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N3521 Gerontologic Nursing > Exam 1 - Study Material > Flashcards

Exam 1 - Study Material Flashcards

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1
Q

What is gerontology?

A

The scientific study of the effects of time on human development, specifically the study of older persons; it encompasses ALL aspects of the aging process and the consequences of these problems for both the elderly population and society.

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2
Q

What is geriatrics?

A

A specialty that focuses on healthcare of elderly people and aims to promote health by preventing and treating disabilities in older adults

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3
Q

Define aging

A

The chornological, biological, psychological, sociological, and spiritual aspects that determines how old one feels.

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4
Q

What are the different age categories?

A
  • Pre-elderly = 55-64 years
  • Young-old = 65-74 years
  • Middle-old = 75-84 years
  • Frail-old = 75+ needing services; or 85+
  • Oldest-old = 85+
  • Elite-old = 95+
  • Centenarians = 100+
  • Super centenarians = 110+
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5
Q

What is the fastest growing segment of the US population?

A

Adults aged 85+ Is the fastest growing segment of the population.

13% of the population are elderly people

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6
Q

What is the goal in studying aging?

A

To use our knowledge and skills to help people of all ages, races, and cultures acheive healthy aging.

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7
Q

What is the rationale for the study of aging?

A
  • Increasing interest in the biology of aging – Why do we get old? Can we retard the process?
  • Phenomenal shift in life expectancy – Growing population of the older adults.
  • Diseases of affluence are abundant in old age – Looking at more long-term illnesses, i.e., cardiovascular disease, cancer, stroke.
  • Cost of health care has increased.
  • Negative attitudes toward elders persist.
  • *
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8
Q

What are some demographic characteristics related to aging and the aged?

A
  • Most people 65+ are high school graduates (78%)
  • More women 65+ live alone, more men living with a spouse
  • Women tend to live longer then men
  • Some minority groups tend to not live as long as the white population, but at a certain age (the minorities) live longer than their white counter parts. (this is known as the Racial Mortality Crossover Phenomenon)
  • More men marry, and if you’re married you live longer.
  • Most elderly people live in houses, apartments, and public housing
  • Main source of income for the elderly has been social security
  • 50% of elderly people will have probelms with hypertension. arthritis and heart disease are other common problems
  • Make up 85% of hospitalized patients
  • Aging population is growing
  • Minorities increasing in population while nonwhite population is decreasing.
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9
Q

What are the 4 main reasons for the increase in life expectancy?

A

Life expectancy in America has trended upward as a result of:

  1. reduced death rates for children and young adults
  2. new drugs
  3. medical tenchology
  4. better disease prevention.
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10
Q

What is compression of morbidity?

A

A concept that proposes that premature dealth will be minimized, and disease and functional decline will be compressed into a period of 3 to 5 years before dealth.

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11
Q

What are the ANA Standards of ​
Gerontological Nursing Practice​?

A
  • Assessment​
  • Diagnosis​
  • Outcomes Identification​
  • Planning ​
  • Implementation​
  • Evaluation​
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12
Q

What is the role of a Gerontological Nursing generalist?

A

A nuse who has completed a basic-entry level educational program.​

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13
Q

What is the role of a Gerontological Nursing specialist?

A
  • Provide direct & indirect care to patients and their families.
  • Serve as nurse consultants to staff on complex issues of patient care.​
  • Advanced preparation at the master’s level; clinical expertise (Educator & Advanced Practice Nurse Roles) ​
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14
Q

What is the role of a Nurse Educator?

A
  • Nurses who teach & practice as faculty in colleges and universities, or as staff development educators in health care facilities.​
  • Design, implement, evaluate and revise academic and continuing education programs.
  • Have a masters or doctoral degree
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15
Q

What is the role of a Gerontological Nurse Practitioner?

A
  • Provide primary care for older adults in an independent practice or a collaborative practice with a physician. ​
  • Have considerable autonomy in treating common illnesses. ​
  • Prescriptive authority
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16
Q

What role do Gerontological Nurse Entrepreneurs play?

A

Nurse Entrepreneurs combine their nursing background with business and utilize their individual creativity and resourcefulness to start their own companies.

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17
Q

Define “certification” as it relates to nursing.

A

The formal process by which clinical competence is validated in a specialty area of practice

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18
Q

What organization gives certifies nurses?

A

ANCC = American Nurses Credentialing Center

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19
Q

What are the 6 steps you need to complete to obtain your Gerontologic Nurse (BSN) Certification?

A
  1. Need a BSN
  2. RN license
  3. 2 years full time nurse expierence

2000 hrs. of clinical practice in ​specialty area (geriatrics) within last 3 yrs.

  1. 30 hrs. of C.E. in Gero in the last 3 years
  2. Pass the specialty certification exam
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20
Q

What is Ageism?

A

Discrimination or prejudice against people of specific ages, especially in employment

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21
Q

What is the Impact of Ageism​?

A
  • Fosters myths and stereotypes​
  • **Decreases opportunity for elder ​employment​ - People think they can’t work as well as younger people. **
  • Rehabilitation and health education not a priority (it is for the younger adult)​
  • Decreases self-esteem on part of the elder​
  • May result in self-fulfilling prophecy​ in the elder - Becomes a self-fulfilling prophecy for the elderly, i.e., dressing the elderly for them; they might start to think that they are actually slow.
  • Fosters social isolation or dependence on part of the elder - They know these myths so they won’t take time to be around people. Need to include them in patient teachings and communication.
  • Creates Gerontophobia for the aging adult​
  • Lack of empathy and patience, disrespect common​
  • Decreased compensation and respect for nurses etc. working in LTC settings​
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22
Q

What is the mortality crossover effect?

A
  • Minorities tend to not live as long as the white population. This is usually due to access to health care, economics, and socioeconomic status.
  • However, after age 75, minorities tend to have lower death rates than the white population and this is due to the fact that they tend to have hardy personalities and they have access to better health care.
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23
Q

How do children and adolescents view aging compared to adults?

A

Children:

  • View it more positively, they want to grow up. (able to drive a car, go out, do more things)

Adults:

  • Tend to view aging negatively, more problems, dying, less strength.
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24
Q

What is the Biological Theory of aging?

A

states that some form of breakdown at the organic and cellular level leads to decline, aging, and death of the cell, which results in aging of the entire body.

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25
Q

Biological Theories of Aging can be classified under what 2 categories?

A
  1. Stochastic
  2. Non-Stochastic
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26
Q

Stochastic theories view aging as what?

