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Gero > Gero- Falls/Fall risk reduction-chapter 19 > Flashcards

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?

A

-over 65

24
Q

What should nursing care be directed towards?

A

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

25
Q

What is included in a foot assessment?

A

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
Q

Orthostatic hypotension along with what has been found to be predictive of falls?

A

-Syncope

27
Q

When does postprandial hypotension occur?

A
  • ingestion of a carbohydrate meal r/t to release of vasodilatory peptide
28
Q

What causes cognitive impairment in the older adults?

A
  • Dementia
  • Delirium
  • Increased risk of falls
29
Q

What type of vision/hearing issues have been associated w/ falls?

A
  • Poor visual acuity
  • Reduced contrast sensitivity
  • Decreased visual field
  • Cataracts
  • nonmiotic glaucoma medications
30
Q

What medications are implemented in fall risks especially for orthostatic hypotension?

A

those that cause:

  • drowsiness
  • mental confusion
  • problems w/ balance or loss of urinary control
  • sudden drops in blood pressure when standing
31
Q

What fall risk screening/ assessments look for?

A
  • pt ability to walk
32
Q

What are the target population for falls based on intensity?

A
  • Community-dwelling individuals
  • Those who report a single fall
  • High risk populations
33
Q

When should patients admitted to a LTC have a assessment done?

A
  • Initial assessment on admission
  • After any change in condition
  • At regular intervals during their stay
34
Q

Assessment is an ongoing process that includes what?

A
  • multiple and continual types of assessment, reassessment, and evaluation following a fall or intervention.
35
Q

What are the interventions for fall prevention?

A
  • 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
Q

What does the national center for patient safety recommend? Excluding LTC

A

-Morse Fall Scale

37
Q

What does the Hartford Foundation for Geriatric Nursing recommend? ( validated in skilled nursing/rehabilitation populations)

A

-Hendrich II Fall Risk Model

38
Q

Why is determination of why a fall occurred important?

A
  • provides information on underlying fall etiologies so that appropriate plans of care can be instituted.
39
Q

What are the purposes of a post fall assessment?

A
  • identify the clinical status
  • verify and treat injuries
  • identify underlying causes
  • assist with risk reduction interventions
40
Q

What are the components of a post falls assessment?

A
  • 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
Q

Fall reduction programs?

A
  • ACE
  • NICHE
  • GRN
  • HELP
  • Vision screening
  • Medication reduction
  • CV assessment
  • Hip protectors/ assistive devices
  • Education (pt/family on fall risks and interventions)
42
Q

What are environment modifications ?

A
  • 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
Q

What are the consequences of restraints?

A
  • Exacerbates problems
  • Cause serious injury or death
  • Emotional/Physical problems
44
Q

What is the most common mechanism of restraint-related death?

A
  • asphyxiation
45
Q

Use of restraints is a great source of ?

A
  • Physical/Psychological distress
  • Intensify agitation
  • Contribute to depression
46
Q

What are side rails defines as and why?

A

-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
Q

Does sides rails decrease risk of fall occurrences? why?

A

-NO

**patient can climb over them- must have at least 2 down.

48
Q

What is now a standard of practice and an indicator of quality care?

A

-Restraint free care

49
Q

What reduces the use of restraints?

A
  • 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
Q

Risk factors for falls include?

OH
Cognitive impairment
Vision/ hearing problems 
foot deformities 
all of the above
A

-All of the above

51
Q

The use of restraints can lead to?

Death 
Depression
Exacerbation of agitation 
Asphyxiation 
All of the above
A

-All of the above

Gero (7 decks)

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