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Gero- Falls/Fall risk reduction-chapter 19 Flashcards

1
Q

Mobility and comparative agility are based on what?

A
  • Muscle strength
  • Flexibility
  • Postural stability
  • Vibratory sensation
  • Cognition
  • Perceptions of stability
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2
Q

What is Gait and mobility impairment a result of?

A

-Chronic disease and Trauma

***Falls can be detrimental syndrome

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3
Q

Impairment of mobility is an early indicator of physical disability and is associated with poor outcomes such as?

A
  • falling
  • loss of independence
  • depression
  • decreased quality of life
  • institutionalization
  • death
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4
Q

Maintenance of mobility and function is an essential component of?

A

-Best practice gerontological nursing and its effectiveness in preventing falls, unnecessary decline, and loss of independence (keep pt. mobile and independent as possible)

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5
Q

What is one of the most important geriatric syndromes and the leading cause of morbidity and mortality in older people?

A

-Falls

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6
Q

Falls are the leading cause of?

A

-Fatal and Non-fatal injuries

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7
Q

Falls are significant?

A
  • Public health problems

- Preventable

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8
Q

What is an important consideration in the Quality and Safety Education for Nurses safety competency?

A

-Education on falls and fall risk reduction

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9
Q

How many hip fractures are caused by falls?

A

95%

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10
Q

How many deaths are from fractures in a month?

A

10%

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11
Q

How many deaths are from fractures in a year?

A

30%

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12
Q

How many deaths are from fractures in a 8 years?

A

80%

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13
Q

How many older adults will not regain level of function after fall/pre fall?

A

50%

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14
Q

What older adult age has the highest rates of TBI- related hospitalizations and death?

A

75 years

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15
Q

What is the leading cause of TBI for older adults?

A

Falls

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16
Q

What is fallophobia?

A

-Fear of falling

***Predictor of general functional decline and risk factor for future falls

  • May had a fall
  • Well being may be diminished
  • Had someone around them fall
  • Stop participating in social activities or being active/ as active
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17
Q

Orthostatic hypotension is?

A

-Less than 20 point+ drop in systolic or more than 10 point+ drop in diastolic w/ change in position.

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18
Q

What is an important risk factor of falls?

A

-Fall history

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19
Q

How many times the risk a patient has if previously fallen?

A

3 times

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20
Q

How many older adults are affected by gait disturbances and what age group?

A
  • 10-60%

- older than 65 years

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21
Q

Gait disturbances are indicative of what?

A

-Underlying pathological conditions

22
Q

With foot deformities falls were reduced in those with?

A
  • disabling foot pain who received enhanced podiatry care
23
Q

Most adults what age have some form of altered foot integrity?

24
Q

What should nursing care be directed towards?

A

-optimal comfort and function, removing possible mechanical irritants, and decreasing likelihood of infection

25
What is included in a foot assessment?
Observation - Gait - Use of assistive devices - Footwear type and pattern of wear Past medical history - Neuropathies - Musculoskeletal vascular limitations - Peripheral Vascular Disease - Vision problems - History of falls - Pain affecting movement Bilateral Assessment - Color - Circulation - Pulses - Structural deformities - Skin lesions - Lower-extremity edema - Evidence of scratching - Abrasions and other lesions - Rash or excessive dryness - Condition and color of toenails
26
Orthostatic hypotension along with what has been found to be predictive of falls?
-Syncope
27
When does postprandial hypotension occur?
- ingestion of a carbohydrate meal r/t to release of vasodilatory peptide
28
What causes cognitive impairment in the older adults?
- Dementia - Delirium - Increased risk of falls
29
What type of vision/hearing issues have been associated w/ falls?
- Poor visual acuity - Reduced contrast sensitivity - Decreased visual field - Cataracts - nonmiotic glaucoma medications
30
What medications are implemented in fall risks especially for orthostatic hypotension?
those that cause: - drowsiness - mental confusion - problems w/ balance or loss of urinary control - sudden drops in blood pressure when standing
31
What fall risk screening/ assessments look for?
- pt ability to walk
32
What are the target population for falls based on intensity?
- Community-dwelling individuals - Those who report a single fall - High risk populations
33
When should patients admitted to a LTC have a assessment done?
- Initial assessment on admission - After any change in condition - At regular intervals during their stay
34
Assessment is an ongoing process that includes what?
- multiple and continual types of assessment, reassessment, and evaluation following a fall or intervention.
35
What are the interventions for fall prevention?
- Fall risk assessment Educate: -Call for the nurse before getting up and going to the bathroom w/o assistance -Nurse has to prioritize getting in there or getting pt. assistance
36
What does the national center for patient safety recommend? Excluding LTC
-Morse Fall Scale
37
What does the Hartford Foundation for Geriatric Nursing recommend? ( validated in skilled nursing/rehabilitation populations)
-Hendrich II Fall Risk Model
38
Why is determination of why a fall occurred important?
- provides information on underlying fall etiologies so that appropriate plans of care can be instituted.
39
What are the purposes of a post fall assessment?
- identify the clinical status - verify and treat injuries - identify underlying causes - assist with risk reduction interventions
40
What are the components of a post falls assessment?
- fall history - fall circumstances - medical problems - medication review - mobility assessment - vision/hearing assessment - neurological examination (how often is the pt. falling) - cardiovascular examination (b/c if they not getting good circulation can cause hypotension, dizziness, lack of oxygen)
41
Fall reduction programs?
- ACE - NICHE - GRN - HELP - Vision screening - Medication reduction - CV assessment - Hip protectors/ assistive devices - Education (pt/family on fall risks and interventions)
42
What are environment modifications ?
- CDC prevention check list - Assistive devices (walker if to not using walker pt lack strength use wheelchair or walker w/ strength until they have built up strength to use walker) - Safe patient handling - Wheelchairs - Osteoporosis treatment/Vitamin D supplementation - Hip protectors - Alarm/ motion sensors/ staff observation
43
What are the consequences of restraints?
- Exacerbates problems - Cause serious injury or death - Emotional/Physical problems
44
What is the most common mechanism of restraint-related death?
- asphyxiation
45
Use of restraints is a great source of ?
- Physical/Psychological distress - Intensify agitation - Contribute to depression
46
What are side rails defines as and why?
-Restraints/Restrictive devices **impede a persons ability to voluntarily get out of bed and the person can not lower them by him to herself
47
Does sides rails decrease risk of fall occurrences? why?
-NO ****patient can climb over them- must have at least 2 down.
48
What is now a standard of practice and an indicator of quality care?
-Restraint free care
49
What reduces the use of restraints?
- removal of Cath, tube, lines as quick as possible will reduce need for restraints. - b/c patients tend to pull at those things listed above.
50
Risk factors for falls include? ``` OH Cognitive impairment Vision/ hearing problems foot deformities all of the above ```
-All of the above
51
The use of restraints can lead to? ``` Death Depression Exacerbation of agitation Asphyxiation All of the above ```
-All of the above

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