A

aging occurs as a random event and occurs over time

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27
Q

Non-Stochastic theories view aging as what?

A

aging is a predetermined and timed phenomenon – non-random

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28
Q

What are some examples of stochastic theories of aging?

A
  • —Free Radical / Oxidative stress theory —
  • Cross link or Collagen —theory
  • Wear & Tear theory
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29
Q

Describe the —Free Radical / Oxidative stress theory

A
  • States that errors are the result of random damage from free radicals, and that over time the production of free radicals increases and the body’s ability to remove them decreases.
  • Mitochondiral DNA is most affected by the ROS damage
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30
Q

Describe the —Cross link or Collagen theory

A
  • Describes aging as the result of accuulated damage from errors associated with corss-linked proteins.
  • Substances that may act as cross-linking agents include unsaturated fats, aluminum, zinc, and magnesium
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31
Q

Describe the wear and tear theory

A
  • Proposes that cell errors are the result of “wearing out” over time because of continued use.
  • Cells are aggravated by the harmful effects of internal and external stressors which include pollutants and free radicals
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32
Q

What are some examples of Nonstochastic theories of aging?

A
  1. —Immunity theory
  2. —Neuroendocrine control or pacemaker theory
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33
Q

Describe the —Immunity —theory

A

Presents aging as a programed accumulation of damage and decline in the function of the immune system, with damage being the result of oxidative stress.

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34
Q

Describe the —Neuroendocrine control or pacemaker theory

A
  • Views aging as a programmed decline in the functioning of the nervous, endocrine, and immune systems. The cells lose their ability to reproduce, called replicative senescence.
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35
Q

How would you promote healthy aging consistent with the biological theories of aging?

A
  • Excercise on soft surfaces, using good body mechanics (wear n tear theory)
  • Avoid skin dryness and joint stiffening (cross-link theory)
  • Watch for research related to the effect of unsaturated fats and heavy metals on cell health (cross-link theory)
  • Avoid environmental pollutants and unecessary radiation (oxidative stress theory)
  • Watch for research on the use and presence of antioxidants (oxidative stress theory)
  • Avoid stress (oxidative stress theory)
  • Minimize the potential for infection; wash hands frequently, undergo immunizations, and avoid those who are ill (Immunity theory)
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36
Q

What do Psycho-Social Theories of aging try to explain?

A

Attempts to explain and predict the behaviors, feelings, mental processes, and role changes of the aging individual

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37
Q

What are the different psycho-social theories of aging?

A
  • —Role Theory
  • —Disengagement Theory
  • —Activity Theory
  • —Continuity Theory
  • —Age Stratification Theory
  • —Modernization Theory
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38
Q

Describe the role theory of aging

A
  • Proposes that the ability of an individual to adapt to changing roles over the course of life is a predictor of adjustment to personal aging
  • Individuals go through different stages in life with new roles in each stage.
  • Successful aging inovlves completing one role to take on another.
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39
Q

Describe the disengagement theory of aging

A
  • Proposes that the natural course of aging inolves the individual slowly withdrawing from his or her former roles and activities to allow the transfer of power to yougner generations.
  • Transfer was viewed as necessary for social equilibrium
  • Elder’s withdrawl is seen as successful aging
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40
Q

Describe the activity theory of aging

A
  • Proposes that activity is necessary to maintain life stisfaction, positive self-concept, and being able to “stay young”.
  • This theory is based on the asumptiom that it is beter to be active than inactive, and better to he happy than unhappy
  • Activity is the indicator for successful aging
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41
Q

Describe the continuity theory of aging

A
  • Proposes than an individual develops and maintains a consistent pattern of behavior, substiuting one role for a similar one as the person matures.
  • Late life roles, responsibilities, and activites are a refluction of a continuation of life patterns.
  • Successful aging is associated with one’s ability to maintain and continue previous behaviors, roles, or find suitable replacements
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42
Q

Describe the age-stratification theory of aging

A

Proposes that aging can best be understood by considering the individual as a member of an age group, with similarities to others in the group

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43
Q

Describe the modernization theory of aging

A
  • Attempts to explain the social changes that have resulted in the devaluing of both the contributions of elders and the elders themselves.
  • The status and value of elders is lost when their labors are no longer considered usful, kinship networks are dispersed, the infromation they hold is no longer pertinent to the society in which they life, and the culture in which they live no longer reveres them
  • Proposed that these changes are the result of advancing technology, urbanization, and mass education
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44
Q

What is the Relevance of Theories of Aging to Nursing?

A
  • —Serve as backdrop for development of one’s philosophy of care & senior programs —
  • provide insight on factors that impact the aging process
  • —provide information on age-related changes & pathology
  • —nurses should educate patients
  • —shed light on the unique ways older adults achieve healthy aging & respond to illness
  • —may be used as a framework for addressing various issues and initiating programs —
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45
Q

What are Erickson’s Developmental Stages?

A
  • —Young Adulthood (20-30)
    • Stage – intimacy vs isolation
  • — —Middle Adulthood (30-60)
    • Stage – Generativity (“making your mark” on the world) vs stagnation (not doing anything)
  • —Older Adulthood (60+)
    • Stage – Ego integrity (able to look back at life accomplishments) vs despair
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46
Q

What are Peck’s Developmental Tasks of Aging?

A
  • —Ego Differentiation vs. Work-Role Preoccupation
  • Body Transcendence vs. Body Preoccupation
  • —Ego Transcendence vs. Ego Preoccupation (looking at the end of life)
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47
Q

What are Havighurst’s Developmental Tasks of Aging?

A
  • —Adjusting to decreasing physical strength and health
  • Adjusting to retirement and reduced income
  • —Establishing an affiliation with one’s age group
  • —Meeting civic and social obligations
  • —Establishing satisfactory living arrangements —
  • Adjusting to death of spouse
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48
Q

What is Self-Actualization or Gerotranscendence?

A

Achieving wisdom through personal transformation

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49
Q

Which two senses are most affected &/or bother people the most?

A
  • Vision and hearing
  • There is a Decline in all five senses however
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50
Q

What is Presbyopia?

A

loss of elasticity of lens causes decreased accommodation and inability to focus sharply for near vision.

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51
Q

What are some vision changes with aging?

A
  • decreased visual acuity
  • Presbyopia (difficulty reading –up close, happens around 40 yrs old)
  • decreased accommodation
  • reduction in pupil size & more sluggish
  • decreased light adaptation & night vision
  • increase sensitivity to glare
  • decreased depth perception
  • yellowing of the lens
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52
Q

What are some normal anatomic changes seen with the eyes with aging?

