with BP changes
Confusion
Dizziness
Dry mouth

73
Q

Examples with strong anticholinergic and sedating side effects

A

Antihistamines
Antimuscarinics
Antispasmodics
Benzodiazepines
Antipsychotics
Antidepressants
Opioids

74
Q

Potential side effects of drugs with strong anticholinergic and sedating properties

A

Constipation
Dry mouth
Blurred vision
Dizziness
Confusion
Urinary retention
Functional impairment
Increased heart rate

75
Q

What is poly pharmacy?

A

Use of 5 or more meds, meds that are medically unnecessary, or use of multiple meds for the same problem

76
Q

3 most common errors when administering medications via enteral feeding tubes

A

Incompatible route
Improper preparation (some meds cant be crushed, some cant be mixed together)
Improper administration

77
Q

Common culprits of adverse drug reactions

A

Anti-platelets
Anti-coagulants
Insulin
Oral hypoglycemics
Digoxin

78
Q

Why are allergic reactions more common in older adults?

A

The immune system decreases in function

79
Q

How should you minimize the likelihood of ADRs?

A

Start low, go slow, but go

80
Q

What is the Beer’s criteria?

A

Potentially inappropriate meds (PIMS) associated with confusion, falls
Identified to have higher than usual risk in older adults

81
Q

Issues associated with antipsychotics

A

Neuroleptic malignant syndrome (high temp and liver damage)
Movement disorders (extrapyramial syndrome (EPS))

82
Q

Abnormal involuntary movement (mouth, face, tongue)

A

Acute dystopia

83
Q

Compulsion to be in constant motion

A

Akathisia

84
Q

Possible irreversible movement disorder from taking antipsychotics for 3-6 months

A

Tardive dyskinesia

85
Q

What is the brown bag approach?

A

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
Q

Most common intervention to promote medication adherence

A

Education

87
Q

What is the prescribing cascade

A

Adding new meds without consideration of those to be discontinued

Gero (2 decks)

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