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Older Adult > Intro to Gerontological Nursing > Flashcards

Intro to Gerontological Nursing Flashcards

1
Q

general gerontological nurses

A
  • direct care providers
  • case managers
  • nurse leaders
  • educators
  • patient advocates
  • administrators
  • advanced practice gerontological nurses: health promotion, dz prevention, long term management of chronic conditions
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2
Q

normal aging

A
  • changes in the heart (thickens), arteries, lungs (less elastic), brain, kidneys, bladder, body fat, muscles, bones, sight, hearing, and personality
  • personality = doesn’t change
  • wake up frequently
  • bone density dec = more fx
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3
Q

current focus of gerontology

A
  • improvement of health holistically
  • physical, mental, emotional, and spiritual well-being
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4
Q

gerontologic nursing

A
  • specialized nursing with knowledge of illness and health of the aging
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5
Q

over the next 20 years 74 million baby boomers will retire. Medicare and social security will what?

A
  • add 10,000 new retirees per day
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6
Q

the old old (over age 85) are the fastest growing segment of the population growing at ____ the rate of the 65 and over and _____ times faster than the total US population. This group will triple by 2050

A
  • twice
  • 4
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7
Q

life after 65

A
  • health care has improved
  • there has been an increase in the use of preventative services
  • people are choosing healthier lifestyles
  • medicare has expanded coverage of preventative services
  • the older adult should be urged to assume more responsibility for healthy aging
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8
Q

longevity and the sex differential

A
  • women make up most of the older population - 55%
  • 49 men to every 100 women in the US
  • older women face different socioeconomic circumstances
  • differences btw countries have narrowed over time
  • women = double jeopardy. financial hardships when spouses die bc they never rlly had a job/have a degree
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9
Q

the death rate for ____ of the 10 leading causes of death has ____

A
  • 7
  • decreased
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10
Q

the death rate ____ for alzheimer’s dz, nephritis, nephrotic syndrome, and nephrosis

A
  • increased
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11
Q

heart dz, cancer, stroke, chronic obstructive pulmonary dz, and diabetes account for ____ of all deaths each year

A
  • two-thirds
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12
Q

healthy people 2020

A
  • healthy people 2020 is the prevention agenda for the US
  • establish quality measures; identifying levels of training for people who care for older adults
  • achieve health equity, eliminate disparities, and improve the health of all groups
  • ensuring quality health care for all
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13
Q

Three levels of prevention

A
  • primary: health promotion-immunizations. also exercise
  • secondary: early diagnosis and prompt treatment. detect early and prevent it from getting worse. health screenings
  • tertiary: restoration and rehabilitation. bring ppl back to a previous level of fxn if possible
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14
Q

opportunities to improve older adults’ health and quality of life

A
  • healthy lifestyles. exercise –> walking, jogging, aerobics, dancing, etc.
  • early dz detection
  • immunizations
  • injury prevention
  • self management techniques
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15
Q

gerontological nursing challenges

A
  • fear of aging, disease, disability, and decline
  • nurses need to relate to perception of the inevitable
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16
Q

most common gerontological chronic dz

A
  • degenerative joint dz (arthritis)
  • diabetes mellitus
  • chronic back pain
  • stroke
  • atherosclerosis
  • lung or respiratory problems
  • deafness or hearing problems
  • blindness or vision problems
  • chronic conditions start as young as 30
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17
Q

chronic disease leading to disability

A
  • disability among older adults
    • chronic conditions
    • 80% have at least one
      chronic condition (things like htn)
  • financial impact of chronic illness $470 billion in 1995
    • 25% increase expected by 2030
    • anticipated to be $864 billion in 2040
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18
Q

physical decline

A
  • smoking, poor nutrition, physical inactivity, and screening services
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19
Q

gerontological nursing myths

A
  • myths can lead to
  • ageism: stereotyping of any age group
  • reduced healthcare services
  • segregation of elders from mainstream society
  • difficulty recruiting nurses to work with the elderly
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20
Q

common aging myths

A
  • old means being sick
  • older people cannot learn new things
  • health promotion is wasted on older people
  • the elderly do not pull their own weight
  • it is too late to change bad habits
  • older people have no interest in sex (higher STDs)
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21
Q

types of aging changes

A
  • benign and superficial: graying hair, wrinkles
  • senescence –> aging process. progressive body system deterioration
  • plastic: modifiable changes that can be slowed. ex: controlling obesity to prevent diabetes. basically healthy lifestyles
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22
Q

organ reserve changes

A
  • reduced organ reserve with aging: normal age related change. Ex: kidney reduction. also lungs –> you can’t change this
  • homeostasis: maintenance of body equilibrium
  • homeostenosis: inability of body to restore homeostasis after environmental changes
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23
Q

biological aging theory: programmed theories

A
  • aging follows a biological timetable
  • hypothesize that the body’s genetic codes contain instructions for regulation of cellular reproduction and death
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24
Q