A
  • Laxity & downward shift of eyelids
  • Atrophy of orbital fat
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53
Q

What is glaucoma?

A
  • Vision loss due to damage to the optic nerve
  • Central vision is spared, however peripheral vision is compromised.
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54
Q

What are cataracts?

A
  • an eye disease in which the lens becomes covered in an opaque film that affects sight, eventually causing total loss of sight
  • Fuzzy or cloudy images
  • Contrast sensitivity is decreased or lost.
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55
Q

What is Macular degeneration?

A
  • a gradual loss of the central part of the field of vision usually affecting both eyes that occurs especially in the elderly
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56
Q

What are some hearing changes with aging?

A
  • Loss of auditory neurons, calcification of auditory mechanisms, loss of hair cells
  • middle ear membranes less flexible; bones stiffen
  • Decrease ability to hear
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57
Q

What are some nursing interventions for hearing changes with the elderly?

A
  • Make sure hearing aid is in
  • Shut the door to lower down background noise
  • Face them when talking
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58
Q

What is presbycusis?

A

Difficulty hearing high frequency sounds

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59
Q

What are some sensory changes seen with aging?

A

Taste:

  • atrophy of the tongue
  • diminished taste sensation
  • decreased saliva production
  • increased sensitivity to bitterness
  • decreased sensitivity to sweetness & salt

Smell:

  • decrease in smell receptors
  • decreased smell acuity

Touch:

  • decrease in # of touch receptors
  • decrease in sensitivity
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60
Q

What ares some changes seen with the integumentary system?

A
  • ↓ Moisture
  • Dermis thins; more fragile
  • Loss of subcutaneous fat
  • Wrinkling
  • Variation in pigmentation
  • Increased melanocytes in people of color’s skin
  • Nail growth slows
  • Less sweat gland activity
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61
Q

What are Implications and Nursing Interventions for changes in the integumentary system?

A
  • Be careful when putting on IVs, especially with tearing off the tape
  • Advise them to use lotion
  • Advise them to use sunscreen
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62
Q

What is Candidiasis?

A

A common yeast infection that usually affects the vagina

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63
Q

What is herpes zoster?

A
  • Also known as Shingles
  • a disease caused by the same virus that causes chickenpox
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64
Q

What is onychogryphosis?

A

A hypertrophy that may produce nails resembling claws or a ram’s horn, possibly caused by trauma or peripheral vascular disorders, but most often secondary to neglect and failure to cut the nails for extended periods of time.[

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65
Q

What is Onychomycosis?

A
  • the most common of all diseases of the nails in adults
  • Individuals who are especially susceptible include those with chronic diseases such as diabetes and circulatory problems and those with diseases that suppress the immune system
  • More common in men than in women
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66
Q

What are some changes seen in the nervous system with aging?

A
  • Reduction of brain weight - 10% by 70
  • Reduction in nerve cells
  • Slower autonomic & voluntary reflexes
  • Increase pain threshold
  • Increase in senile plaques & neurofibrillary tangles
  • Decreased:
    • Cerebral blood flow
    • Neurotransmitters
    • Impulse velocity
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67
Q

What are Implications and Nursing Interventions for nervous system changes with aging?

A
  • Provide mental stimulation
  • Encourage them to be mentally active (crossword puzzles) •
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68
Q

What are some changes in sleeping patterns with aging?

A
  • 40% complain of sleep problems
  • Decrease in total sleep time in stages 3 & 4.
  • Frequent awakening
  • Changes in circadian rhythms – more multiphasic
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69
Q

What are some changes in the cardiovascular system with aging?

A
  • ↓ in tone and elasticity of aorta and great vessels → Aorta & other arteries stiffen
  • Heart sz. may increase slightly → slight increase in systolic BP
  • Heart valves thicken & stiffen
  • ↓ # pacemaker cells
  • ↓ cardiac reserve & output
  • Myocardium is slower to recover its contractility
  • Baroreceptors which monitor B/P become less sensitive
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70
Q

What are some changes in the respiratory sytem with aging?

A
  • Lungs stiffen / chest wall rigid
  • Total lung capacity constant

Decreased:

  • mobility of chest wall → elastic recoil of lung
  • cough reflex
  • vital capacity ↓ up to 50% by age 75
  • number of alveoli → Pa02 decreases with age
  • number & activity of cilia

Increased:

  • A-P diameter
  • residual volume
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71
Q

What are some nursing interventions for respiratory system changes with aging?

A
  • Deep breathing exercises
  • Encourage them to get the flu (yearly) and pneumonia vaccines (every 5 years)
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72
Q

What are some changes in the musculoskeletal system with aging?

A
  • Ht. ↓ (2-3 in.) due to loss of cartilage, thinning of vertebral disks, & curvature of spine
  • Kyphosis
  • ↓ in muscle mass (up to 30%) → ↓ in muscle strengt
  • Bone becomes more porous and brittle
  • ↓ Bone mineral & mass
  • Loss of Ca from bone → osteoporosis
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73
Q

What is Rheumatoid arthritis and what are some nursing considerations of this disease?

A
  • Rheumatoid arthritis (RA) is a long-term disease that leads to inflammation of the joints and surrounding tissues.
  • It involves symmetric joints (if one joint is inflammed, the other one will be too). Other musculoskeletal illnesses invovle isolated or unilateral joints.
  • RA pain is worse in the morning when arising.
  • RA stiffness occurs in the morning and after rest periods
  • Movement decreases pain
  • S/S: fatiuge, weakness, anorexia, Weight loss, low grade fever, lymphadenopathy.
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74
Q

What is Osteoarthritis and what are some nursing implications for this disease?

A
  • Osteoarthritis (OA) is the most common joint disorder, which is due to aging and wear and tear on a joint.
  • asymetric pain is localized and is worse usually later in the day
  • Movement increases pain
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75
Q

What is Osteoporosis?

A

A decrease in skeletal bone mass occuring when rate of bone resorption is > than that of bone formation

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76
Q

What are some risk factors w/ osteoarthritis?

A
  • age > 50
  • Family history ( eg Rheumatoid Arthritis)
  • Obesity
  • Joint abnormality
  • History of trauma
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77
Q

What are Bouchard & Heberden’s nodes and what is the difference between them?

A
  • they are nodes found on people’s hands with osteoarthritis
  • Bouchard’s nodes – proximal – closest to hand
  • Heberden’s nodes – distal – near fingertips
78
Q

What are some changes with the gastrointestinal system with aging?

