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adults > healthcare of the older adult > Flashcards

healthcare of the older adult Flashcards

1
Q

what is ageism

A

stereotype/bias/discrimination that stigmatizes and disadvandtages older adults based on chronological age

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2
Q

what is comorbidity

A

having more than 1 illness at a time

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3
Q

what is delirium

A

sudden onset of confusion that is the result of illness/injury

generally reversible

can become fatal if not caught in time

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4
Q

what is dementia

A

long term loss of memory, cognition, confusion

slow and progressive

irreversible

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5
Q

describe depression

A

can be oten confused as dementia in the older adult

often ahve apathy

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6
Q

what is durable power of attorney (DPOA)

A

healthcare proxy

make decision in the event the patient can’t

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7
Q

describe elder abuse

A

can be mental, physical, financial, or neglect

often not reported/recorded

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8
Q

describe geriatric syndromes

A

multifactorial conditions prevalent in older adults

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9
Q

what is geriatrics

A

area of emdical field that deals with older people

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10
Q

what is gerontologic nursing

A

area of nursing that deals with the care of the older population

physiological, social, psychological, economic, cultural, spiritual, and advocacy for the needs of the older adult

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11
Q

what is gerontology

A

study of the older population

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12
Q

what is polypharmacy

A

taking multiple meds

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13
Q

describe the health status of the older adult

A
  • most have at least 1 chronic illness
  • major cause of disability and pain
  • most deaths occur >65 years
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14
Q

describe theories of aging

A
  • provide framework
  • used to gain insight into different aspects of aging
  • grouped into biologic, developmental, and sociologic aspects
  • functional consequences theory (miller, 2012)
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15
Q

well-being of older people depends on following…

A
  • physical (must determine normal aging changes vs pathological changes)
  • psychosocial (stress and coping, living arrangements, role of the fam)
    -cognitive/mental (affected by sensory impairment, physiologic health, environment and sleep)
  • pharmacological (more prescription meds. altered pharmacokinetics, and adherance issues)
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16
Q

what are some mental health problems in the older adult

A
  • depression
  • substance use disorder
  • delirium
  • dementia
  • alzheimers
  • vascular dementia
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17
Q

what is the most common affective disorder of the older adult

A

depression

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18
Q

name and describe some different types of depression

A
  • major: interferes with daily life
  • persistant: lasts more than 2 years
  • other types include psychotic, SAD, depression, other chronic conditions, or an adverse effects of meds
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19
Q

age-related changes

cardiovascular

A
  • decreased cardiac output, slower heart recovery rate, increased blood pressure
  • complaints of fatigue with activity
  • tx: regular exercise, avoid smoking, diet changes, adherance to meds, weight control
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20
Q

age-related changes

respiratory

A
  • increase in residual lung volume, decrease in muscle strength, endurance, gas exchange, and cough efficiency
  • fatigue and breathlessness with activity, difficulty coughing
  • tx: regular exercise, avoid smoking, vaccinations, infection prevention
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21
Q

age-related changes

integumentary

A
  • decerased subq fat, muscle tone, and sesory receptors
  • thing, wrinkled, and dry skin;easily bruised and sunburned
  • tx: limit sun exposure, stay hydrated, lotion and lube skin
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22
Q

age-related changes

reproductive (female)

A
  • vaginal narrowing and decreased elasticity, decreased secretions, slower sexual response
  • painful intercourse, vaginal itching and irritation
  • tx: may require estrogen replacement
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23
Q

age-related changes

reproductive (male)

A
  • gradual decline in fertility, less form tests and decreased sperm production, slower sexual response
  • less form erection and delayed erection and achievement of orgasm
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24
Q

age-related changes

musculoskeletal

A
  • loss of bone density and muscle strength and size
  • height loss, prone to fractures, back pain, and loss of endurance
  • tx: weight bearing exercise regularly, bone density screening, calcium and vitamin D suplements
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25
Q

age-related changes

genitourinary

A
  • decrease in detrusor muscle contractility, bladder capacity, flow rate, and increased residual urine
  • male: BPH
  • female: urge incontinence and urethra dysfunction
  • urinary rentention and urgency/frequency syndrome
  • tx: drink adequate fluids and avoid bladder irritants, empty bladder completely when voiding
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26
Q

age-related changes

GI

A
  • decreased senses and salivation, difficulty swalloing food and reduced motility
  • risk for dehydration and poor nutritional intake, constipation and abdominal discomfort
  • tx: good dental hygiene, small frequent meals, hydrate, and limit antacid and laxative use
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27
Q

