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Nurs 3035 > Midterm > Flashcards

Midterm Flashcards

1
Q

high level wellness

A

integration toward maximizing potential with continuum of balance and purposeful direction in environment/life

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2
Q

subjective age

A

person’s perception of age

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3
Q

perceived age

A

other people’s estimation of someone’s age

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4
Q

chronological age

A

length of time that has passed since birth

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5
Q

functional age

A

physiologic health, psychological well-being, socioeconomic factors, ability to function and participate in activities

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6
Q

examples of successful aging

A
  • Active engagement with life
  • High cognitive and physical function
  • Low probability of disease and disability
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7
Q

higher levels of education =

A

longer life expectancy & better ratings of self-reported health

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8
Q

true or false. Huge economic disparity exist among older adults

A

True

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9
Q

world’s population aging at an unprecedented rate (true or false)

A

true

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10
Q

nurses role with older adults

A

-Empower older adults to lead fulfilling lives despite their illness diagnosis.
- Interventions to manage chronic diseases so older adults can maintain optimal levels of functioning.
- A holistic approach for the maintenance of well-being of older adults (wellness approach).
- Explore patients’ abilities and strengths for optimal health outcome and enhanced wellness.

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11
Q

health disparities

A

significant differences in regard to rate of disease incidence, prevalence, morbidity, mortality, life expectancy between one population and another

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12
Q

health literacy

A
  • Major determinant of health outcomes and measure of quality of care
  • Low health literacy associated with negative outcomes and increase in costs
  • National initiatives include identifying and implementing evidence-based approaches to assessment and interventions for health literacy.
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13
Q

Ethnogeriatrics

A

integrates influence of race, ethnicity and culture on health and well-being of older adults

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14
Q

Older Adults in high risk groups

A
  • ​​Older adults in rural areas
  • Homeless older adults
  • Lesbian, gay, bisexual and transgendered older adults (LGBT)
  • aboriginals
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15
Q

functional consequence theory

A
  • Observable effects of actions, risk factors, and age related changes that influence the quality of life or day to day activities of older adults
  • Older adults experience positive or negative functional consequences because of a combination of age-related changes and additional risk factors.
  • Nurses can promote wellness in older adults through health promotion interventions and other nursing actions that address the negative functional consequences.
  • Nursing interventions result in positive functional consequences, also called wellness outcomes, which enable older people to function at their highest level despite the presence of age-related changes and risk factors.
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16
Q

Negative functional consequences

A

those that interfere with functioning or quality of life, cause dependency

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17
Q

Positive functional consequences:

A

those that facilitate the highest level of functioning, least dependency and best quality of life. They are wellness outcomes

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18
Q

functional assessment

A

Focuses on older adult’s ability to perform activities of daily living that affect survival and quality of life

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19
Q

Functional Consequences Theory vs Functional Assessment

A

Functional Consequences Theory is broader because it
- Distinguishes age-related changes that increase vulnerability and risk
- Focuses on consequences
- Focuses on assessment of conditions that affect function
- Leads to interventions to address the negative
- Leads to wellness outcomes

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20
Q

age related changes vs risk factors

A
  • Age-related changes cannot be reversed or altered, but it is possible to compensate for their effects so that wellness outcomes are achieved.
  • By contrast, risk factors can be modified or eliminated to improve functioning and quality of life for older adults.
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21
Q

age related changes

A
  • Inevitable, progressive and irreversible changes that occur and are independent of extrinsic or pathologic conditions
  • On the physiologic level, these changes are typically degenerative.
  • Holistic focus: identify age-related changes to improve/adapt to physiologic decline
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22
Q

risk factors

A
  • Conditions that increase vulnerability to negative functional consequences
  • Common sources of risk factors include diseases, environment, lifestyle, support systems, psychosocial circumstances, adverse medication effects, and attitudes based on lack of knowledge
  • Environmental conditions are risk factors when they interfere with function.
  • Environmental conditions are interventions when they enhance function.
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23
Q

theoretical perspectives on aging

A

Biological Theories of aging
Sociocultural Theories
Psychological Theories

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24
Q

biologic theories

A
  • wear and tear theory
  • cross linkage theory
  • free radical theory
  • genetic theory
  • immune theory
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25
Q

wear and tear theory

A

Body can be likened to a machine that is expected to function well during the period of its warranty, but that will wear out at a fairly predictable time.

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26
Q

cross linkage theory

A

Biochemical processes create linkages, or connections, between structures that normally are separated. This causes a buildup of collagen-like substances that leads to failure of tissues and organs.

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27
Q

free radical theory

A

They are waste products of metabolism and they can damage cells. Healthy bodies have protective mechanisms that can remove and repair damaged cells; however, these mechanisms become less effective with increased age and cellular damage becomes cumulative.