A
  • Tongue atrophies, loss of papillae, teeth become brittle
  • Some atrophy of L & S intestine but motility of feces not largely affected

MOTILITY:

  • Decreased: esophageal peristalsis & emptying
  • Decrease in stomach motility

ABSORPTION:

  • Slower absorption of fat, Vitamins B, B12, D, Ca, & Iron

SECRETION:

  • Saliva is diminshed
  • Decrease in digestive enzymes (HCL acid & pepsin)
  • Increase in biliary lipid secretion (gallstones)
79
Q

What are some not normal changes with the gastrointestinal system with aging?

A
  • Tooth loss is abnormal. Causes: poor dental care, periodontal dz., poor diet.
  • Constipation is not normal. Other factors such as poor diet, lack of fiber & exercise are culprits.
80
Q

What are some changes to the kidney with aging?

A
  • **Delayed and less thirst response **
  • Blood flow to kidneys declines
  • Number / size of nephrons decrease
  • Tubular function decreases
  • Glomerular filtration rate decreases
  • Decreased ability to concentrate urine
  • Heightened risk of trauma, infection, etc.
81
Q

What are some changes to the bladder with aging?

A
  • Bladder muscles weaken
  • Increase in urgency & frequency
  • Increase in residual urine &urinary retention
  • Increase in nocturia
  • Bladder capacity decreases
  • Higher rate of UTI’s
  • Stress incontinence more common
82
Q

What are some changes to the female reproductive system with aging?

A
  • Estrogen production decreases
  • Ovaries become fibrotic & atrophy
  • Cessation of ovulation & Menopause
  • Loss of capacity to reproduce
  • Uterine lining thins & shrinks
  • Atrophy of vulva, cervix, & ovaries
  • Vaginal wall becomes thinner, drier, & lose elasticity
83
Q

What are some changes to the male reproductive system with aging?

A
  • Decrease in testosterone production
  • Size & firmness of testes decreases
  • Decline in rate of sperm production
  • Prostate enlargement
  • Takes longer to achieve erection, smaller, less firm, but maintained longer
  • Erectile dysfunction increases with age
84
Q

What are some changes to the endocrine system with aging?

A
  • Pituitary gland shrinks
  • Thyroid gland atrophies but function remains adequate
  • Reduced sensitivity to insulin
  • Decrease in adrenal gland secretion of glucocorticoids & steroids
  • Decrease in aldosterone levels
  • Decrease secretion of cortisol
85
Q

What are some changes to the immune system with aging?

A
  • Shrinkage of thymus gland
  • Decreased production of thymic hormones
  • Less production of antibodies
  • Response to antigens diminishes
  • Vulnerable to infections, tumors, & immune diseases
86
Q

What are “Geriatric Syndromes?”

A
  • S – leep disorders
  • P – roblems with eating and feeding (P) - ain
  • I – ncontinence
  • C – onfusion
  • E – vidence of falls
  • S – kin breakdown
87
Q

What are some changes in blood work with aging?

A

Decrease:

  • ​Hgb, Hct, & WBC (slight)
  • Creatinine, serum
  • Iron & B12
  • Potassium
  • T cells
  • T3 & T4
  • Protein
  • PO2

Increase:

  • E. Sed. Rate (slight)
  • B cells & Monocytes
  • BUN
  • Glucose (higher normal)
  • Cholesterol
  • Uric Acid
88
Q

What is a comprehensive functional assessment?

A

It is a thorough evaluation of a person’s ability to carry out basic tasks for self-care and tasks needed to support independent living.

89
Q

What is the goal of a comprehensive functional assessment?

A

To improve functional status and independence and enhance quality of life.

90
Q

What is the purpose of a thorough functional assessment?

A
  • The purpose of this is to get a baseline for the patient.
  • Should be performed on admission
  • Or when the patient’s condition changes
91
Q

How is the process of assessment of older adults strikingly different than assessment of younger adults?

A
  • Communication is different, they may not be able to understand what you are saying, and or physically able to do things, mobility and reaction time, looking for age related changes
  • Might have to be more patient with the pts.
92
Q

What are some myths related to functional ability?

A
  • # of conditions on problem list correlates with degree of functional status
  • Objective indicators of health are the best indicators of a person’s ability.
  • Severity of disease determines the presence of functional impairment
  • All problems of elderly are related to a result of “aging or having lived a long life.”
93
Q

What are the major components of a comprehensive functional assessment?

A
  • Physical Functioning
  • Cognitive Status
  • Psychological Status
  • Social Functioning / Support
  • Environmental Characteristics
94
Q

What is the acronym FANCAPES evaluate, and what does it stand for?

A

It is an acronym that assess basic functions

  • Fluids
  • Aeration
  • Nutrition
  • Communication
  • Activity
  • Pain
  • Elimination
  • Social skills
95
Q

What do you assess for in the fluids section of the acronym FANCAPES?

A
  • Evalue client’s current state of hydration
  • Assess client’s ability to obtain adequate fluids independently, to express thirst, to awallow effectively, and to evalue medications that affect intake an output
96
Q

What do you assess for in the aeration section of the acronym FANCAPES?

A
  • This section refers to the adequacy of oxygen exchange
  • You observe fro RR, depth of respirations at rest and during activity
  • Evaluate breath sounds and medications that may affect breathing
  • Determine O2 saturation level
97
Q

What do you assess for in the nutrition section of the acronym FANCAPES?

A
  • Examine mechanical and psychological factors in addition to the type and amaount of food consumed.
  • Assess ability to bite, chew, swallow, dentures, and condition of gums and teeth
  • Assess diet, medical restrictions, economic resources, and living conditions
98
Q

What do you assess for in the communication section of the acronym FANCAPES?

A
  • Assess the client’s ability to send and receive verbal and nonverbal information
  • Determine sight and sound acuity, adequate function of tongue, teeth, pharynx and larynx.
  • Determine client’s ability to red, write, and understand spoken language
99
Q

What do you assess for in the activity section of the acronym FANCAPES?

A
  • Asses the client’s ability to ambulate, eat, toliet, dress, and groom
  • Coordination, balance, finger dexterity, grip strength, and other abilities are necessary in daily life should also be assessed.
100
Q

What do you assess for in the pain section of the acronym FANCAPES?

A
  • Assess for physical, mental, and spiritual pain
  • Gather infromation about any recent losses or anxiety
101
Q

What do you assess for in the elimination section of the acronym FANCAPES?