biological aging theory: error theories

A
  • hypothesize that environmental assaults and the body’s constant need to make energy and fuel metabolic activities cause toxic by products
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25
Q

error theory - wear and tear theory

A
  • slows down from environmental assaults. like athletes
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26
Q

error theories – cross link theory

A
  • cross-linked proteins cause a lot of issues
27
Q

error theory – free radical theory

A
  • oxygen radicals causes organs to lose fxn
28
Q

error theory – somatic DNA theory

A
  • genetic mutation cause cells to deteriorate and malfxn
29
Q

error theory – emerging biological theories

A
  • responsible for aging
30
Q

psychological aging theories – Jung’s theory of individualism

A
  • as a person ages, the shift of focus goes from extroversion (external world) to introversion (internal world)
31
Q

psychological aging theories – erikson’s developmental theory

A
  • eight stages of life
  • the older adult integrity versus despair
  • in this stage, ppl ask if they lived a good life
32
Q

sociological aging theories

A
  1. disengagement theory – ex: no longer wanting to go in big crowds
  2. activity theory
  3. continuity theory – maintaining previous valves and habits
33
Q

trends in financing health care for older persons

A
  • federal spending for medicare, medicaid, and social security is expected to surge, nearly doubling by 2035
  • nurses should assume a leadership position in debates and discussions regarding healthcare reform and financing relating to older people
34
Q

long-term health care costs

A
  • approximately $207 billion spent in 2005
  • accounts for 12% of all healthcare expenditures
  • 70% of this figure is covered by medicaid and medicare
  • 18% paid by patients and families
  • medicaid: managed by states and based on income
    • designed for low-income individuals, children, pregnant women, elderly adults and people with disabilities
    • covers 49%of long term care expenses
35
Q

medicare

A
  • federal program
  • established for ppl over 65 or young disabled ppl
  • limited prescription drug benefits
  • may pay a limited amount of subacute care, rehab, and home health care
    A: inpatient. hospital stays, snf, hospice
    B: outpatient. dr.’s visits, preventative services
    C: medicare advantage –> covers A, B, and D. choose to receive these benefits thru a private insurance company
    D: drug coverage. gap in coverage where they meet the deductible
36
Q

Skilled Nursing Facility (SNF)

A
  • goal to return back to living situation from before
  • these services can be necessary over the short term after an illness or injury, or long term for patients who need care on a frequent or around-the-clock basis due to a chronic medical condition.
  • examples of skilled nursing services include wound care, intravenous (IV) therapy, injections, physical
    therapy, and monitoring of vital signs and medical equipment
  • may be some self-paid involved
37
Q

assisted living facility (ALF)

A
  • provides medical needs but also with daily living
  • a system of housing and limited care that is designed for senior citizens who need some assistance with daily activities but do not require care in nursing homes
  • assisted living services typically provide assistance w/ bathing, dressing, grooming, meds, and meal prep
38
Q

nursing home

A
  • have social and recreational services
  • a public or private institution providing residential accommodations with health care, especially for elderly ppl
  • for individuals who require a higher level of medical care than can be provided in an assisted living facility
  • Skilled nursing staff consisting of RNs, LPNs,
    and certified nurses’ aides (CNAs) are available to provide 24-hour medical
  • Can be used for short-term rehabilitative stays.
  • Extending stays into longer-term care must be medically necessary for the treatment of a serious medical condition
39
Q

adult day care

A
  • provide a structured program of therapeutic, rehabilitative, social and leisure activities in a monitored setting
  • The programs offer supportive services to the
    participant, as well as to the family, by providing care
    and supervision in a protective environment during the day
  • Planned activities are included. Typically fees are paid privately. Meals services are normally included. Additionally health service availability varies
  • include things like supervision, meals, exercise, recreation, transportation, PT, health screening, socialization, education, respite care, evening care, counseling
40
Q

retirement community

A
  • Housing complex designed for older adults who are generally able to care for themselves
    • assistance from home care agencies is allowed in
      communities and activities and socialization opportunities are often provided.
  • There are various types of retirement communities to choose from. New types of
    retirement communities are being developed as the population ages.
    • Assisted Living Communities, also known as Assisted Living and Memory Care assisted living communities, provide all the daily services seniors need in an apartment or condominium style environment - such
      as dining, housekeeping, nursing, and wellness -
      usually in a locked and secured building.
    • Congregate housing, which includes at least one
      shared meal per day with other residents.
41
Q
A
42
Q

rehab hospital

A
  • return individuals to previous level of fxning
  • Devoted to the rehabilitation of patients with various neurological,
    musculoskeletal, orthopedic and other medical
    conditions following stabilization of their acute
    medical issues.
  • There are independent hospitals that operate these facilities within acute care hospitals.
  • There are also inpatient rehabilitation hospitals
    that offer this service in a hospital-like setting,
    but separate from acute care facilities.
  • Most inpatient rehabilitation facilities are located w/in hospitals
42
Q

