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Gero 214 > Gero Exam 1 > Flashcards

Gero Exam 1 Flashcards

1
Q

Guidelines that establish an expectation for the nurse to provide safe, effective, and appropriate care.

A

Standards of Care in Nursing Practice

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2
Q

What is the purpose of the ANA in gerontological nursing?

A

Concerned with the assessment of nursing needs of older people, planning and implementing nursing care, and evaluating the effectiveness of such care.

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3
Q

What does HIPAA stand for and its purpose?

A

Health Insurance Portability and Accountability Act; it protects patient information and advocates for patients.

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4
Q

What are the four parts of Medicare coverage?

A

Part A: Hospital (inpatient, home health, hospice, nursing facility)
Part B: Medical
Part C: Medicare Advantage
Part D: Prescription drug coverage

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5
Q

What does DNR stand for?

A

Do Not Resuscitate; a medical directive indicating no CPR.

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6
Q

What does POLST stand for?

A

Physician Orders for Life-Sustaining Treatment

  1. CPR
  2. Medical Interventions
  3. Artificially administered nutrition
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7
Q

What is a Living Will?

A

A written expression of wishes regarding medical treatments in the event of a terminal illness.

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8
Q

What is the purpose of a Gero Assessment?

A

To identify strengths and limitations to deliver effective interventions and support optimum function.

Establish a baseline

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9
Q

What are pharmacokinetics?

A

What the body does to the drug, including absorption, distribution, metabolism, and excretion.

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10
Q

What are pharmacodynamics?

A

What the drug does to the body, including efficacy and toxicity.

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11
Q

What are some normal findings in the geriatric population?

A
  • Decreased renal and hepatic blood flow
  • Decreased lean body mass
  • Increased adipose tissue
  • Altered pharmacokinetic and pharmacodynamic responses
  • Increased insulin resistance
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12
Q

What is the purpose of therapeutic communication?

A

To promote the patient’s maximum degree of participation and trust.

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13
Q

What are the seven types of elder abuse?

A
  • Physical abuse
  • Sexual abuse
  • Emotional abuse
  • Financial exploitation
  • Neglect
  • Abandonment
  • Self-neglect
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14
Q

What is autonomy in the context of healthcare?

A

Self-determination; the right of patients to make their own healthcare decisions.

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15
Q

What is primary prevention?

A

Seeking out services and education to prevent disease, such as immunizations and yearly well visits. (EDUCATION, immunizations)

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16
Q

What is secondary prevention?

A

Detecting early disease and seeking care before symptoms become apparent. (Screening; mammogram/colonoscopy)

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17
Q

What is tertiary prevention?

A

Care of established disease aimed at restoring the highest function and minimizing complications. (REHAB)

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18
Q

What is quaternary prevention?

A

Limiting disability while maintaining functional ability through adaptation.

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19
Q

What are possible barriers to patients obtaining healthcare?

A

Lack of transportation
Financial limitations
Lack of insurance coverage
Lack of availability
Language barriers
Health illiteracy

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20
Q

What factors contribute to dehydration in older adults?

A
  • Decreased intake of fluids
  • Altered thirst mechanisms
  • Confusion, depression, dementia
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21
Q

What should you look out for when patients are on loop diuretics such as furosemide (Lasix)?

A

Monitor for electrolyte imbalances, especially hypokalemia

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22
Q

What is sarcopenia?

A

Muscle wasting due to inactivity, disuse, and insufficient dietary protein.

Patient will need high protein diet to promote healing and RN should monitor albumin/pre-albumin levels

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23
Q

What is cachexia?

A

Loss of fat and muscle mass, often seen at the end of life with anorexia.

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24
Q

What is xerostomia?

A

Dry mouth; can lead to mucositis and dental caries.

