Exam 1 Chapter 1-6 Flashcards
What are the three major theories?
- Biological
- Psychological
- Social
results of sequential switching on and off of certain genes with senescence defined as the point in time when age-associated functional deficits are manifested. People who endorse this theory are interested in studying genome and genetic theories of aging.
programmed longevity
theory of biological clocks acts through hormones to control the pace of aging
endocrine theory
programmed decline in immune system functions leads to increased vulnerability to infectious diseases, aging, and eventual death
immunological theory
biological theory consists of these two theories:
programmed and error
cells and organs have vital parts that wear out after years of use
wear and tear theory
accumulation of crossed linked proteins resulting from the binding of glucose to protein causing various problems
cross link theory
theory that involves accumulated damage caused by oxygen radicals causes cells, and eventually organs lose function and organ reserve
free radical theory
theory of genetic mutations occur and accumulate with increasing age, causing cells to deteriorate and malfunction
somatic DNA damage theory
theory of human genome may be activated by certain enzymes and/or environmental conditions and may account for the influence of toxins, stress and lifestyle choices
emerging biological theories
theory that the shift focus goes from extroversion to introversion
jung’s theory of individualism
theory that consists eight stages of life and for older adult?
erikson’s developmental theory
integrity vs. despair; the older adult will become preoccupied with acceptance of eventual death without becoming morbid or obsessed with these thoughts. If major failures or disappointments have occurred in the older person’s life, this final stage may be despairing rather than accepting death. Older persons who have not achieved ego integrity may look back on their lives with dissatisfaction and feel unhappy, depressed, or angry over what they have done or failed to do. Psychological counseling can help to resolve some of these issues.
theory that an older person and society engage in a mutual and reciprocal withdrawal
disengagement theory
theory that older adults staying active and engaged to enjoy old age
activity theory
theory of aging that involves maintaining previous values and habits
continuity theory
The biological theory of aging uses a genetic perspective and suggests that aging is a programmed process in which:
a. each person will age exactly like those in the previous generation.
b. a biological clock ticks off a predetermined number of cell divisions.
c. genetic traits can overcome environmental influences.
d. age-related physical changes are controlled only by genetic factors.
B
The theory that identifies an unstable molecule as the causative factor in aging is the _____ theory.
a.
free radical
b.
molecular
c.
neuroendocrine
d.
crosslink
A
The 80-year-old who teaches Sunday school every week and delivers food for Meals on Wheels is following _____ theory.
a.
Newmans developmental
b.
the life course
c.
the activity
d.
the disengagement
C
List the myths of aging
Myth: Being old means being sick
Myth: most older people are set in their ways and can’t learn new things or take up new activities.
Myth: Health promotion is wasted on older people.
Myth: Older adults do not pull their own weight and are a drain on societal resources.
Myth: Older people are isolated and lonely.
Myth: Older people have no interest in sex.
What is the Katz Index?
Progress toward independence that can be measured.
6 = High (independent) 0 = Low (very dependent)
What is QSEN?
to meet the challenge of preparing future nurses who will have the knowledge, skills, and attitudes necessary to continuously improve the quality and safety of the healthcare systems within which they work.
What is the average lifespan in the United States now?
Women-80.8 years
Men- 75.7 years
Who are the Baby boomers?
era of increased fertility; 1946-1964
Who is the ANCC?
bestows a lot of geriatric titles to nurses based on examination and experience.
Associate Degree (ADN) & Baccalaureate Degree (BSN)
o Required License: Registered nurse with 2 years of practice, 2000 hours of clinical practice, and 30 continuing education hours in the past 3 years
o Certification Eligibility: Gerontological Nurse
o Credential: RN-BC (RN, Board Certified)
Master’s Degree with APRN Specialization (MSN) & Doctor of Nursing Practice (DNP) with APRN Specialization
o Required License: RN licensure and completion of a minimum of 500 supervised clinical hours; completion of advanced pathophysiology, pharmacology, and health assessment courses
o Certification Eligibility: Adult-gerontological nurse practitioner or clinical nurse specialist
o Credential: AGNP-BC (Adult-Gerontological Nurse Practitioner, BC) or AGCNS-BC (Adult-Gerontological Clinical Nurse Specialist, BC)
Who is the ANA?
