Intro to Gero: Evidence-Based Practices Flashcards
1
Q
What is the Fulmer SPICES Framework used for?
A
identify six serious “marker conditions” that help quickly identify common health concerns in older adults.
2
Q
What outcomes can the Fulmer SPICES Framework help prevent?
A
- Longer hospital stays
- ↑ medical costs
- ↑ risk of death
3
Q
What is another name for the Fulmer SPICES Framework?
A
- Geriatric Vital Signs
4
Q
Who developed the Fulmer SPICES Framework?
A
- Nurses Improving Care for Healthsystem Elders (NICHE)
5
Q
Why is managing sleep disorders important in older adults?
A
- Rest is needed for health and mental/physical fxn
- help ↓ and falls
6
Q
What are key nursing interventions for sleep disorders in older adults?
A
Assess sleep patterns/contributing factors:
- Pain
- Avoid daytime napping
- Minimize noise
- Dim lights
7
Q
What should nurses know about sleep disorders in older adults?
A
- they are common
8
Q
What are nursing interventions for problems with eating or feeding?
A
- Perform nutrition screening on admission
-> pmHX, weight, height, BMI - Manage nausea/pain
- Collaborate with dietitians and speech-language pathologists
9
Q
What are important considerations in eating/feeding issues?
A
- respect cultural preferences
10
Q
What is a common issue associated with eating/feeding problems in older adults?
A
- Malnutrition
-> linked to poor clinical outcomes
11
Q
What are key nursing interventions for incontinence?
A
- Assess & identify cause of incontinence or retention
-> Use bladder training programs
-> Implement scheduled toileting
12
Q
What are nursing considerations for incontinence?
A
- Risk factor for falls
- may result from side effects of medications
13
Q
What are important facts about incontinence in older adults?
A
- Common in hospital and long-term care settings
- Vary in type & severity
- Incontinence is NOT a normal part of aging
14
Q
What are nursing interventions for confusion in older adults?
A
- Use CAM (Confusion Assessment Method) to assess delirium
- Avoid multiple drugs
- Reorient pt
- Promote sleep & comfort
15
Q
What are risk factors for confusion in older adults?
A
- Drug therapy
- Fluid/electrolyte imbalance
- Relocation
- Infections
16
Q
What are the two types of confusion in older adults?
A
- Acute confusion = delirium
- Chronic confusion = dementia
17
Q
Is confusion a normal part of aging?
A
- NOOOO!!
18
Q
Why is evidence of falls important in geriatric care?
A
- most common accident among older adults in hospitals & nursing homes.
19
Q
What is a required nursing intervention for fall prevention?
A
- Perform fall risk assessment (required by Joint Commission)
- Use NPSG (National Patient Safety Goal) fall risk tool & fall reduction plan
20
Q
What are common risk factors for falls in older adults?
A
- pmHX falls
- Advanced age
- HTN
- Substance use
- Stability issues
- Incontinence
21
Q
What is the best approach for managing skin breakdown?
A
- Prevention
22
Q
What nursing interventions prevent skin breakdown?
A
- Assess risk using the Braden Scale
- Frequent turning and repositioning
- Keep skin clean and dry
- Use pressure-relieving mattresses
- Collaborate with dietitians and wound care specialists
23
Q
Why is skin breakdown a major concern in geriatric patients?
A
- Pressure injuries are problematic in hospitals and nursing homes
- Skin is fragile among “old-old” population (85+)
24
Q
What mobility-related factors contribute to fall risk?
A
- Decreased mobility
- Chronic pain
- Fear of falling (fallophobia)
25
What sensory changes increase fall risk in older adults?
- ↓ Eyesight
- ↓ Proprioception
- ↓ Depth perception
26
How do medications increase fall risk?
- affect the CNS
-> lead to dizziness & confusion
27
What screening tool is used to assess fall risk?
- Morse Fall Scale
28
What does the NPSG require regarding fall prevention?
- set of fall risk assessment requirements
- create fall reduction plan
- required by the Joint Commission
29
What are examples of vision-related fall prevention interventions?
- Refer to vision specialists
- Improve lighting at home
30
How should medications be handled in fall prevention?
