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Gero 1 Flashcards

1
Q

Defining Aging

A
  • described since birth
  • old is 65; qualifies for retirement benefits
  • biological aging based on cellular decline
  • sociological aging is based on changes in roles and relationship
  • psychological aging is based on aging as a developmental stage fo through
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2
Q

marital status

A
  • 70% of people 65 and older are married
  • older men are more likely to be married than older women
  • women outlive men
  • marital status impacts income, mobility, housing, intimacy, and social interaction
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3
Q

struggles of elderly women

A
  • twice as likely to be poor
  • pay inequity, occupational differnces
  • rising health care cost
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4
Q

Financial status

A
  • major source of income: social security
  • half of older adults had less than 24,224 in yearly income
  • poverty is major issue
  • poverty: gender and race
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5
Q

Health concerns

A
  • 80% of older adults have at least 1 chronic condition
  • leading cause of death among older adults: heart disease, cancer, chronic lower res. disease, stroke, Alzheimer’s disease, and diabetes
  • most common health concerns: arthritis and hypertension
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6
Q

comorbidities

A

more than 1 chronic diseases

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7
Q

cultural groups

A
  • the largest growth in older adults is Hispanic pop
  • united states is rich w diversity
  • immigrant pop growing
  • intergenerational conflict
  • adaptation to institutional norms
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8
Q

ageism

A
  • prejudice against older adults
  • media portrayal of aging
  • one’s attitude towards aging depends on culture and history
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9
Q

ADLS

A

activities of daily living

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10
Q

IADLs

A

instrumental activities of daily living

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11
Q

aging in place

A

remain were they live- own home

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12
Q

acute care

A

acute conditions with chronic issues (comorbidities)
Dangers- drug reactions, falls, immobility, confusion
Other issues- sepsis, nutritional status, never events/ wounds
Nursing care- promotion of safety, assessment of baseline function, goal is to max independence, and enhance functioning

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13
Q

Subacute care

A

pt are stable but still actue, do not need daily physician visits, services like rehab, IV therapy

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14
Q

Rehab units

A

located in hospital, subacute care, SNF
- goal is rehab to return to original place

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15
Q

community-based residential facility (CBRF)

A

a place where 5 or more unrelated people live together in a community setting
services provided include room and board, supervision, support services, and may include up to 3 hours of nursing care per week

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16
Q

Residential care apartment complexes (RCAC)

A

independent apartment units in which the following services are provided: room and board, up to 28 hours per week of supportive care, personal care and nursing services

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17
Q

Adult family home (AFH)

A

3-4 adults reside and receive care, treatment, or services that are above the level of room and board

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18
Q

SNF

A

the decision to move in depends on pt physical/cognitive needs, support system, community resources
emphasis on quality of life and residents rights

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19
Q

Resident assessments

A

RAI- ongoing comprehensive assessment of the resident, focusing on functional abilities - long term
- hearing & speech, vision, cognition, mood, behavior, routines, functional status (incontinence), bladder and bowel, active disease, oral health, skin, nutrition, meds

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20
Q

Home care

A

multiple services or just a few
criteria: must have skilled care needed, person must be homebound, require intermittent care
must have physicians statement supporting need for homecare

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21
Q

OASIS

A

-outcome and assessment info set
- mandated by CMS for performance improvement in home care

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22
Q

community programs and services

A

senior centers, adult day care, respite care, homemaker services

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23
Q

medicare

A

federal health insurance program

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24
Q

Medicaid

A

combo of state and federal funds to pay for SNF

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25
Q

legal and ethical issues

A

common concerns: capacity and competence to make own decisions, identification of decision makers, conflict about care, disclosure of info, long-term care decisions, end of life, fraud

26
Q

OBRA

A

omnibus Budget Reconciliation act of 1987
major reform of nursing facilities
major parts: provision of services for nursing facilities, survey and certification process, enforcement of regulations
resident empowerment and rights

27
Q

quality of care

A
  • focus on SNF
  • three major areas: reduce overuse of antipsychotics, reduce inappropriate use of restraints, reduce inappropriate use of indwelling urinary cath
28
Q

resident rights

A

resident bill of rights

29
Q

Older Americans Act (OAA)

A

directs states to provide various services for older adults

30
Q

ombudsmen

A

a person to come in and speak up for residents of that facility

31
Q

health insurance portability and accountability act of 1996 (HIPPA)

A

privacy and insurance coverage

32
Q

abusive and protective servicies

A
  • neglect
  • abuse - domestic- individual with a special relationship, institutional - facility caregiver, self-abuse
    -exploitation
  • mistreatment
    -physical, sexual, emotional
33
Q

The nurse as an interviewer

A

communication techniques, attitude, respect, consider barriers, be aware of verbal and non- verbal communication

34
Q

education

A

teaching the individual in a place that feels safe for them and assessing their personal needs to learn in an environment

35
Q

components of the assessment

A

health history, physical assessment, specific assessments (functional, adl, fall, nutritional)

factors that affect the norm - lab values, atypical presentation of illness, loss or decrease in compensatory reserve, and decrease immune response