What is the scope of practice?
Responsible for defining the scope of practice and standards of nursing
Scope of Practice – range of nursing functions that are differentiated according to the level of practice, role of the nurse, and the work setting. (Three elements: quality, evidence, and safety); standards are defined as statements by which the quality of practice, service, or education can be judged.
Integrating individual clinical expertise with the best available external evidence from systematic research.
It is good to be able to update outdated techniques to something safer and more helpful.
evidence based practice
What are the top 10 causes of death?
- Heart Disease
- Malignant Neoplasms
- Cerebrovascular
- Bronchitis / Emphysema / Asthma
- Alzheimer’s Disease
- Diabetes Mellitus
- Influenza / Pneumonia
- Nephritis / Nephrosis
- Accidents
- Septicemia
What are the top 10 causes of death?
- Heart Disease (cardiac)
- Malignant Neoplasms
- Cerebrovascular
- Bronchitis / Emphysema / Asthma
- Alzheimer’s Disease
- Diabetes Mellitus
- Influenza / Pneumonia
- Nephritis / Nephrosis
- Accidents
- Septicemia
term for the nurse understands and attends to the total context of the older person’s situation. Complex combination of knowledge, skills, and attitudes. Example: if the older adult has dietary practices such as not mixing meat and dairy foods, food and beverage combinations that the older person prefers can be readily supplied.
cultural competence
nurse possess some basic knowledge and constructive attitudes toward the health traditions observed among the diverse cultural groups found in a practice setting
Cultural sensitivity
nurse applies underlying background knowledge that must be possessed to provide a given patient with the best possible health care
Culturally appropriate care
key element of the Spector’s heritage chain. Described as the extent to which a person’s lifestyle and belief system aligns with the culture of their tribal culture; can be expanded to include connection to the traditional culture of one’s family of origin whether its european, middle eastern, asian, african, or hispanic.
Heritage consistency
Process of being raised within a culture and acquiring the characteristics of that group.
For instance, education.
Socialization
What are normal changes in the elderly?
· Heart - muscles thicken with age, pumping rate, and oxygen extraction diminishes
· Arteries - stiffen with age = heart pumps harder
· Lungs - breathing capacity declines by 40% between ages 40-70
· Brain - loses axons and neurons
· Kidneys - become less efficient at removing waste from blood
· Bladder - capacity declines
· Body fat - increases until about middle age, vulnerable to heart disease
· Muscles - no exercise can cause muscle mass to decline
· Bones - mineral is lost = weaker bones. Exercise and calcium help.
· Sight - increased sensitivity to glare, difficulty seeing in low light or fast-moving objects or fine details
· Hearing - difficulty in hearing high frequencies, vowels, or understanding speech. Declines faster in men.
· Personality - may be at risk for depression or social isolation
What is the scope of practice and who authors it?
American Nurses Association (ANA) - responsible for defining the scope of practice and standards of nursing
What is “Standard of Care” based upon?
- Determined by what action a reasonable nurse would take in the same situation.
- Enable the nursing profession to identify and meet the professional responsibility to deliver quality patient care to older persons.
- The standards are defined as authoritative statements enunciated and promulgated by the profession by which the quality of practice, service, or education can be judged. (ANA)
What is HIPPA?
Confidentiality — Only the right people can see protected information.
o Patient-identifying info (name, med rec #)
o Health info relating to past, present, or future health status or condition
o Documentation regarding the provision of health care
o Past, present, or future payment for the provision of health care
Integrity — The information is supposed to be without alteration or destruction.
Availability — The right people can see it when needed.
What is xerostomia?
Edentulism?
Sarcopenia?