residential care facilities

A
  • Previously called “rest homes”
  • Offer 24 hour supervision and health monitoring
  • like a dorm
43
Q

transitional care units

A
  • bridge btw a hospital and home
  • Established by acute care hospitals
  • Provide subacute care, rehabilitation and palliative care services
  • Most patients are recuperating from surgery, major illness, or injury.
  • Support services of the acute care facility are provided
44
Q

rehabilitation facilities

A
  • specialized facilities provide subacute care to patients with complex healthcare needs
  • patients may have head injuries, be ventilator dependent
45
Q

community nursing care

A
  • visiting nurse service
  • provides skilled care in the home
  • services may include vital signs, education, wound care, and med administration
46
Q

geriatric evaluation schedule

A
  • hospitalization for acute illness
  • change in living status
  • abrupt change in physical, social, or psychological function
  • annual physical examination
47
Q

benefits of comprehensive geriatric evaluation

A
  • reduced hospital use
  • reduced mortality rates
  • improved mental status
  • consumption of lower health care costs
  • improved fxnal ability
  • lower hospital admission rates
48
Q

functional health pattern assessment

A
  • health perception-health management
  • nutritional-metabolic
  • elimination
  • activity-exercise
  • sleep-rest
  • cognitive-perceptual
  • self-perception- self-concept
  • roles-relationships
  • sexuality-reproductive
  • coping-stress tolerance
  • values-beliefs
49
Q

the health hx: geriatric reveiw of symp emphasis will include

A
  • hearing, vision, falls, fractures, bowel and bladder fxn
50
Q

health hx – potential problems to obtaining

A
  • communication difficulties
  • underreporting of symptoms
  • vague or nonspecific complaints
  • multiple complaints
51
Q

social history key elements

A
  • occupational hx, family hx, present and former marital status, include quality of relationships, identifying family members, living arrangements, family dynamics, family and caregiver expectations, economic status adequacy of health insurance, social activities and hobbies, mode of transportation, community involvement and support
52
Q

psychological hx

A
  • hx of past mental illness or related tx
  • current and past stress and coping mechanisms
  • current and past alcohol and recreational drug use
  • medications taken for anxiety, insomnia, or depression
  • impaired memory, judgment, or thought processing
  • personality changes,
  • identification of feelings regarding self-worth, feelings of appropriate emotions related to present life and health situation,
  • presence of someone to love, support, and encourage individual,
  • feelings of hopelessness or suicidal ideation
53
Q

ethics

A
  • Important aspects of ethical decision making:
    • Assessment
    • Capability of the patient to make decisions
    • Patient preferences
    • Needs of the patient as a person
    • Preferences of the family
    • Competing interests
    • Issues of power or conflict
    • Opportunity for all involved to speak and be heard
54
Q

patient and family teachings

A
  • Nurses assume the role of
    teacher and coach, teaching the key concepts of gerontology and gerontological nursing.
  • Gerontological nurses require skills and knowledge related to teaching patients and families about the key concepts of gerontology and gerontological nursing
55
Q

health promotion and disease screening

A
  • health for older adults is a complex interaction of physical, functional, and psychosocial factors
  • the older person’s health beliefs will indicate the motivational support and perceived benefits of action
56
Q

frailty

A
  • Has been defined as having the presence of three or more:
  • Unexplained weight loss (10 lbs. in the last year)
  • Weakness and exhaustion
  • Poor endurance and energy
  • Decline in gait speed
  • Slowness
  • Low activity
57
Q

the four i’s of frailty

A
  • instability, immobility, intellectual impairment, incontinence
58
Q

frail older person = at high risk for

A
  • Dependency
  • Institutionalization
  • Falls
  • Injuries
  • Hospitalizations
  • Slow recovery from illness
59
Q

Frail older adults and individuals at the end of life exhibit four distinct trajectories of functional decline:

A
  • Sudden death
  • Diagnosis with a terminal illness
  • Organ failure
  • Frailty
60
Q

nurses in all settings should practice according to the following guidelines

A
  • Be aware of drug interactions.
  • Remember that the presentation of illness is less dramatic and more vague than in other age groups.
  • Conduct holistic nursing assessments when caring for frail older adults and those with comorbidities.
  • Seek to access and provide the most intensive services to those considered the most frail and those diagnosed with multiple comorbidities.
  • Promote healthy aging in all clinical settings
61
Q

housing for the older adult is primarily based on which of the following factors

A
  • promotes functional independence
62
Q

legal issues

A
  • Legal issues affecting older adults are increasingly common
  • The gerontological nurse should be aware of all the rules, regulations, and standards that govern professional practice.
  • Older patients have many rights.
  • The healthcare facility is required to post the bill of rights in a conspicuous place

Older Adult (1 decks)

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