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28
Q

genetic theory

A

emphasizes the role of genes in the development of age-related changes

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29
Q

Immunosenescence/immune theory

A

Immunosenescence, which is an age-related decline of the immune system, increases the susceptibility of older people to diseases, such as cancer and infections. The immune system may even attack healthy cells, leading to autoimmune conditions, such as rheumatoid arthritis.

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30
Q

biologic theory: nursing

A

Primary role: Identify and address modifiable factors that lead to diseases, disability, death, as well as health-promoting factors.

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31
Q

sociocultural perspectives on aging

A
  • disengagement theory
  • activity theory
  • subculture theory
  • age stratification theory
  • person environment fit theory
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32
Q

disengagement theory

A

a society and older people engage in a mutually beneficial process of reciprocal withdrawal to maintain social equilibrium

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33
Q

activity theory

A

older people remain socially and psychologically fit if they remain actively engaged in life

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34
Q

subculture theory

A

states that old people, as a group, have their own norms, expectations, beliefs and habits; therefore, they have their own subculture

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35
Q

age stratification theory

A

People pass through society in cohorts that are aging socially, biologically and psychologically. New cohorts are continually being born, and each experiences a unique sense of history

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36
Q

person environment fit theory

A

considers the interrelationships between personal competence and the environment. (ego strength, motor skills, biologic health, cognitive capacity and sensory–perceptual capacity)
-focuses on interaction between characteristics of the individual and the environment

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37
Q

psychological perspectives on aging

A

​​Nurses can use psychological theories to address response to losses, continued emotional development, devote time and energy to life review and self-understanding.

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38
Q

Five categories of basic human needs, ordered from lowest to highest

A

physiologic needs
safety and security needs
love and belongingness
Self-esteem
Self-actualization

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39
Q

life course theories

A

address old age within the context of the life cycle
-how early life events affect future decisions and outcomes

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40
Q

personality development theories

A

identify personality types as predictive forces of successful or unsuccessful aging

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41
Q

psychological theories of successful aging

A
  • Selection, optimization and compensation
  • Socioemotional selectivity theory
  • Strength and vulnerability integration theory
  • gender related theories
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42
Q

Selection, optimization and compensation

A

According to this theory, older adults select certain goals and tasks while disengaging from other goals; they optimize necessary resources to achieve these goals; and they compensate by establishing new resources to substitute for lowered or lost abilities and skill

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43
Q

Socioemotional selectivity theory

A

Proposed to explain emotional well-being during older adulthood. Older adults recognize that their time is limited, so they focus on emotional goals rather than on knowledge-seeking goals

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44
Q

Strength and vulnerability integration theory

A

Experience age-related gains as well as losses in emotion-related processes, and overall older adults maintain a positive level of emotional experience

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45
Q

gender related theories

A
  • Compare and contrast male and female performance data.
  • Examine the nature of change in gender roles.
  • Study the relationship between gender role differences and social roles and social power.
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46
Q

Faith community nursing

A

Faith community nurses spend 50% to 100% of their time providing services to older adults, such as health education, referrals, health screenings, personal counselling, spiritual support and health advocacy

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47
Q

geriatric care managers

A

primary care coordinator who is responsible for implementing immediate and long-term plans as the needs of the older adult change

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48
Q

sources of home care services

A

-Formal sources (agencies)
- Informal sources (independent caregivers, word-of-mouth network)
- Geriatric care management services

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49
Q

external ear

A
  • pinna and the external auditory canal
  • Cerumen is naturally expelled, but age-related changes—such as an increased concentration of keratin, the growth of longer and thicker hair (especially in men), and thinning and drying of the skin lining the canal—can cause it to build up.
  • decreased sweat gland activity with age (makes cerumen drier)
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50
Q

middle ear

A
  • tympanic membrane - transmits sound energy
  • With increased age, collagenous tissue replaces the elastic tissue, resulting in a thinner and stiffer eardrum.
  • the middle ear muscles and ligaments become weaker and stiffer.
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51
Q

inner ear

A
  • Age-related changes of the inner ear include loss of hair cells, reduction of blood supply, degeneration of spiral ganglion cells and loss of neurons in the cochlear nuclei.
  • These degenerative changes of the cochlea and other inner ear structures are the primary cause of the age-related hearing impairment.
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52
Q

The auditory nervous system is affected by all the following age-related changes:

A
  • Degenerative changes in the inner ear
  • Narrowing of the auditory meatus
  • Diminished blood supply and central nervous system changes.
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53
Q

build up of cerumen causes

A
  • Increased concentration of keratin
  • Growth of longer and thicker hair (especially in men), and
  • Thinning and drying of the skin lining the canal
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54
Q

leading cause of hearing loss

A

Impacted cerumen/impacted wax

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55
Q

risk factors for hearing loss

A

Genetic predisposition
Increased age
White race
Recreational or occupational exposure to noise
Smoking of nicotine products
Secondhand smoke
Ototoxic medications
Certain medical conditions (otosclerosis, diabetes, acoustic neuromas)
Ototoxic environmental chemicals