- Xerostomia- lack of saliva production, dry mouth
- Edentulism- lack of teeth
- Sarcopenia- lean muscle that diminishes with aging; muscle loss from lessened physical activity, disability, disease related to sedentary lifestyle
What are the risk factors of dehydration and the elderly?
- Lower lean body mass→ lower body water
- Low thirst from aging, medication or disease
- Impaired angiotensin production
designed to identify the most significant preventable threats to health and establish national goals to reduce these threats.
healthy people 2020
Goals for healthy people 2020 are?
- Attain high-quality, longer lives free of preventable disease, disability, injury, premature death
- Achieve health equity, eliminate disparities, and improve the health of all health groups
- Create social and physical environments that promote good health for all
- Promote quality of life, health development, and healthy behaviors across all life stages
GORDON’S FUNCTIONAL HEALTH PATTERNS:
the older individual’s perceived health and well-being along with self-management strategies
Health perception-health management
GORDON’S FUNCTIONAL HEALTH PATTERNS: patterns of food and fluid consumption relative to metabolic need and nutrient supply
Nutritional-metabolic
GORDON’S FUNCTIONAL HEALTH PATTERNS:
patterns of excretory function and elimination of waste (bowel, bladder)
Elimination
GORDON’S FUNCTIONAL HEALTH PATTERNS:
patterns of exercise and daily activity. Includes leisure and recreation
Activity-exercise
GORDON’S FUNCTIONAL HEALTH PATTERNS:
patterns of sleep, rest, and relaxation
Sleep-rest
GORDON’S FUNCTIONAL HEALTH PATTERNS:
patterns of thinking and ways of perceiving the world and current events
Cognitive-perception
GORDON’S FUNCTIONAL HEALTH PATTERNS:
patterns of viewing and valuing self (body image and psychological state, self-image)
Self-perception- Self Concept
GORDON’S FUNCTIONAL HEALTH PATTERNS:
patterns of engagement with others, ability to form and maintain meaningful relationships, assumed roles
Roles-relationships
GORDON’S FUNCTIONAL HEALTH PATTERNS:
patterns of sexuality and satisfaction with present level of interaction with sexual partners
Sexuality-reproductive
GORDON’S FUNCTIONAL HEALTH PATTERNS:
patterns of coping with stressful events and level of effectiveness of coping strategies
Coping-stress tolerance
GORDON’S FUNCTIONAL HEALTH PATTERNS:
patterns of beliefs, values, and perception of the meaning of life that guide choices or decision
Values-beliefs
Requires all states to operate long-term care ombudsman programs and to notify patients about their rights. These programs provide trained people to investigate complaints made by residents and families about poor care or violation of patients’ rights within the nursing home. If a violation is found, the ombudsman may seek administrative or legal action.
OBRA 87 & OMBUDSMAN
What are the roles of MDS in nursing homes?
- Provide valuable input into the formation of a care plan and may serve as leader of the interdisciplinary team.
- Holistic role to improve healthcare in residents of long term care facilities
Assessment of an older person for proper placement within a nursing home or long term care facility.
- Comprehensive multidisciplinary assessment of all residents in long-term care facilities.
- All facilities that collect funds from Medicare or Medicaid are required to assess patients.
- Used for validating the need for long-term care, reimbursement, ongoing assessment of clinical problems, and assessment of and need to alter the current plan of care.
- Physical, psychological, and psychosocial function.
MINIMUM DATA SET (MDS)
Diet recommendation for the elderly include?
Reduce salt, consume good fats, increase fiber, eat whole grains, look for hidden sugar, eat a variety of foods, slow down at meal time
Goal of Antipsychotic medication?
Goal is to not use it as a “chemical restraint”
Dosing narcotics for the very old include?
ncreased drug-receptor response can occur; resulting in increased sedation, analgesic effects and respiratory depression, anticoagulation, CNS, bladder and heart tend to be more sensitive to meds with anticholinergic effects
Where do the majority of nurses work in the US?