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25
What is a possible complication of an oral infection?
Endocarditis
26
What is the effect of sleep-wake cycle changes in older adults?
Reversed sleep patterns can lead to insomnia.
27
What is the second leading cause of blindness in older adults?
Glaucoma
28
What are the clinical manifestations of chronic glaucoma?
* Slow vision loss * Peripheral vision loss * Intolerance to glare * Difficulty adapting to dark
29
What are the clinical manifestations of acute glaucoma?
* Occurs suddenly * Very high intraoccular pressure * Blurred vision, N/V, severe peripheral loss, severe pain * MED EMERGENCY
30
Which medications are used for glaucoma?
travoprost (Tarvatan) - also used for ocular HTN latanoprost (Xalatan) bimatoprost (Lumina) **beta blockers**
31
What is the treatment for cataracts?
Surgery is required to correct the vision.
32
What is diabetic retinopathy?
A microvascular complication of diabetes causing **central vision loss** and can lead to blindness.
33
What is the nursing diagnosis for patients with visual impairment?
Risk for injury due to decreased visual acuity.
34
How to administer ophthalmic medication?
Hand hygiene Place bottle as close to the eye as possible w/o touching it Place drops in lower eyelid pocket Wait **5 min** between administering multiple meds Close the eye and press lower eye lid for 1 min
35
What are the two types of hearing loss and main characteristics?
Sensorineural (**presbycusis**) - damage to the inner ear or auditory nerve; normal part of aging Conductive - **sound waves cannot efficiently travel** through outer/middle ear; may be caused by cerumen buildup, fluid in the middle ear, perforated eardrum, or otosclerosis
36
What are the signs of elder abuse?
* Bruises * Wounds * Unsanitary living conditions * Unexplained disappearance of funds
37
What is the role of nutrition in wound healing?
Adequate **protein intake** is essential for wound healing.
38
What are signs of decreased hearing?
Complaining about people mumbling Difficulty understanding women and children talking Asking for frequent repetition of what others say Hard to follow conversation when two or more people are talking Difficulty hearing over the phone Turning up volume so loud that others complain Presence of background noise interferes with ability to hear
39
What physiologic changes occur in vision as people age?
Eyelids lose tone and become lax **Sclera develops brown spots, cornea yellow** Pupils decrease in size and lose some ability to constrict **Peripheral vision/night vision diminishes Sensitivity to glare increases** Lens increases in density and rigidity
40
What is cerumen impaction?
Build up of ear wax in the ear canal d/t atrophic changes in sebaceous and apocrine glands, which leads to drier cerumen
41
What are some treatments for cerumen impaction?
* Cerumen removal * OTC cerumenolytic agents * Baby oil, mineral oil, liquid docusate sodium, or hydrogen peroxide * Water or saline irrigation
42
What nursing care should be provided for cerumen impaction?
**Teach patient how to instill cerumen softening agents Document cerumen removal and patient’s response**
43
What are the clinical manifestations of tinnitus?
Noise in ear defined as ringing, buzzing, hissing
44
What treatments are available for tinnitus?
* Treat correctable problems * Softening loud sounds through improved acoustics * Using protective ear plugs * Avoiding ototoxic substances
45
What is the purpose of neuro/cognitive/sensory/functional assessment in the elderly?
To identify impairment
46
What are some assessment tools used for cognitive impairment?
* Mental status assessment * Neurologic assessment * Functional assessment * Mini-Cog * MOCA * Geriatric depression scale (GDS)
47
What are common clinical manifestations of Alzheimer's dementia?
* Repeated questions and statements * Forgetting to pay bills or take medicine * Language deterioration * Mood swings * Increasing problems with orientation
48
What is 'sundowning' in Alzheimer's patients?
Tendency for confusion and agitation to increase in the late afternoon or evening
49
What is the gold standard for definitive diagnosis of Alzheimer's?
Autopsy
50
What are cholinesterase inhibitors used for in Alzheimer's treatment? (and give examples)