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56
Q

otosclerosis

A
  • A hereditary disease that affects the bones in the middle ear.
  • This impacts the normal movement of ossicles and this disrupts the transmission of sound waves to the inner ear.
  • Otosclerosis primarily causes a conductive hearing loss, but some sensorineural loss may also occur.
  • it is difficult to hear soft and low-pitched sounds; as the hearing loss worsens, the person is likely to experience dizziness, tinnitus or balance problems.
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57
Q

meunière disease

A

build up of fluid in inner ear

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58
Q

acoustic neuromas

A

tumor along vestibulocochlear nerve

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59
Q

conductive hearing loss

A

abnormalities of external and middle ear interfering with sound conduction

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60
Q

sensorineural hearing loss

A

abnormalities of sensory and neural structures of inner ear, usually age related or noise induced

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61
Q

Hearing acuity for high-frequency tones normally begins to decline when

A

in early adulthood, and by the age of 30 years for men and 50 years for women, there is some decline in hearing sensitivity at all frequencies

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62
Q

conductive hearing loss

A
  • Characterized by a reduced intensity of sounds and difficulty hearing vowels and low-pitched tones.
  • Occurs in one or both ears
  • Often there is a history of otosclerosis, perforated eardrum or other ear disease
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63
Q

presbycusis

A
  • Presbycusis is the sensorineural hearing loss associated with an age-related degeneration of the auditory structures.
  • Usually occurs in both ears
  • loss of ability to hear high-pitched sounds and sibilant consonants.
  • words become distorted
  • As the hearing loss progresses, explosive consonants, such as b, d, k, p and t, also become distorted.
  • Background noise and environmental conditions, compound the effects of sensorineural hearing loss and can interfere with the ability to recognize words
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64
Q

tinnitus

A
  • persistent sensation of ringing, roaring, blowing and buzzing
  • Symptom of underlying condition
  • Associated with hearing loss, ototoxic medications and Ménière disease
  • Exacerbated with caffeine, alcohol or nicotine
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65
Q

Normal Otoscopic Findings in Older Adults

A
  • Small amount of cerumen
  • Pinkish-white epithelial lining, no redness or lesions
  • Pearl-grey tympanic membrane, which is less translucent than in younger adults
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66
Q

how often should adults with hearing aids get otoscopic exams

A

every 3-12 months

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67
Q

auditory rehab

A

services that improve communication for people who are hearing impaired.
Auditory rehabilitation programs provide: counselling, education, amplification aids, communication methods and management of the environment.

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68
Q

presbyopia

A
  • loss of accommodation
  • accommodation - It is the ability to focus clearly and quickly on objects at various distances.
  • This vision change is caused by degenerative changes in the lens and the ciliary body.
  • ex: the need to hold reading materials farther from the eye to focus clearly on the print.
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69
Q

diminished acuity

A
  • normal value is 20/20
  • Visual acuity is best around age 30, after which it gradually declines.
  • changes in visual acuity can particularly affect night-driving competence.
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70
Q

dark and light adaptation

A
  • The ability to respond to both dim and bright light begins to decline around the age of 20 years and diminishes more markedly after age 60
  • older adult requires more time to adapt to dim lighting when moving from a brighter to a darker environment
  • older person responds more slowly to lights, such as car or bus headlights, and requires more time to recover from exposure to glare and bright lights
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71
Q

increased glare sensitivity

A
  • Glare is experienced when light is reflected from shiny surfaces, when the light is excessively bright or inappropriately focused, or when bright light originates from several sources at once
  • Beginning in the fifth decade, age-related changes increase a person’s sensitivity to glare and the time required to recover from glare.
  • these changes can significantly affect the person’s ability to read signs, see objects, drive at night and manoeuvre safely in bright environments.
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72
Q

reduced visual field

A
  • Functionally, the visual field is important when people engage in tasks that require a broad perception of the environment and moving objects.
  • Walking in crowded places and driving a vehicle are examples of activities that depend on the field of vision.
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73
Q

diminished depth perception

A
  • Depth perception is the visual skill responsible for locating objects in three-dimensional space, judging differences in the depth of objects and observing relationships among objects in space.
  • Older adults experience diminished depth perception, making it more difficult to use objects effectively and manoeuvre safely in the environment.
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74
Q

altered colour vision

A
  • Opacification and yellowing of the lens causes an altered perception of blues, greens and violets.
  • darkening of blue objects and a yellowed perception of white light.
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75
Q

diminished critical flicker fusion

A
  • Critical flicker fusion is the point at which an intermittent light source is perceived as a continuous, rather than flashing, light.
  • diminished critical flicker fusion causes a flashing light to appear to be continuous and it can interfere with the discernment of emergency vehicles and road construction lights, especially at night.
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76
Q

slower visual information processing

A
  • Age-related changes of the retinal–neural pathway affect the accuracy and efficiency of visual information processing.
  • Thus, older adults generally need more time to process visual information, but the effects are minimal or negligible when tasks are familiar.
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77
Q