36
Q

Physical assessment

A

challenges with assessment - nonspecific signs and symptoms, reduced energy level, pain, sensory deficits, multiple health issues

37
Q

sensory changes

A

can lead to anxiety
causes of deprivation
-reduced sensory capacities
-restrictive, monotonous environments
sensory overload
-usually related to abrupt changes or hospital delirium

38
Q

sensory changes 2

A

smell - decreased
taste - modest decrease
tactile - decreases skin changes, and decreased functioning of sensory neurons
eyes and vision - cataracts, glaucoma, need for more light, yellowing of lenses, decreased color and clarity
auditory - presbycusis

39
Q

Integumentary

A

skin assessment - determine hydration status, potential for infection
changes in older adults
- decreased thickness, elasticity
- dry skin
- decrease vascular supply to skin and glands - decreased sweating
- decreased sensation
- decrease subq fat - body cooling system
hair - melanin decreases (hair turns gray)
hair loss
men - increase hair in ears, nose, and eyebrows
women- hair on face and chin (change in hormonal influences
nails- brittle, flat

40
Q

Benign skin conditions

A

uneven pigmentation - age spots
seborrheic keratoses - think, brown raised lesions
cherry angiomas - increased vascularity in the dermis
skin tags - small flesh-colored tumors

41
Q

dermatoporosis

A

chronic skin fragility
35% of older adults
skin changes
actinic purpura
white pseudoscars

42
Q

arterial ulcers

A
  • pain w exercise or rest
    -cramping, burning, aching
    -cool, thin, shiny, dry
  • loss of hair
  • thick toenails
  • ulcers - well defined, outer ankle, feet, toes
    treatment - revascularization
43
Q

venous ulcers

A

stasis ulcers
brownish skin discoloration (accumulation of erythrocytes)
medical aspect of lower leg
flat, shallow, exudate
treatment - prolonged elevation and compression therapy

44
Q

diabetic lesions

A

neuropathy - risk factor
foot inspection and care
risk for amputation

45
Q

pressure injury assessment

A

major risk factors
-shearing
-friction
-moisture
-nutritional status (protein deficiency)

46
Q

Muscko

A

changes in stature and posture
decrease bone density
decrease joint movement
vertebral disc height thins
less flexibility
sarcopenia - age-related changes to muscles
-tissue mass decreases
-decreased strength and stamina
nursing implications
- mobility; assisted devices
- increase risk of falls

47
Q

atherosclerosis

A

plac build-up , black stuff that builds up - not normal

48
Q

arteriosclerosis

A

normal hardening of arterial walls

49
Q

cardiovascular

A

arterial wall thickening and stiffening
left ventricular and atrial hypertrophy
sclerosis of atrial and mitral valves
strong arterial pulses, diminished peripheral pulses, cool extremities
decreased cardiac reserve and efficiency

50
Q

respiratory

A

decreased respiratory muscle strength; stiffer chest wall
diminished ciliary & macrophage activity, drier mucus membranes
decreased cough reflex
increase risk of aspiration
decreased lung capacity

51
Q

renal and urological

A

loss of nephrons, kidney mass, ability to concentrate urine, decreased kidney size and decreased blood flow to kidneys, decreased glomerular filtration rate (GFR), unable to tolerate dehydration or fluid overload as well as a younger adult, itching, edema, raised BP

52
Q

digestion and nutrition

A

decreased sensitivity to insulin
changes in dental health
decreased taste buds and salivary secretions
decreased digestive juices
GERD
decreased absorption of nutrients
constipation is not a normal part of aging

53
Q

Nervous system

A

most changes in aging are seen in CNS - decrease brain weight and size
loss of deep sleep
subtle changes in cognitive and motor functioning and balance
slower PNS functioning, prolonged recovery
increase risk of falls

54
Q

reproductive system

A

women - menopause, structural changes typical of aging muscles and skin, vaginal dryness
men - able to procreate entire lives following puberty, but structure changes may interfere with sperm motility. BPH (Benign prostatic hypertension) is another common issue

55
Q

other changes

A

decrease antibodies
slower healing
reduce cellular immunity
lean body mass declines and body water is lost
temp regulation issues

56
Q

SPICES

A

-sleep disorders
-problems w eating or feeding
-incontinence
-confusion
-evidence of falls
-skin breakdown

57
Q

functional assessment

A
  • important because actual age does not reveal individual ability
  • hospitalized older adults are at risk for loss of function skills
  • loss of function is the major cause of institutionalization
58
Q

goals of functional assessment

A
  • restore/ improve health
  • monitor changes in health
  • enhance independence
  • identify disabilities
  • screen for issues needing further assessment and referral
  • evaluate need for community resources, equipment
59
Q

components of the functional assessment

A
  • environmental
  • physical
  • psychological
  • socio - economical
60
Q

mobility

A

upper extremity
-touch palms to back of head
-reach up over the head
-tough hands together behind waist
lower extremity
-get up and go test
indications for therapy

61
Q

fall risk assessment

A

tinettie balance and gait evaluation
morse fall scale
hendrich II scale

62
Q

cognitive assessment

A

short portable mental status questionnaire
mini-mental state exam
mini-cog

Gero 1 (2 decks)

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