age-related changes

nervous system

A
  • decrease in brain volume and cerebral blood flow
  • slower to respond and react, increased vulnerability to delirium, increased risk of falls
  • tx: pace education, enhance senesory stimulation, fall prevention measures
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28
Q

age-related changes

vision

A
  • presbyopia, glare problems, dry eyes
  • wear glasses and large print books
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29
Q

age-related changes

hearing

A
  • presbycusis - decreased ability to hear high pitched sounds
  • recommend hearing exams and reduce background noise
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30
Q

what does SIGECAPS stand for

A

Sleep
Interest
Guilt
Energy
Concentration
Appetite
Psychomotor
Suicidal thoughts

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31
Q

what are some causes/risk factors for depression

A

genes, personal history, brain chemistry, stress

32
Q

describe treatment of depression in older adults

A

treat underlying issues

if that doesnt work, antidepressants, psychotherapy, electroconvulsion therapy

33
Q

whats included in medical management of depression

A

SSRIs, tricyclic antidepressants and MAOIs

most are avoided bc of adverse effects on the elderly

34
Q

what are some common adverse effects of medication management with antidepressants

A

anticholinergic effects and orthostatic hypotension

35
Q

describe delirium

A
  • acute onset
  • confusion develops over a short period of time
  • most comon complication of hospitalized older adult
  • may be the sign of an underlying medical condition
36
Q

describe the outcomes of delirium

A
  • possible full recovery with early detection and intervention
  • may progress to stupor and/or coma, seizures, and death
37
Q

describe assessment of delirium

A

assessment of risk factors:
- baseline or pre-morbid impairment
- pain
- metabolic, dehydration, infection
- environment
- impariemnt of mobility

confusion assessment methods (CAM) diagnostic algorithm

38
Q

name three clinical subtypes of delirium

A
  • hyperactive
  • hypoactive
  • mixed
39
Q

describe hyperactive delirium

A
  • increased psychomotor activity
  • rapid speech
  • irritability
  • restlessness
40
Q

describe hypoactive delirium

A
  • lethargy
  • slowed speech
  • decreased alertness
  • apathy
41
Q

describe mixed delirium

A

shift between hyperactive and hypoactive states

42
Q

whats included in delirium management

A
  • multi-componenet interventions are most effective
  • indentification of risk (HARP)
  • prevention activities (watch closely)
  • prompt treatment of underlying cause
  • create maximum support system
  • immediate medical treatment
  • assess medications
43
Q

describe dementia

A

a clinical syndrome of cognitive, fucntion, and behavioral changes

involves:
- sudden onset
- slow progession
- memory impairments
- disturbance in at least one other area of cognition

44
Q

what are the most common forms of progressive dementia

A
  • alzheimers disease (AD)
  • vascular dementia (lack of bloodflow to brain and brain cells die)
  • dementia with lewy bodies (can happen at any age)

other types include degenerative, neoplastic, demylenating, infectious, inflammatory, toxic, metabolic, psychiatric

45
Q

is there a cure for AD

A

nope, no cure or preventative measures

46
Q

what are some causes/risk factors for AD

A

causes may include a combo of risk factors like genetic, neurotransmitter changes, vascular changes, vascular abnormalities, stress, hormones, circadian changes, head trauma, seizure disorders

risk factors include advanced age, cognitive impairment, genetics, environement, dietary issues, immune issues

47
Q

name two types od AD

A
  • familial (early onset- rare)
  • sporadic (late onset)
48
Q

describe the clincial manifestations of AD

A

early stages: forgetfulness, subtle memory loss, difficulties in work/social life, but they are able to compensate

progression: loss of ability to recognize familiar faces/places/items, orientation and reasoning make more anxiety, loss of abstract thinking, personality changes, loss of functioning

terminal stage: immobile, total care, death d/t complications

49
Q

how is a definitive diagnosis of AD made?