A
  • Bladder and bowel elimination are asseessed
  • Examine for any urinary dribbling, incontinence, use of protective garments, or medications that affect voiding and intestinal peristalsis
  • Don’t use complex words when talking about bowel and bladder functioning
102
Q

What do you assess for in the social skills section of the acronym FANCAPES?

A
  • Asess the client’s ablity to negotiate in society, to give and receive love and friendship, and to feel self-worth
  • This assessment focuses on the individual’s ability to deal with loss and to interact with other people in give-and-take situations
103
Q

What does Katz ADL scale consist of?

A
  • Eating
  • Bathing
  • Dressing
  • Toileting
  • Transferring
  • Urine & Bowel Continence
104
Q

What does Lawton’s IADL scale consit of?

A
  • Telephone Use
  • Shopping
  • Food Preparation
  • Housework
  • Transportation
  • Medication Use
  • Money Management
105
Q

What are different tests uses to assess cognitive function?

A
  • Folstein Mini-Mental Status Exam
  • The Mini Cog
  • Clock Drawing
  • Time & Change Test
106
Q

What are the different parts of the folstein mini-mental status exam?

A
  • Orientation
  • Registration
  • Attention and Calculation
  • Recall
  • Language
107
Q

How would you conduct a mini-cog exam?

A
  • Instruct pt. to listen carefully to and remember 3 unrelated words and then to repeat the words.
  • Instruct pt. to draw face of a clock on a blank sheet of paper or on a sheet with the clock circle already drawn. After pt. puts numbers on clock face, ask him/her to draw hands of clock to read a specific time (11:10).
  • Ask pt. to repeat the 3 previously stated words.
108
Q

How would you conduct the time & change test?

A
  • Tell time on clock with hands set to 11:10.
  • Count out one dollar in change (provide 3 quarters, 7 dimes, & 7 nickels)
109
Q

What tools are used for a psychological assessment?

A
  • Geriatric Depression Scale
  • Spiritual Assessment (Jarel Spiritual Well-Being Scale & Stoll’s Guidelines for Spiritual Assessment)
110
Q

What does a family APGAR test consist of?

A
  • I am satisfied that I can turn to my family for help when something is troubling me.
  • I am satisfied with the way my family talks over things with me and shares problems with me.
  • I am satisfied that my family accepts and supports my wishes to take on new activities or directions.
  • I am satisfied with the way my family expresses affection and responds to my emotions, such as anger, sorrow or love.
  • I am satisfied with the way my family and I share time together.

Responses: Always, Some of the time, Hardly ever

111
Q

What does OARS Economic Resource Scale consist of?

A
  • It assess the availability & relationship with family, relatives, & friends

It lalso looks at :

  • employment,
  • Income & assets,
  • expenses,
  • financial resources, &
  • medical insurance
112
Q

What is a nursing facility resident assessment instrumenta and what is it used for?

A
  • It is an assessment required by CMS (Centers for Medicare & Medicaid Services) for all residents of Medicare/Medicaid approved N.H. & SNF
  • Required within 14 days of admission, major “permanent” change in condition, quarterly (selected items), & annually
  • Resident Assessment Protocols
  • Assists with care planning
113
Q

What is the purpose of the minimum data set?

A
  • Care Planning
  • Quality Improvement
  • Reimbursement – Medicare
  • Coordination
  • Delegation
  • Attestation of accuracy for some parts
114
Q

Who develops pressure ulcers?

A

Patients with:—

  • Fx hip
  • —Stroke
  • —Severe arthritis
  • —Paraplegia/Tetraplegia
  • —Children following heart surgery (back of the head)
115
Q

What are some risk factors for pressure ulcers?

A
  • —Friction
  • —Shear forces
  • —Incontinence, perspiration, urine, feces, drainage
  • —Blood or serum concentrations
116
Q

What is the purpose of a pressure ulcer risk assessment?

A
  • Reduce the incidence of pressure ulcers/improve quality
  • Identify who is and who is not at risk
  • Plan care based on risk factors and level of severity of risk factors
  • Avoid unnecessary expensive care
  • Improve quality of care and decrease costs
117
Q

When should a pressure ulcer risk assessment be done?

A
  • —Pressure ulcers develop in the early days & hours following admission
  • —Study of support surfaces….5 of 20 developed ulcers in one day
  • —Risk assessment should be done on admission for both prevention and treatment
  • —Skin assessment must be done on admission or hospitals can be penalized
118
Q

What are the different levels of risk scores for pressure ulcers and what does each group score represent?

A

Risk for pressure ulcer development based on score:—

  • 15-18 Mild Risk
  • —13-14 Moderate Risk
  • —10-12 High Risk
  • —9 or less Very High Risk
119
Q

What are some nursing interventions for mild risk (15-18 braden score) patients in regards to pressure ulcers?

A
  • —Turning reminders at night for some
  • —Maximal remobilization
  • —Protect heels—for some
  • —Manage moisture, nutrition and friction and shear
  • —High density foam mattress and chair cushions
  • * If other major risk factors present, advance to next level of risk
120
Q

What are some nursing interventions for moderate risk (13-14) braden score) patients in regards to pressure ulcers?

A
  • —High density foam replacement mattress
  • —Turning schedule (2, 3, or 4 hour) when in bed with 30 degree rule
  • —Maximal remobilization
  • —Protect heels through elevation
  • —Manage moisture, nutrition and friction and shear
  • * If other major risk factors present, advance to next level of risk
121
Q

What are some nursing interventions for high risk (10-12) braden score) patients in regards to pressure ulcers?

A
  • —High density foam replacement mattresses
  • —Turn 2, 3 or 4 hour, 30 degree rule with foam wedges or pillows
  • —Supplement with small shifts if necessary
  • —Maximal remobilization
  • —Protect heels
  • —Manage moisture, nutrition and friction and shear
122
Q

Describe nutrition management in relation to pressure ulcers

A
  • —Increase protein intake
  • —Increase calorie intake to spare protein
  • —Supplement with commercial product when meals are missed
  • —Supplement with Multi-Vitamins (esp A, C, E)
  • —Act quickly to alleviate deficits
  • —Consult a dietitian
123
Q

Describe mostiure management in relation to pressure ulcers

A
  • —Toilet at regular intervals
  • —Use commercial moisture barrier
  • —Use absorbent pads that wick and hold moisture…take off at intervals to let skin breathe
  • —Address causes of incontinence
  • —Provide plenty of water
124
Q

Describe friction and shear management in relation to pressure ulcers

A
  • —Elevate HOB no more than 30o
  • —Use trapeze when indicated
  • —Use lift sheet and friction reducing devices to move patients
  • —Protect elbows and heels if being exposed to friction
  • —Watch for friction from assistive devices, casts, bedrails, etc.
125
Q

What is a fall?