Hospitals
A hiring manager is hiring a certified gerontological nurse. Which candidate would be qualified for this position?
- The nurse has a master’s degree in nursing and has worked in a nursing home for 10 years.
- The nurse has worked in administration at a geriatric psychiatric facility for 5 years.
- The nurse has worked full time at least 2 years in gerontological nursing and is in a PhD program.
- The nurse’s clinical competence in gerontological nursing has been validated via testing.
4
The director of nursing at a skilled facility is implementing the Quality and Safety Education for Nurses (QSEN) project to improve the quality of care of the older residents. Which topics will the director include in staff teaching? Select all that apply.
- Directions on accessing evidence-based practice resources
- Methods for ensuring effective team collaboration
- A plan for staff incentives for meeting care goals
- Examples of respectful team communication
- Information on the most prevalent cultures in the region
1,2,4
The nurse caring for older clients wants to return to school to become a gerontological nursing specialist. Which criteria would the nurse need to achieve in order to fulfill this career goal? Select all that apply.
- Been a practicing nurse for at least 2 years, with 2,000 unsupervised clinical practice hours.
- Complete at least 500 supervised hours of providing care to older clients.
- Have a gerontological nurse manager recommend the nurse for the credential.
- Complete a course in advanced pathophysiology and pharmacology.
- Receive their doctor of nursing practice degree.
2,4
The nurse is preparing to discharge an older client with instructions on smoking cessation. The nurse states to a colleague, “This client has been smoking for years and isn’t going to stop now.” Which negative stereotype of aging does the nurse’s statement most reflect?
- Old people are expected to be sick.
- Old people are set in their ways.
- Old people do not value health promotion education.
- Old people are a drain on societal resources
3
The nurse is planning to conduct education for older adult clients regarding preventative health screenings. Which type of screening does the nurse anticipate educating this population on?
- Glaucoma
- Nutrition
- An annual mammogram (breast)
- Prostate-specific antigen
3
A 62-year-old former professional football player is in the hospital for a total knee replacement as a result of wear and tear and a medical diagnosis of osteoarthritis. Which biological theory of aging would help explain this patient’s current health problem?
- Cross-link
- Free radical
- Wear-and-tear
- Somatic DNA damage
3
Who pays for long term care?
Most: Medicaid
Least: Private insurance only 1%
Jung’s theory of individualism focuses on the client’s inner psychological state in regards to aging. When assessing an older client, the nurse might find which thoughts? Select all that apply.
- Signs of sadness and depression
- Questions about nutrition and vitamins
- Regrets on not accomplishing more in life
- A belief that past injuries have altered their abilities
- Concerns that damaged cells are slowing down their body
1, 3
The nurse is assessing an older female patient admitted to the hospital for generalized weakness and a cough. Which assessment findings indicate normal changes of aging? Select all that apply.
- Blood pressure of 160/90
- Needing to urinate every 3 hours
- Needing to wear eye glasses for reading
- Pulse rate 110 bpm
- Respiratory rate 22 per minute after walking a short distance
2,3,5
A patient takes herbal and vitamin supplements in order to “slow down” the aging process. The nurse realizes that the patient believes in the use of antioxidants to slow down cell damage. Which is associated with the biological theory of aging?
- Cross-link
- Wear-and-tear
- Free radical
- Emerging biological
3
A patient voices concerns about her body weight despite diligently following a healthy diet. Which age-related change would explain this patient’s issue with body weight?
- Body fat increases until middle age.
- Body weight increases after middle age.
- Fat is redistributed to the hips after middle age.
- Body fat promotes a pear-shaped appearance for aging women.
1
The nurse is planning a program about the Immunological Theory of Aging for a group of senior citizens. Which information should the nurse include in this program? Select all that apply.
- Restrict spending time with others who are ill.
- A healthy diet supports immune function.
- An active lifestyle supports immune function in the older person.
- Immune responses increase with aging.
- Obtaining an annual influenza vaccination supports immune function.
1,2,3,5