Factors that interfere with visual wellness

A
  • Lifestyle factors: poor nutrition, cigarette smoking
  • Environmental factors: poor lighting, exposure to sunlight, wind, low humidity, warmer environmental temperatures, secondhand smoke
  • Chronic conditions: diabetes, hypertension, Alzheimer or Parkinson disease
  • Adverse medication effects: estrogen, corticosteroids, anticholinergics, β-blockers, antiparkinson agents
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78
Q

cataracts

A
  • Leading & reversible cause of visual impairment
  • Primary cause of avoidable blindness
  • the normally transparent lens becomes cloudy, transmission of light to the retina is diminished and vision is impaired
  • difficulty performing activities such as reading and night driving
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79
Q

cataracts risk factors

A
  • Advanced age, exposure to sunlight, smoking, diabetes, malnutrition, trauma or radiation to the eye or head, adverse effect of medications (e.g., corticosteroids)
  • Cigarette smoking and exposure to sunlight -most modifiable and preventable risk factor
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80
Q

cataracts signs and symptoms

A

Dim or blurred vision
Increased sensitivity to glare,
Decreased contrast sensitivity
Double vision
Seeing halos around bright lights*
Diminished color perception

81
Q

cataracts management

A
  • Initially managed with changes in correctives lenses
  • Surgical removal of lens followed by implantation of an intraocular lens
  • Nurses Responsibility
82
Q

age related macular degeneration (AMD)

A

Leading cause of severe vision loss in older adults

83
Q

AMD signs and symptoms

A
  • Initial form: loss of central vision, faces or straight lines appear wavy, blurred vision
  • advanced stage: it affects central vision and significantly interferes with activities such as reading, driving, watching television, recognizing people and
84
Q

AMD management

A

goal is to reduce the risk of further vision loss
Smoking cessation, nutrition interventions, visual rehab

85
Q

glaucoma

A
  • leading cause of blindness
  • aqueous humour accumulates and pushes the optic nerve into a cupped or concave shape. The resulting damage to the optic nerve causes a loss of peripheral vision. If left untreated, the damage can progress to blindness.
86
Q

glaucoma risk factors

A

Advanced age; African, Latino and Asian descent; family history of glaucoma; diabetes; regular or long-term use of corticosteroids

87
Q

chronic (open angle) glaucoma

A
  • Signs & symptoms: slow onset, diminished vision in dim light, increased sensitivity to glare, decreased contrast sensitivity, diminished peripheral vision
  • Treatment: medical therapy with prescription eye drops
88
Q

acute (closed angle) glaucoma

A
  • Caused by a sudden complete blockage of the flow of aqueous humour.
  • Abrupt onset in one or both eyes
  • Medical emergency.
  • Signs & symptoms: sudden onset, intense pain, blurred vision, halos around lights, nausea and vomiting
  • Treatment: immediate treatment with medications, followed by surgery
89
Q

oral cavity

A
  • With increased age, the tooth enamel becomes harder and more brittle.
  • Teeth are less sensitive to stimuli and more susceptible to fractures.
  • Gradual flattening of the chewing cusps.
    teeth may loosen or fall out.
  • xerostomia (dry mouth)
  • Slower emptying of the stomach
90
Q

digestion and eating patterns

A
  • Presbyphagia—slowed swallowing
  • reduced secretion of mucus, decreased elasticity of the rectal wall and diminished perception of rectal wall distention.
  • diminished bile acid synthesis
91
Q

protein

A

minimum daily intake of 1-1.6 g/kg of body weight

92
Q

carbs and fibre

A

25-38 g/day

93
Q

fat

A

no more than 20-30% of daily caloric intake

94
Q

Changes in the kidneys

A
  • Degenerative changes (glomerular filtration rate (GFR)
  • Replacement of the smooth muscle tissue in the bladder and urethra with less elastic connective tissue
  • Decreased blood flow
  • Decreased number of functioning nephrons
  • By age 50 GFR decreases by 50%
95
Q

medications that increase the risk for urinary incontinence

A

antihistamines, atypical antipsychotics and antihypertensive agents, particularly diuretics, calcium-channel blockers and angiotensin II receptor blockers