A
  • —Unintentionally coming to rest on a lower area such as the ground or floor
  • —Inadvertently coming to rest on the ground, floor or other lower level, excluding change in position to rest in furniture, wall or other objects
126
Q

What is the importance of falls to gerontologic nursing?

A
  • —Older adults are at greatest risk for falls
  • —Falls and/or their consequences can be fatal
  • —The cost of falls is high and is expected to increase
  • —Hospitals and Healthcare Professionals are responsible for fall prevention
  • —Rate of falls in the hospital setting is used as a Nursing Quality Indicator
127
Q

What are some risk factors for falls?

A

—Times of highest risk:

  • —Acute Illness
  • —Exacerbation of chronic illness

—The risk of falls increases with the number of risk factors

—Risk factors are categorized as:

  • —Intrinsic
  • —Extrinsic

—Most falls occur from a combination of intrinsic and extrinsic risk factors

128
Q

What are hospital acquired conditions?

A

—Conditions that are:

  • —High cost and/or high volume
  • —Result in the assignment of a case to a DRG that has a higher payment when presented as a secondary diagnosis
  • —Could have reasonably been prevented through the application of Evidenced Based guidelines – Such as falls
129
Q

What are some intrinsic risk factors for falls?

A
  • —Reduced vision
  • —Unsteady gait
  • —Cognitive impairment
  • —Foot deformities
  • —Hypotension
  • —Acute and Chronic Illness
  • —Effect of Medications
130
Q

What is the relationship between foot deformities and falls?

A

—Foot Deformities can cause unsteady gait:

  • —Neglect of corns, bunions and overgrown nails

—Other Causes of foot problems:

  • —Loss of fat cushioning related to aging
  • —DM- ulcers, neuropathy
  • —Poor fitting shoes

—As part of the head to toe assessment- inspect feet (top and bottom) and foot wear

131
Q

What are some extrinisic risk factors for falls?

A
  • —Lack of support equipment by bathtubs and toilets
  • —Height of beds
  • —Condition of floors
  • —Poor lighting
  • —Inappropriate footwear
  • —Improper use of assistive devices
  • —Inadequate assistive devices
132
Q

What are some nursing intreventions to prevent falls related to foot deformities?

A

—Instruct older adults/caregivers on proper foot care:

  • —Wash and thoroughly dry feet daily
  • —Trim toenails regularly
  • —Check top and bottom of feet as well as in between toes daily
  • —Report decreased sensation, tingling, etc to healthcare provider
  • —Wear properly fitting shoes and socks
133
Q

What is postprandial hypotension?

A
  • It is —a sudden drop in blood pressure after eating caused by increased blood flow to the digestive tract with failure of circulatory compensation.
  • —More common in the elderly and those with DM and Parkinson’s disease
134
Q

What are 3 consequences of falls?

A
  1. Hip fractures
  2. Traumatic brain injury
  3. Fallophobia
135
Q

What are the outcomes of hip fractures?

A
  • —Mortality
  • —Limitations in mobility
  • —Decline in bone mineral density, lean body mass, strength
  • —Decreased quality of life
  • —Persistent pain
  • —Depression
  • —Only ½ of patients with hip fractures recover to their pre-fracture ambulation status within 1 yr.
136
Q

What is a traumatic brain injury and what are some risk factors for it?

A

It is damage to the brain as the result from a violent blow or jolt to the head

—

Factors placing the older adult at risk:

  • —Comorbid conditions
  • —Use of Aspirin, Anticoagulants
  • —Age related brain changes
137
Q

What are the symptoms of a mild TBI?

A
  • —Low grade headache
  • —Memory loss
  • —Trouble with daily tasks
  • —Fatigue
  • —Change in sleep pattern
  • —Blurred vision
  • —Mood changes
138
Q

What are the symptoms of a moderate-severe TBI?

A
  • —Severe headache that gets worse
  • —Repeated vomiting or nausea
  • —Seizures
  • —Dilation of one or both pupils
  • —Weakness
  • —Confusion, restlessness, agitation
139
Q

What is fallophobia and what its effects?

A
  • It is the fear of falling
  • —Falls lead to loss of confidence which reduces physical activity which increases dependency and leads to social withdrawal.
140
Q

What is a postfall assessment and what does it consist of?

A
  • —Purpose is to identify the underlying cause, implement risk reduction programs and prevent future falls

—Postfall Assessment:

  • —Assess for any obvious injuries and provide appropriate care
  • —Physical Exam including vital signs
  • —Notify MD
  • —Description and circumstances of the fall from the patient or witness
  • —Associated Symptoms that occurred with fall
  • —Medication Review
  • —Environmental Assessment
141
Q

How would you instruct a person to get up from a fall?

A
  1. —Remain still on the floor or ground for a few moments. This will help you get over the shock of falling.
  2. —Decide if you’re hurt before getting up. Getting up too quickly or in the wrong way could make an injury worse.
  3. —If you think you can get up safely without help, roll over onto your side.
  4. —Rest again while your body and blood pressure adjust. Slowly get up on your hands and knees, and crawl to a sturdy chair.
  5. —Put your hands on the chair seat and slide one foot forward so that it is flat on the floor. Keep the other leg bent so the knee is on the floor.
  6. —From this kneeling position, slowly rise and turn your body to sit in the chair.
142
Q

What is the purpose of using assistive devices in older adults?

A
  • Broadens patient’s base of support
  • Improves balance and stability
  • Redistributes weight from lower extremities to: alleviate joint pain, compensate for weakness or injury
143
Q

What are the goals of using assistive devices?

A
  • Improve independent mobility
  • Reduce disability
  • Delay functional decline
  • Decrease the burden of care
144
Q

How would you instruct a patient to use a cane/walker when ambulating?

A
  • Advance cane/walker with affected leg, then move the unaffected leg forward
  • Posture should be upright without leaning forward
145
Q

How would you instruct a patient to use a cane when walking up stairs?

A
  • Walking up stairs- place cane on unaffected side and lead with unaffected leg
  • Moving cane with affected leg step up (keep cane in line with affected leg)
  • Healthcare provider remains behind patient
146
Q

How would you instruct a patient to use a cane when walking down stairs?

