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Med Surg 1 > Exam 2- Nursing Management of the Older Adult > Flashcards

Exam 2- Nursing Management of the Older Adult Flashcards

1
Q

Life expectancy varies by…

A

Gender and race

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2
Q

Preventative health care (3)

A

Encouragement
Community-based support services
Promote lifelong health behaviors

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3
Q

Which of the following interventions is the MOST effective way to promote preventative healthcare in the older adult population?
A) Encouraging a high-protein diet to enhance muscle strength
B) Advising a one-time pneumonia vaccine at age 65
C) Recommending bi-annual bone density tests starting at age 70
D) Encouraging regular moderate exercise to maintain cardiovascular health

A

D) Encouraging regular moderate exercise to maintain cardiovascular health

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4
Q

Leading cause of death

A

Heart disease

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5
Q

Decreased cardiac output

A

Myocardial hypertrophy

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6
Q

Reduced stroke volume

A

Increased fibrosis

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7
Q

Hypertension and increased workload

A

Calcium and fat deposits

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8
Q

Slower heart recovery rate due to…

A

Stress

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9
Q

Orthostatic hypotension

A

BP drops when standing up or sitting down

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10
Q

Age-related change in the respiratory system: onset

A

Subtle and gradual

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11
Q

What happens to respiratory efficiency in older adults?

A

Diminished

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12
Q

What happens to inspiratory and expiratory force in older adults?

A

Reduced

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13
Q

What happens to lung mass in older adults?

A

Decreases

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14
Q

What happens to residual volume in older adults?

A

Increases

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15
Q

Most significant risk factor for respiratory system in older adults

A

Smoking

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16
Q

What happens to epidural proliferation in older adults?

A

Decreases

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17
Q

What happens to the dermis in older adults?

A

Becomes thinner

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18
Q

What happens to elastic fibers in older adults?

A

Reduced

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19
Q

What happens to collagen in older adults?

A

Becomes stiffer

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20
Q

What happens when subcutaneous fat diminishes?

A

Less likely to conserve body heat

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21
Q

With wrinkling and sagging of the skin, what happens?

A

Loss of resiliency

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22
Q

Does hair pigmentation change?

A

Yes, and balding may ocur

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23
Q

Why does sex decline for women?

A

Loss of partner, widowhood

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24
Q

Why does sex decline for men?

A

Poor health, erectile dysfunction, medications, and emotional factors

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25
Q

What happens to the reproductive system in females?

A

Vaginal narrowing
Decreased elasticity
Decreased vaginal secretions
Involution
Decreased tone

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26
Q

What happens to the reproductive system in males?

A

Less firm tests but may continue to produce viable sperm up to 90+ years of age
Diminished production of testosterone

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27
Q

What happens to the filtration rate in older adults?

A

Decreased

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28
Q

What happens to the tubular function?

A

Diminished, with less efficiency in reabsorbing and concentrating the urine

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29
Q

What happens in the genitourinary system from the response of stress?

A

Slower restoration of acid-base balance

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30
Q

What can occur in the genitourinary system in males?

A

Benign prostatic hyperplasia

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31
Q

What occurs in the genitourinary system in females?

A
  • Relaxed perineal muscles
  • Detrusor instability (urge incontinence)
  • Urethral dysfunction (stress urinary incontinence)
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32
Q

Normal BUN

A

7-20

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33
Q

Normal creatinine

A

0.7-1.3

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34
Q

What happens to sense of thirst, smell, and taste in older adults?

A

Decreases

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35
Q

What happens to salivation in older adults?

36
Q

What happens with chewing and swallowing food in older adults?

A

More difficulty

37
Q

What happens to esophageal, gastric emptying in older adults?

38
Q

What is diminished in the gastrointestinal system in older adults?

A

Secretion of gastric acid and pepsin

39
Q

What happens to gastrointestinal motility in older adults?

40
Q

Do older adults require more or fewer calories?

41
Q

Recommendations for nutritional health in older adults?

A

Reduce fat intake
Intake sufficient protein, vitamins, minerals, and dietary fiber for health and prevention of disease

42
Q

What may interfere with food shopping and meal preparations?

A

Budgetary constraints and physical limitations

43
Q

Factors that affect sleep quality (5)

A
  • Respiratory problems
  • Restless leg syndrome
  • Nocturia
  • Pain
  • Dementia
44
Q

Consequences of poor sleep (6)

A
  • Cognitive decline
  • Increase risk for falls
  • Daytime fatigue
  • Reduced physical and mental health
  • Reduced quality of life
  • Poor ICU outcomes
45
Q

What is there a loss of in the musculoskeletal system in older adults?

A

Loss of bone density
Loss of muscle strength
Loss of muscle size

46
Q

What deteriorates in the MSK system in older adults?

A

Muscle fibers and cell membranes

47
Q

What happens to joint cartilage in the MSK system in older adults?

A

Degenerated joint cartilage

48
Q

What is difficult to maintain in the nervous system in older adults?