To decrease signs and symptoms of mild to moderate Alzheimer’s disease Donepezil Rivastigmine
51
What are common side effects of anticholinergics medications used for Parkinson’s Disease?
**drying up effect** risk for dehydration, constipation
52
What is the primary effect of N-Methyl-D-Aspartate (NMDA) receptor antagonist in Alzheimer's treatment?
Delaying some symptoms’ progression
53
What are the clinical manifestations of Parkinson's Disease?
**Tremorsd at rest Bradykinesia Rigidity Impaired postural reflexes**
54
What is the risk of benzodiazepines in geriatric patients?
Increased risk for **cognitive impairment**, CNS depression and **severe orthostatic hypotension** = **Fall Risk**
55
Which is the drug of choice for the older adult with depression?
SSRI's
56
MAOI's nursing considerations in geriatric patients?
Serotonin syndrome/hypertensive crisis - medication has dietary restrictions (no tyramine) and should not be used in combo with other serotonin increasing drugs One study showed selegiline (MAOI) in combo with levodopa (Dopaminergi) = higher mortality rate
57
What are the warning signs of a stroke?
BE FAST = **B**alance, **E**yesight changes, **F**acial drooping, **A**ctivity (leg/arm weakness and numbness), **S**lurred speech, **T**ime to call 911 * Severe headache with no known cause
58
What are the two main types of strokes?
* Ischemic * Hemorrhagic
59
What is the primary medical management for ischemic strokes?
Thrombolytic agents within 3 hours of onset
60
What are the primary prevention strategies for stroke (modifiable risk factors)?
* Manage ideal body weight * Manage cholesterol * Stop smoking * Reduce alcohol consumption * Eliminate illicit drug use
61
What is delirium, and what are its clinical manifestations?
**Sudden change in cognitive function** Difficulty concentrating Slurred/forced/rambling speech Disorganized thinking
62
What is the role of respite care in supporting caregivers?
Provides temporary relief for caregivers
63
What is the risk of dysphagia in older adults?
Aspiration pneumonia
64
What are some common infectious processes that older adults are at risk for?
UTI Pneumonia
65
What are common physiological changes in older adults affecting the urinary system?
Diminished ability of the immune system and decreased urinary function **which can lead to more frequent UTI**
66
How is dehydration assessed in older adults?
Assess for tenting at the glabella or below the clavicle
67
What is a tertiary prevention strategy?
Initiate rehab program early ## Footnote This strategy aims to reduce the impact of an ongoing disease.
68
What nursing implementation should be done to prevent increased intracranial pressure (ICP)?
Position patient 30-45 degree angle ## Footnote This position helps in managing ICP effectively.
69
What nursing actions should be taken to promote mobility and independence?
Encourage ROM, turn q2h, monitor for DVT, encourage use of unaffected arm for ADLs, put on clothing on affected side first ## Footnote These actions help maintain mobility and prevent complications.
70
When can a patient resume an oral diet after a stroke?
After successful completion of swallow evaluation ## Footnote This evaluation ensures the patient's safety during eating.
71
What is a key indicator of a patient returning to baseline after a UTI?
Mental status change ## Footnote Monitoring mental status is crucial rather than relying on temperature or WBC counts.
72
What does SPICES stand for?
**S**leep Disorders **P**roblems with Eating or Feeding **I**ncontinence **C**onfusion **E**vidence of Falls **S**kin Breakdown
73
The priority focus of nursing care for the patient with dementia is:
Maintaining cognitive and global **function** early in the disease process to postpone the need for institutional care
74
The leading cause of blindness among older adults in the US is:
Macular degeneration
75
What is the cornerstone of fall prevention and management?
Patient education
76
Falls related to gait, balance, and stability are examples of _______ risk factors.
intrinsic
77
Which agency would you report elder abuse to?
Adult Protective Services (APS)
78
What is a major complication of shingles?
Postherpetic neuralgia (nerve pain)
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Gero 214 (11 decks)

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