A
  • place cane on unaffected side. Place cane on lower step.
  • Step with affected leg first, then unaffected leg
  • Healthcare provider remains in front of patient
147
Q

What is nursing jurisprudence?

A

It is a system of ethical principles and legal mandates which govern the behavior of professional nursing practitioners to further the goal of promotion and protection of the health, safety, and welfare of the public

148
Q

What are laws?

A

binding rules of conduct enforced by authority.

149
Q

What is ethics?

A

Examines values, choices, and actions to determine right and wrong.

–Values: strongly held personal and professional beliefs about worth and importance of human beings upon which choices are made and actions taken.

150
Q

What does patient advovacy involve?

A
  • recognizing conflicts in values and beliefs
  • mediating, negotiating, clarifying, explaining, intervening (important to determine competency of elder’s understanding)
  • assuring respect, equality/fairness and right of human dignity toward others without discrimination
  • serving as a liaison between patient receiving health care and the health care system;
151
Q

What is competence?

A

A legal term used to indicate a person has decision-making capacity

152
Q

Why would you need to determine the decisional capacity of an individual?

A

To determine decisional ability of a person:

  • have an “ordinary” conversation
  • observe person’s behavior
  • talk with family, friends or staff
153
Q

How would you determine decisional capacity?

A

Discuss interactions between you and individuals whom you have interviewed, assessed their functional capacity and/or their nutritional status (identify age, gender, psycho-social being)

154
Q

What are some potential risk factors with the elderly regarding value based decisions?

A

Employment vs. Retirement:

  • (Medicare A and B; Social Security; Pension funds; Medicaid)

Living accommodations:

  • Independent /alone or with spouse or child; assisted-living facility; LTC/nursing home; CCRC/senior residential community (rental vs. “life-care”); use of day care facility

Driving:

  • continuing licensure vs. cessation

Polypharmacy:

  • prescriptive; OTC

Nutrition (adequate vs. inadequate)

  • Dehydration

Financial management:

  • cash; credit card/s;
  • bank account/s; investments; property ownership…Vulnerability to fraud/scams

Healthcare resources:

  • availability; accessibility

Healthcare insurance:

  • no coverage; Medicaid; Medicare; MCO/HMO; PPO; supplemental health insurance; Long Term Care insurance. “Fee for Service” as a choice for whom?
155
Q

What is decisional incapacity/in-competency?

A

Individuals who clearly lack capacity to decide for themselves, as manifested in “dementia” or in situations of “disorientation” or “delusions” whether transitory or irreversible

  • should have a surrogate decision-maker
  • even if person might be seriously incapacitated in decision-making, he/she might retain ability to designate an appropriate surrogate; allow him/her this choice to name the surrogate person
156
Q

How is Elder Abuse/Neglect/Exploitation defined?

A

It is defined by state law

157
Q

What does elder abuse incorporate?

A
  • Physical abuse (force with body injury)
  • Sexual abuse
  • Emotional/psychological abuse
  • Financial exploitation
  • Neglect “passive abuse” or Self-neglect
158
Q

What are some common signs and symptoms of elder neglect/abuse?

A
  • Vision and hearing problems
  • Decubiti; Unexplained bruises, burns, skin tears
  • Pain: What ways can be used as determinants?
  • Mobility vs. restraints (physical, drug/s)
  • Nutritional status; thirst and dehydration
  • Urinary and/or bowel incontinence
  • Over-medication or under-medication
  • Infection (URI, UTI; others?)
  • Poor personal hygiene; clothing appearance
  • Residential appearance (interior)
  • Social withdrawal; loneliness; despair; anger/hostility; fear
159
Q

What are some ethical issues with prolonging life in the elderly?

A
  • escalating medical costs; scarce public resources
  • increasing use of high technology for procedures/treatments
  • rationing of health care: decisions made by society vs. medical professionals
  • State law and the court system
160
Q

What does the patient self-determination do?

A
  • Ensures rights of individual/client/patient to “author or execute” written and signed instructions about his/her wishes for medical treatment in the event of becoming “incapacitated” and appropriately witnessed.
  • Requires health care facilities receiving Medicare funds to provide information about Advance Directives to patients on admission.
161
Q

What is an advance directive?

A

written statement that directs health care providers concerning consent or refusal of treatment when the individual patient does not possess decision-making capacity.

162
Q

What is a living will?

A

document that establishes a written mechanism for an individual to specify wishes about withdrawing or forgoing life-sustaining treatment (treatment that only prolongs or delays the process of dying

163
Q

How can advance directives/living wills be revoked?

A
  • Oral revocation
  • Destroying the document
  • Amending document in writing
164
Q

What does JCO mandate regarding advance directive and hospital policies?

A
  • that each hospital provides adult patients information to initiate Advance Directives; unless patient
  • has a valid document that is available to physician or on patient’s chart
165
Q

If an individual does not have a valid Advance Directives and does not have decisional-making capacity who make make decisions?

A
  • may use a Healthcare Proxy (surrogate) or
  • decisions can be made through state “guardianship” laws
166
Q

What are guardians?

A

individuals, agencies or corporations appointed by the court to have care, custody, and control of a legally disabled person (not medically disabled; cite examples).

167
Q

What are the functions of guardians?

A
  • Manage his/her personal and/or financial business
  • Make provisions for one’s physical health and safety, such as health care, food, shelter, personal hygiene (partial dependency) vs. “total dependency” person unable to meet basic needs for survival and manage his/her environment
  • Consider high risk for exploitation
168
Q

What is a terminal patient?

A

Any patient with a “lethal/deadly” disease or condition.

169
Q

Is refusal of life-sustaining treatment suicide?

A

nnot considered suicide by ethical standards; courts have ruled these practices as legally acceptable.

170
Q

What does a DNR order mean?

A
  • do not perform endotracheal intubation in event of cardiac arrest or respiratory failure;
  • do not resuscitate by chemical/drug, electrical or manual means;
  • do not contact “code team”; all other medical care will be provided unless ordered otherwise
171
Q

What is acculturation?

A

It is the willingness to modify one’s own culture as a result of contact with another culture. An individual’s adaptation to customs, values, beliefs, and behaviors of a new country.

172
Q

What is assimilation?

A

willingness of a person emigrating to a new culture to gradually adopt and incorporate characteristics of the prevailing culture

173
Q

What is Cultural competence?

A

conscious process of demonstrating knowledge and understanding of a client’s culture to recognize, accept, respect cultural differences; be able to incorporate these cultural beliefs and practices about wellness and illness into the delivery of care; and adapt interventions to be congruent with the client’s culture

174
Q

What is Health literacy?