96
Q

Environmental Factors That Can Contribute to Urinary Incontinence

A
  • Stairways between the bathroom level and the living or sleeping areas
  • A distance to the bathroom that is more than 40 feet
  • Living arrangements where several or many people share a bathroom
  • Small bathrooms and narrow doors and hallways that do not accommodate walkers or wheelchairs
  • Chair designs and bed heights that hinder mobility
  • Poor colour contrast, as between a white toilet and seat and light-coloured floor or walls
  • Public settings with poorly visible or poorly colour-contrasted signs designating gender-specific bathroom facilities
  • Public settings with dim lighting and out-of-the-way bathroom facilities
  • Very bright environments, where glare interferes with the perception of signs for bathrooms
  • Mirrored walls, which reflect bright lights and create glare
97
Q

pathologic risk factors for incontinence

A
  • Stroke, arthritis, dementia, delirium, depression, diabetes mellitus, metabolic syndrome, Parkinson disease, fecal impaction and chronic obstructive pulmonary disease (COPD)
  • pelvic floor disorders
  • BPH
  • Any acute illness or surgical intervention that temporarily limits mobility or compromises mental abilities also represents a risk factor for urinary incontinence.
  • Constipation and low stool frequency (i.e., fewer than three bowel movements weekly)
  • Obesity and smoking
98
Q

aging: Effects on renal function

A
  • Impaired absorption of calcium, predisposition to hyponatremia and hyperkalemia, diminished ability to maintain fluid and electrolyte balance, and correct pH imbalances
  • Diminished renal function contributes to increased incidence of drug interactions and adverse medication reactions
99
Q

aging: effects on voiding patterns

A
  • Bladder capacity is smaller, & empties incompletely
  • May retain residual urine post voiding predisposing older adults to UTIs
  • Nocturia
100
Q

stress incontinence

A

sudden leakage of urine as a result of an activity that increases abdominal pressure, such as lifting, coughing, sneezing, laughing or exercise

101
Q

urge incontinence

A

involuntary urinary leakage soon after perceiving the urge to void

102
Q

mixed incontinence

A

involuntary leakage of urine with both the sensation of urgency and activities such as coughing, sneezing or exertion

103
Q

overflow incontinence

A

involuntary loss of urine due to overdistention of the bladder

104
Q

functional incontinence

A

involuntary loss of control over urination due to inability to reach appropriate toileting facility

105
Q

UTIs

A
  • Common in older adults
  • Common in long-term care settings
  • Risk factors: increased age, urinary incontinence and impaired functional or cognitive status
  • Catheter-associated urinary tract infections (CAUTIs), which is the single-most common cause of preventable health care–associated infections.
106
Q

Actions to Promote Good Urinary Control

A
  • Avoid foods and beverages that can irritate the bladder (e.g., caffeine, alcohol, artificial sweeteners and spicy and acidic foods).
    smoking.
  • Maintain ideal body weight and good physical fitness.
  • Take steps to prevent constipation (refer to Chapter 18, Box 18-6).
  • Practice pelvic muscle exercises
107
Q

Nursing Interventions to Promote Urinary Wellness

A

Teach about overall urinary wellness.
Interventions for urinary incontinence
Teach pelvic floor muscle exercise (PFME).
Initiate continence training programs.
Suggest environmental modifications.
Use appropriate continence aids.
Be knowledgeable about medications for urinary incontinence.
Interventions such as asking patient to void before bedtime

108
Q

Teach pelvic floor muscle exercise

A

It’s useful in the following conditions:
Urge incontinence
stress incontinence
pelvic organ prolapse

109
Q

Age-Related Changes that Affect Cardiovascular Function

A
  • myocardial atrophy or hypertrophy, valvular thickening and stiffening, and increased amounts of connective tissue.
  • Changes in the tunica intima, the innermost vascular layer, contribute to the development of atherosclerosis
  • Changes in the tunica media, the middle layer, are associated with hypertension.
  • The outermost layer (the tunica externa) does not seem to be affected by age-related changes.
110
Q

Risk Factors for Cardiovascular Function

A

Cardiovascular disease/heart disease
Atherosclerosis
Physical inactivity/physical deconditioning
Tobacco smoking and secondhand smoke
Dietary habits
Obesity/abdominal obesity
Hypertension
Lipid disorders/dyslipidemias
Metabolic syndrome/insulin-resistance syndrome
Psychosocial factors (stress, anxiety, depression, social isolation, poor social supports)
Heredity and socioeconomic factors
Women & minority groups: African American women have higher risk for developing cardiovascular dysfunction

111
Q

effects on cardiac function

A

healthy older adults do not experience any decline in cardiac output.