- Review and manage
-> minimize side effects
31
What lifestyle interventions help prevent falls?
- Participate in exercise programs
- Use assistive devices as needed
32
What home modifications help prevent falls?
- slip-proof pads/non-slip bathmats
- handrails
- Avoid scatter rugs/slippery floors
- raised toilet seats
33
What safety equipment is useful for high fall-risk patients?
- Bed and chair alarms
34
Why are women at higher risk for falls?
- take more opioids
35
Where do most falls occur?
- at home
36
What percentage of older adults experience a fall each year?
- 1 in 4 older adults
37
Why might older adults avoid leaving home?
- Fear of falling
38
What is the Beers Criteria?
- rating scale used to screen for medication-related risks in older adults with chronic health conditions.
39
What is the main purpose of the Beers Criteria?
- Identify appropriate medications for older adults
- Reduce drug-related risks in older adults (OA)
40
What are the important considerations in the Beers Criteria?
- Highlight medications that are part of the Beers Criteria
- Highlight medications where indications for use are unclear
- Highlight inappropriate or discontinued medications
41
How often should medication use be assessed according to Healthy People 2020?
- every 6 months or more
42
What should be included in a complete medication assessment?
- Prescription medications
- Over-the-counter meds (OTC)
- Herbal products
- Supplements
43
What are examples of at-risk drugs for older adults?
- Meperidine
- Oxycodone
- Digoxin (w/ med calculation concerns)
44
What screening tool is used to evaluate medication safety in older adults?
- Beers Criteria
45
Who should nurses collaborate with to promote medication safety?
- Patient
- Family
- Provider
- Pharmacist
46
What communication strategies support medication safety?
- Pvd verbal & written instructions @ appropriate reading lvl
47
What teaching strategies help ensure adherence to a drug therapy regimen?
- Encourage pill boxes
- Link medication to daily events
48
What lifestyle and safety tips should be taught regarding medication use?
- Encourage nonpharmacologic interventions and healthy lifestyle changes
- Never share/borrow medications
- Suggest once-a-day dosing
49
What are restraints in healthcare?
- Devices or drugs that prevent a patient from moving freely
50
When should restraints be used?
- Only as a last resort
51
What are the two main types of restraints?
- Physical restraints
- Chemical restraints
52
What types of medications are considered chemical restraints?
- Antipsychotics
- Antianxiety medications
- Antidepressants
- Sedative-hypnotics
53
Who must prescribe restraints?
- healthcare provider (HCP)
54
What should be attempted before using restraints?
- Alternatives to restraints should **always** be used first.
55
What are safety requirements if restraints are used?
- Use the least restrictive restraint (mittens)
- Check restraints every 30–60 minutes
- Release restraints every 1–2 hours
-> turning, repositioning, or toileting
56
What are effective alternatives/interventions to avoid restraints?
- **Reorient** the patient
- **Relocate** (pt closer to nurse’s station)
- **Remind** (to use call bell)
- **Request** (family to stay or use a sitter)
- **Record** (via camera/frequent observation)
- Use bed alarms, mittens, activity vests
- Provide towels to play with
- Hide or wrap IV lines and drains
57
What should a nurse do if a patient keeps pulling out their IVs?
- wrap IV lines with keflex
58
What legal right do U.S. nursing home residents have regarding restraints?
- right to refuse restraints
59
Why must chemical restraints be used sparingly?
- prolong hospital stays
- stunt recovery
60
What physiological changes of aging contribute to driving accidents?
- ↓ Depth perception
- Slower reaction times
- Mental deficits (Alzheimer's, dementia)
61
What should be included in a driving safety consult with an HCP?
- eye exams
62
What community-based interventions support older adult driving safety?
- Community-based transportation options
- Encourage driver-refresher courses
63
What is a legal consideration some states have regarding older adult drivers?
Some states require older adults to be tested more frequently for driving ability
63
Why is driving safety a critical concern for the elderly?
- Accidents are a major cause of death elderly.
64
What does SPICES stand for?
Sleep disorders
Problems with eating/feeding
Incontinence
Confusion
Evidence of falls
Skin breakdown