A

knowledge and fundamental ability to manage illness as well as navigate the health care system

175
Q

What is a cultural assessment?

A

A systematic appraisal or examination of individuals, groups, and communities about their cultural beliefs, values, and practices to determine explicit needs and intervention practices.

176
Q

What is ethnicity?

A

How members of a group perceive themselves and how they are perceived by others; associations due to customs, and cultural patterns, rather than biological origins; a shared kinship.

177
Q

What is race?

A

generally defined as a biological factor of discrete group whose members share distinctive genetic, biological, and other factors from a common or claimed or ancestor.

178
Q

What is cultural marginality?

A

“situations and feelings of passive betweeness when people exist between two different cultures and do not yet perceive themselves as centrally belonging to either one.”

179
Q

What is Ethnocentrism?

A

universal tendency of persons to think that their ways of thinking, believing and behaving are the only right, proper and natural ways.

180
Q

What is a folk health system?

A
  • It embodies beliefs, values and treatment approaches of a particular cultural group that are products of cultural development.
  • It ses a holistic approach of family and support systems. When folk healing is not effective, person may turn to Western health care (scientific).
181
Q

What is the 4 step approach to providing culturally sensitive care?

A
  1. Examine personal culture
  2. Get familiar with client culture
  3. Identify adaptations made by client
  4. Modify the client teaching based on data from earlier steps
182
Q

What is the nurse’s role in the general assessment and when providing teaching assessments?

A
  • Observe interactions between client and family members and among family members.
    • Who makes the decisions? How are decisions made?
  • Consider communication abilities & primary language: verbal, non-verbal; etiquette of interaction-acceptable, nonacceptable.
  • ** Explore** customs or taboos to clarify beliefs and practices that may restrict care or treatment.
  • Determine importance of time and time periods to client and family.
  • Be aware of cues for interaction: respect is key behavior. Know correct way to address the persons.
183
Q

When would you consider the use of a professional translator/interpreter?

A
  • If client speaks foreign language, whenever possible the client’s primary language should be used.
  • Use of family or friends for translation of communication is not recommended; use professionally trained interpreters. Family or friends:
    • May choose to omit portions of content they believe to be unnecessary or unacceptable
    • Presence with client may inhibit communication & violate confidentiality.
184
Q

What are the 4 major cultural groups in the U.S.?

A
  1. American Indians/Native Americans/Eskimos: unique to the U.S.
  2. Asian/Pacific Islanders: composed mainly of people from Korea, Viet Nam, Laos, Thailand, Cambodia, Taiwan, Japan, China, Philippines, India, Pakistan
  3. Blacks: origins are mainly from Africa and Caribbean Islands.
  4. Hispanics: Mexicans, Puerto Ricans, Central and South Americans, Cubans.
185
Q

What are some characteristics of the hispanic culture regarding healthcare?

A
  • The centrality of the family and extended family is single most important source of social support
  • Heavy reliance on family has been linked to Hispanics’ low use of health care services
  • May view physical illness as an act of God; something to be endured; mental illness as an enemy’s hex or witchcraft from envy or vengeance; remains a stigma and not discussed with strangers; genetic defects attributed to God’s will; mother’s failure to care for herself or a hex
186
Q

How should a nurse communicate verbally and nonverbally to a hispanic patient?

A

Verbal:

  • Consider loudness as rude; requests should be in non-confrontational tone of voice
  • Converse in warm, respectful manner
  • Communicate serious/terminal illness with patient and family together

Nonverbal:

  • Direct eye contact may interpret as intimidation or “evil eye” from authority and opposite gender
  • Personal space: prefer to keep appropriate social distance
  • Silence may indicate disapproval, disappointment or anger; politeness or not understanding
  • Gestures: handshake appropriate between strangers
  • Touch: enjoy touching family members, friends but not by strangers
  • Time: usually focused on here and now; leave the future in God’s hands
  • Modesty greatly valued
  • Privacy: usually share info about illness with selected family/extended members. Do not share problems/conflicts outside the family
  • Self-care: expect hospital staff to give help or will wait for family member to help
  • Self-care management: may self-treat, especially if uninsured or questionable legal status
  • Special clothing includes crucifixes, religious medals, amulets. Clinicians should handle with respect
187
Q

What are some characteristics of the african american culture regarding healthcare?

A
  • Their strong religious values and beliefs (inner strength from their trust in God) may extend to feelings about health promotion and illness. “What happens is God’s will”.
  • May have folk practice beliefs about spirits in the world: animate or inanimate objects which have good or evil spirits (religious priests, witch doctor or medicine man have power to release hostile spirits). May use faith and “root healers” (herbalists) with biomedical resources
188
Q

What are major philosophical orientations of the asian/pacific islander culture?

A

Buddhism: “all existence is suffering”; pattern of authority is inferior to superior; man in harmony with universe; ancestor worship.

Hinduism: Dharma, traditional law of morality and ethics that establishes norms and expectations; roles/ceremonies based on caste system, focus on birth, marriage, death.

Muslim: Islam religion guides and governs all aspects of life; reading of the Quran; prayer highest form of worship; communicate with Allah. Do not expect Muslim leader (imam) to visit patient; summoned after death.

189
Q

What are some common values reflected Asian/Pacific Islander Culture?

A
  • Male authority and dominance
  • Strong family ties
  • Respect for parents, elders, teachers and other authority figures
  • Personal behaviors are a result of a sense of pride
190
Q

What are some common health behaviors of Asian/Pacific Islanders?

A
  • Older generation tend to have more difficulty adapting to acculturation; children usually adapt more quickly
  • Medical practices differ significantly from Western scientific medicine
  • Tend to seek health care only when seriously ill; “crisis oriented” (especially immigrants)
191
Q

What are some Major Characteristics of the Native American Culture?

A
  • Spiritual attachment to land and harmony with nature
  • Intimacy of religion and medicine; varies by individuals and with practices/rituals
  • Strong ties to extended family network, including entire tribe
  • Elders view children as assets, not liabilities; children given much freedom to learn from their decisions and live with the consequences of their actions
  • nBelief that supernatural powers exist in animate and inanimate objects

nDesire to remain Native American and avoid acculturation, especially elders

nLack materialism and desire to share with others

192
Q

Describe women in the arab american culture

A

Women expected to act in submissive role:

  • Preservation of female chastity
  • Fidelity prohibits adult males to be alone with female, except with spouse
  • Females omit handshakes; touching in marriage only

N3521 Gerontologic Nursing (3 decks)

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