112
Q

effects on pulse and blood pressure

A
  • pulse rate for healthy older adults is slightly lower than that for younger adults
    -harmless ventricular and supraventricular arrhythmias
  • Atrial fibrillation commonly occurs in older adults, but this is associated with pathologic conditions (e.g., hypertension, coronary artery disease) rather than with age-related changes.
  • age-related increase in systolic blood pressure from ages 30 to 40 years.
113
Q

Effects on Response to Exercise

A
  • The maximum heart rate achieved during exercise is markedly decreased, and oxygen consumption decline in older adults.
  • Most of this decline is attributable to physical deconditioning and other risk factors, rather than to age-related changes alone.
114
Q

effects on circulation

A
  • reduce cerebral blood flow to some extent in healthy older adults
  • Increased dilation of the veins, along with decreased efficiency of the valves, lead to impaired venous return from the lower extremities.
115
Q

Orthostatic hypotension/postural hypotension

A

Reduction in systolic blood pressure of at least 20 mmHg or diastolic blood pressure of at least 10 mmHg when assuming a standing position after being recumbent for at least 5 minutes

116
Q

Postprandial hypotension

A

Reduction of systolic blood pressure—drop of 20 mmHg in a supine/sitting position within 120 minutes after eating a meal

117
Q

Pseudohypertension

A

the phenomenon of elevated systolic blood pressure readings that result from the inability of the external cuff to compress the arteries in older people with arteriosclerosis

118
Q

cardiovascular disease modifiable risk factors

A

Hypertension
Lipid disorders
Smoking cessation
Obesity, physical inactivity, dietary habits

119
Q

primary and secondary interventions for healthy cardiovascular function

A

These interventions address specific risk factors, such as smoking, hypertension, obesity and lipid disorders as well as preventive measures, such as optimal levels of physical activity, heart-healthy dietary patterns and stress-reduction actions.

120
Q

Age-Related Changes:
Upper respiratory structures

A
  • Diminished blood flow to the nose
  • Thicker mucus
  • Stiffening of trachea
  • Blunted cough and laryngeal reflexes
  • Atrophy of laryngeal nerve endings
121
Q

Age-Related Changes: Chest wall and musculoskeletal structures

A
  • Ribs and vertebrae become osteoporotic
  • Costal cartilage calcifies
  • Respiratory muscles weaken
  • Structural changes
  • Kyphosis: curvature of spine
  • Shortened thorax
  • Increased anteroposterior diameter of the chest
  • Chest wall stiffens
122
Q

Age-Related Changes: Lung structure and function

A
  • Lungs become smaller and flaccid.
  • Pulmonary artery becomes wider, thicker and less elastic.
  • Diminished capillaries
  • Decrease in capillary blood volume
  • Mucosal bed thickens
    gas exchange is compromised in the lower lung regions
123
Q

age related changes in immune function

A

Age-related alteration of T cells contribute to increased prevalence of lung diseases.

124
Q

Workforces With an Increased Risk for Harmful Respiratory Effects

A

Firefighters
Miners
Traffic controllers
Shipyard workers
Rubber workers
Aluminum workers
Iron and steel foundry workers
Tunnel and street repair orkers
Asbestos workers
Quarry workers
Farmers, agricultural workers, grain handlers
Construction workers
Paper mill workers
Workers exposed to the following: dust, fumes, gases, nickel, arsenic, beryllium, chromium or radiation

125
Q

risk factors for respiratory disease

A
  • ​​Obesity or chronic illness
    bedrest
  • Kyphosis - associated with poor posture and shallow breathing patterns
  • Lack of vaccinations
  • Medications - sedatives and anti-cholinergic medications
126
Q

Poor oral care

A

increases the risk of pneumonia

127
Q

Risk factors for TB

A

Overcrowded areas
Smoking
Diabetes
Malnutrition
Debilitating conditions

128
Q

COPD

A
  • Chronic obstructive pulmonary disease (COPD): chronic airflow obstruction interfering with breathing
  • Risk factors: exposure to secondary smoke and other air pollutants, increased age, genetic predisposition, low socioeconomic status and history of significant childhood respiratory disease.
  • Common manifestations: cough, dyspnea, wheezing and sputum production
  • Health promotion: participation in self-management programs
129
Q

most visible indicator of biologic aging, lifestyle and environment

A

skin

130
Q

epidermis

A

-rate of epidermal turnover gradually decreases.
- Beginning around the age of 25 years, the number of active melanocytes decreases
-Moisture content of the outer epidermal layer decreases.
-flattening of the dermal-epidermal junction and diminishing the surface area between the epidermis and dermis slows the transfer of nutrients and oxygen between the dermis and epidermis.

131
Q

dermis

A
  • dermal thickness gradually diminishes
  • The dermal vascular bed decreases and this contributes to the atrophy and fibrosis of hair bulbs, sweat and sebaceous glands.
132
Q

Subcutaneous Tissue and Cutaneous Nerves

A

-With increased age, atrophy of subcutaneous tissue , particularly in the plantar foot surface and in sun-exposed areas of the hands, face and lower legs takes place.
- This increased body fat is more pronounced in women than in men and is most noticeable in the waists of men and the thighs of women.
- Age-related changes also affect the cutaneous nerves responsible for sensations of pressure, vibration and light touch.