A

autopsy

need to r/o other possible causes of dementia

50
Q

what can be used to make a probable diagnosis of AD

A
  • health hx
  • physical exam
  • diagnostic tests
  • assess for underlying depressiona dn cognitive function
51
Q

what is included in AD nursing management

A
  • support cognitive function
  • promote safety
  • promote independence in self-care activities
  • reduce anxiety and agitiation
  • improve communication/socialization
  • promote adequate nutrition
  • promote balnced activity/rest
  • avoid the use of restraints
  • encourage and support through advance care planning
52
Q

describe progressively lowered stress threshold (PLST)

A
  • framework for the nursing care of people with dementia
  • need alternating quiet and stimulating environments
  • behaviors have meaning
  • check for physical problem, pain, and environemnt
53
Q

name some geriatric syndromes

A
  • impaired mobility
  • dizziness
  • falls and falling
  • urinary incontinence
  • changes in cognitive status
  • increased susceptibility to infection
  • atypical response
  • altered emotional impact
  • altered systemic response
54
Q

what syndromes are components of the geriatric triad

A
  • falls and falling
  • urinary incontinence
  • changes in cognitive status
55
Q

what code says the healthcare professionals are required to report suspected abuse to job and family services?

A

ohio revised code

56
Q

what code says department of health is to investigate allegations of abuse at long term care facilities

A

ohio administrative code

57
Q

what are some risk factors for elder abuse

A

divorce/separation, low income, functional impairment, poor health

58
Q

what are some barriers to understanding elder abuse

A

professionals are not equipped to recognize and report, or may be reluctant to report

59
Q

what is neglect

A

not carig for the elder

60
Q

what are some characteristics and abuser may have

A
  • developmentally delayed
  • substance abuse
  • financially dependent on victim
61
Q

elder mistreatment

physical abuse

A
  • use of physical force that may result in injury, physical pain, or impairment
  • shaking, slapping, kicking, pinching, burning, improper use of restraints, drugs, or force feeding
  • signs and symptoms include bruises, black eyes, fractures, injuries in various stage of healing
62
Q

elder mistreatment

psychological/emotional abuse

A
  • infliction of pain or distress through verbal or nonverbal acts
  • verbal threats, harrassment, isolation in the home, silent treatment
  • signs and symptoms include extreme withdrawal, emotional upset or agitiation
63
Q

elder mistreatment

sexual abuse

A
  • nonconsenual sexual contact, with an elderly incapable in giving consent
  • unwanted touching, coerced nudity, sexual harrassment
  • signs and symptoms include genital bruising, unexplained STDs
64
Q

elder mistreatment

financial exploitation

A
  • taking advantage of eldee for money or personal benefit
  • numerous unpaid bills, papers and credit cards missing, unable to pay for food and meds
  • signs include new will when elder is incapable of writing one, frequent checks to cash, forged signatures, cargivers refusal to spend money on the elder
65
Q

elder mistreatment

caregiver neglect

A
  • intentional or unintentional to failure to meet the need sof the elders physical and mental well being
  • failure to provide adequate food, clothing, shelter, medical care, hygiene, social stimulation
  • signs and symptoms include dehydration, malnutrition, urine burns, left alone
66
Q

elder mistreatment

self neglect

A
  • personal disregard or inability to perform self care
  • poor hygiene, unkept home environment
  • signs and symptoms include malnurition, fungal, skin/nail infections, insect/rodent infestation
67
Q

elder mistreatment

abandonment

A
  • willful disertion of an elder
  • dropping the elder off in ED and not coming back
  • elder inappropriately left alone
68
Q

elder mistreatment

institutional mistreatment

A
  • disregard of contractual arrangement resulting in abuse or neglect
  • signs include dehydration, urine burns, malnutrition
69
Q

describe caregiver strain

A
  • majority of long term care to chronically disabled older adults by the caregiver
  • associated with premature tools to identify
70
Q

what screening tools are used to identify caregiver strain

A

modified caregiver strain index
13 question tool that covers the following domains:
- financial
- physical
- psychological
- social
- personal

71
Q

how do you document supected elder abuse

A

document only the facts, use direct quotes

72
Q

what social service healthcare programs are available for elders

A
  • medicare
  • medicaid
  • older americans act
  • supplemental security income
  • section housing
  • title XX social services

other services:
- home health care
- hospice services

73
Q

what two major programs finance health care in the U.S.

A
  • medicare
  • medicaid

both are through centers of medicaid and medicare

74
Q

what is the nurses role in ethical/legal issues surrounding the older population

A
  • informing and suporting
  • encorage end of life discussions
  • education on advanced directives (DNR/advanced directive, surrogate decision making, and patient self determination act)
75
Q

describe the patient self determination act

A

law that states that any facility that is funded by medicare must provide patients with info on advanced directives

76
Q

what ethical principles may nurses run into

A
  • patient confidentiality
  • access to complementary treatments
  • faor distribution of resources
  • economic decision making

adults (51 decks)

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