A

Homeostasis

49
Q

In the NS, there are decreased nerve cells in older adults. What does this mean for the brain?

A

Small loss of brain mass

50
Q

What happens to the speed in nerve conduction in the NS in older adults?

51
Q

What happens along with physical illness in older adults?

A

Increased confusion, loss of environmental cues

52
Q

In the NS, older adults may become faint and lose balance. What is this?

A

Reduced cerebral circulation

53
Q

Primary cause of loss of vision

A

Macular degeneration

54
Q

What happens with vision in older adults?

A
  • Diminished ability to focus on close objects
  • Inability to tolerate glare
  • Difficulty adjusting to changes of light intensity
  • Decreased ability to distinguish colors
55
Q

Prejudice or discrimination against older adults

56
Q

Negative images in society

A

An understanding of the aging process and respect for each person as an individual can dispel the myths of aging

57
Q

Psychosocial aspects (3)

A

Ageism
Fear of aging
Negative images in society

58
Q

Common stressors (5)

A
  • Normal aging changes that impair physical function, activities, and appearance
  • Disabilities from injury or chronic illness
  • Social and environmental losses related to loss of income
  • Decreased ability to perform previous roles and activities
  • Death of significant others
59
Q

Coping: Who do older adults commonly rely on for comfort during stressful times?

A

Their families and spiritual beliefs

60
Q

Abilities to adapt to change, make decisions, and respond predictably are determined by…

A

Past experiences

61
Q

Where do most older adults live?

A

In the community

62
Q

Places for older adults to live (5)

A
  • Nursing home
  • At home or with family
  • Continuing care retirement communities
  • Assisted living facilities
  • LTC facilities
63
Q

Focuses on physiology, pathology, diagnosis, management of disorders, and diseases of older adults

A

Geriatrics

64
Q

Nursing process applied to older adults in all environments, including acute, intermediate, skilled care, and in the community

A

Gerontologic/geriatric considerations

65
Q

Combined biologic, psychological, sociologic study of older adults within their environment

A

Gerontology

66
Q

Nursing management for older adults (9)

A
  • Supporting cognitive function
  • Promoting physical safety
  • Promoting independence in self-care activities
  • Reducing anxiety and agitation
  • Improving communication
  • Providing for socialization and intimacy needs
  • Promoting adequate nutrition
  • Promoting balanced activity and rest
  • Supporting home, community-based, and transitional care
67
Q

Aging changes alter drug… (4)

A

Absorption
Metabolism
Distribution
Secretion

68
Q

Polypharmacy

A

Administration of multiple medications at the same time; common in older adults with several chronic illnesses

69
Q

Nursing implication for medication dosage

A

Start low, go slow

70
Q

Most common mental health problems in older adults

A

Depression
Increased suicide risk
Substance misuse
Delirium

71
Q

Acute, confused state that begins with disorientation

72
Q

If mental illnesses aren’t immediately evaluated and treated, what might happen?

A

Can progress to changes in LOC, irreversible brain damage, and sometimes death

73
Q

Dementia symptoms onset

A

Subtle and progresses slowly

74
Q

Accounts for 70% of dementia

A

Alzheimer’s disease

75
Q

Non-Alzheimer’s disease

A

Degenerative, vascular, neoplastic, demyelinating, infectious, inflammatory, toxic, metabolic, and psychiatric disorders

76
Q

Seventh leading cause of death for adults over age 65

A

Alzheimer’s disease

77
Q

Alzheimer’s disease affects how many of those 85 years and older?

78
Q

Is Alzheimer’s a normal aging process?

79
Q

Two types of Alzheimer’s disease

A

Familial/early onset
Sporadic/late onset

80
Q

Nursing management of Alzheimer’s (9)

A
  • Supporting cognitive function
  • Promoting physical safety
  • Promoting independence in self-care activities
  • Reducing anxiety and agitation
  • Improving communication
  • Providing for socialization and intimacy needs
  • Promoting adequate nutrition
  • Promoting routine, including balanced activity and rest
  • Supporting home, community, and transitional care
81
Q

Geriatric syndromes (9)

A
  • Geriatric triad
  • Impaired mobility
  • Dizziness
  • Falls and falling
  • Urinary incontinence
  • Increased susceptibility to infection
  • Altered pain and febrile responses
  • Altered emotional impact
  • Altered systemic response
82
Q

Elder neglect and abuse (6)

A
  • Physical
  • Psychosocial
  • Emotional
  • Sexual
  • Abandonment
  • Financial exploitation
83
Q

Potential economic effects in older adults (5)

A
  • Social services
  • Health care costs of aging
  • Home health care
  • Hospice services
  • Aging with a disability
84
Q

When reviewing the need for medication, there are 3 things to do

A
  • Factors that affect compliance
  • Keep medication regimen as simple as possible
  • Strategies to improve compliance
85
Q

What nursing implications for medication?

A

Assess knowledge
Review need for medication, coordination of prescriber

Med Surg 1 (14 decks)

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