133
Q

sweat and sebaceous glands

A

-Both eccrine and apocrine glands decrease in number and functional ability with increased age.
-sebaceous glands increase in size but produce less sebum.

134
Q

nails

A
  • Nail growth begins to slow in early adulthood
  • Nails of older adults gradually become thinner, fragile, brittle and more prone to splitting.
  • In appearance, the older nail is dull, opaque, longitudinally striated, and yellow or grey.
135
Q

hair

A

-About half of adults at the age of 50 years have greying hair
-By the age of 50 years, about 60% of men have a noticeable degree of baldness
-Progressive loss of body hair, initially in the trunk, then in the pubic area and axillae.

136
Q

risk factors that affect skin wellness

A
  • genetics (People with fair skin, light hair and light eyes are more sensitive to the effects of ultraviolet radiation)
    -Smoking, sun exposure, emotional stress, and substance or alcohol abuse are the health behaviours and environmental factors that significantly affect skin wellness.
    -Exposure to ultraviolet radiation is the most significant environmental factor.
  • medication
137
Q

Effects of smoking on the skin include all of the following:

A
  • More wrinkles
  • Greyish discolouration
  • Diminished ability to protect against ultraviolet radiation damage
  • Increased risk of skin cancer
138
Q

Medication effects on skin

A
  • Common adverse medication effects involving the skin include pruritus, dermatoses and photosensitivity reactions.
  • Medications that commonly cause dermatitis include antibiotics, nonsteroidal anti-inflammatory drugs, anti-convulsants, and antihypertensive agent
  • Photosensitivity is an adverse medication effect that causes an intensified response to ultraviolet radiation.
  • Amiodarone, furosemide, naproxen, phenothiazines, sulfonamides, tetracyclines, and thiazides are examples of medications that can cause photosensitivity reactions.
    -St. John’s wort and other herbal preparations may also increase the risk of photosensitivity.
139
Q

skin cancer

A

-abnormal growth of skin cells
- Age-related changes and long-term sun exposure
- Main 2 types of cancer: Basal cell carcinoma & Squamous cell carcinoma
- Melanoma: originates in the melanocytes, is the most serious type of skin cancer and the one most likely to be fatal

140
Q

Skin tear classification system

A
  1. No skin loss, with an average of 10 days to heal
  2. Partial thickness (i.e., epidermis separated from the dermis), with an average of 14 days to heal
  3. Full thickness (i.e., both epidermis and dermis separated from underlying tissue), with an average of 21 days to heal
141
Q

maintaining healthy skin

A
  • Include adequate amounts of fluid in the daily diet.
  • Use humidifiers to maintain environmental humidity levels of 40% to 60%.
  • Apply moisturizing lotions twice daily or as needed.
  • Use moisturizing lotions immediately after bathing, when the skin is still moist.
  • Avoid massaging over bony prominences when applying lotions.
  • Avoid skin care products that contain perfumes or isopropyl alcohol.
  • Avoid multiple-ingredient preparations because unnecessary additives may cause allergic responses.
  • Inspect skin monthly for suspicious-looking changes.
142
Q

personal care practices for maintaining skin

A

When bathing or showering, use soap sparingly or use a mild, unscented soap (e.g., Dove, Tone, Basis, Aveeno).
Maintain water temperatures for bathing at about 32°C to 37°C.
Rinse well after using soap. Whirlpool baths stimulate circulation, but moderate temperatures should be maintained.
Apply emollient moisturizing products after bathing, rather than using them in the bath water, to minimize the risk for falls on oily surfaces and to maximize the benefits of the emollient.
Use emollient products containing petrolatum or mineral oil (e.g., Keri, Eucerin, Aquaphor, Vaseline).
If you use bath oils, take extra safety precautions to prevent slipping.
If moisturizing products are applied to the feet, wear nonskid slippers or socks before walking.
Dry your skin thoroughly, particularly between your toes and in other areas where your skin rubs together.
When drying your skin, use gentle, patting motions rather than harsh, rubbing motions.
Include adequate amounts of fluids and vitamins in the daily diet
Obtain regular podiatric care.

143
Q

Prevent Sun Damage and Skin Cancers

A

Wear wide-brimmed hats, sun visors, sunglasses and light-coloured clothing when exposed to the sun.
Wear clothing made of cotton, rather than polyester fabrics, because ultraviolet rays can penetrate polyester.
Apply sunscreen products liberally beginning 1 hour before sun exposure and reapplying at frequent intervals.
Use sunscreen lotions with an SPF of 30. Avoid exposure to the sun between 10:00 AM and 4:00 PM.
Protect yourself from ultraviolet rays even on cloudy days and when you are in the water (lake, pool, ocean).
Artificial tanning booths use ultraviolet type A rays, which have been found to cause damage and increase the risk for skin cancers.

144
Q

The best methods of preventing skin lesions and wrinkles

A

avoiding too much exposure to sunlight and using a sunscreen and other protective measures when exposure to sunlight is unavoidable.

145
Q

Age-Related Changes That Affect Sleep and Rest: Sleep Quality

A

Sleep Quantity: Sleep efficiency decreases in older people
Sleep Quality: Longer time to fall asleep, more frequent arousals.

146
Q

risk factors that affect sleep

A
  • Anxiety, boredom and social isolation
  • Noise, lack of privacy, temperature of room, light and hot or humid conditions
  • Chronic conditions, nocturia, obstructive sleep apnea
  • Restless leg syndrome:
  • Periodic limb movements during sleep (PLMS),
  • Adverse effects of medications, caffeine and alcohol
147
Q

Functional Consequences Affecting Sleep Wellness

A
  • Longer time needed to fall asleep
  • Frequent arousals during night
  • More time in bed to achieve same quantity of sleep
  • Diminished quality of sleep (less dreaming and deep sleep)
148
Q

Pathologic Conditions Affecting Sleep: Sleep Disorders

A

-Insomnia
-Excessive daytime sleepiness
-Obstructive sleep apnea

149
Q

Health Promotion Teaching About Sleep

A
  • Establish a bedtime ritual that is effective for you, and try to follow it every night.
  • Maintain the same daily schedule for waking, resting and sleeping.
  • Take a warm, relaxing bath in the afternoon or early evening.
  • After 1:00 PM, avoid foods, beverages and medications that contain caffeine or stimulants (e.g., tea, cocoa, coffee, chocolate, sugar, refined carbohydrates, and some over-the-counter pain relievers and cold preparations).
  • Pre-bedtime foods that promote sleep include milk (warm), chamomile tea and a light snack of complex carbohydrates (e.g., whole grains).
  • Use one or more of the following relaxation methods: imagery, meditation, deep breathing, progressive relaxation, soothing music, body or foot massage, rocking in a chair, reading non stimulating materials or watching non stimulating television.
  • Perform daily moderate aerobic exercise, preferably before the late afternoon, but avoid vigorous exercise in the evening.
  • Ensure adequate intake of the following nutrients: zinc, calcium, magnesium, manganese, vitamin C and vitamin B complex.
150
Q

sleep: actions to avoid

A

-Do not drink alcohol before bedtime because it may cause early-morning awakening. If you use alcohol, use only in small amounts.
-Do not smoke cigarettes in the evening because nicotine is a stimulant.
-If your bedtime is temporarily changed, try to keep your waking time as close to the usual time as possible, and avoid staying in bed beyond your usual waking time.
-Do not use your bed for reading or other activities not associated with sleeping.
-If you awaken during the night and cannot return to sleep, get out of bed after 30 minutes and engage in a nonstimulating activity, such as reading, in another room.
-Arise at your usual time, even if you have not slept well.

151
Q

Perimenopause

A

refers to the several years before menopause when women begin experiencing manifestations of approaching menopause (e.g., changes in menstrual cycles, vasomotor symptoms, vaginal dryness).

152
Q

postmenopause

A

begins 12 months after a woman’s last menstrual cycle.

153
Q

sexual changes affecting women

A

-Diminished estrogen levels
breasts become more pendulous and have more fat and less mammary tissue.
-Vaginal dryness
diminished quantity of pubic hair and atrophy of sexual organs.
-About 75% to 80% of all menopausal women experience hot flashes
-increased risk for osteoporosis, cardiovascular disease, Alzheimer disease and metabolic dysfunction, depression

154
Q

sexual changes affecting men

A

-Production of viable sperm gradually diminishes
-Andropause (or male menopause) is the age-related decline in testosterone in men that begins around the age of 30 years
-low serum testosterone levels are associated with increased risk for pathologic conditions, such as anemia, diabetes and osteoporosis

155
Q

Detrimental effects on sexual wellness

A

-Pain, cancer, diabetes, cardiovascular disease, obstructive sleep apnea
-Prevalence of erectile dysfunction in men with diabetes is 50% or more
-Women with diabetes or metabolic syndrome also have a high prevalence of sexual dysfunction, such as problems with orgasm or lubrication
-Depression is strongly associated with sexual dysfunction

156
Q

sexual dysfunction: gender specific conditions

A

Prostatic hyperplasia
Urethritis & Vaginitis

157
Q

Functional Consequences Affecting Sexual Wellness

A

-Reproductive ability: ceases in women and diminishes in men
Response to sexual stimulation: slower and less intense
-Regularly engaging in sexual activity helps older adults respond to sexual stimulation.
-Any major changes in response to sexual stimulation are associated with risk factors rather than aging
-Sexual interest and activity: older adults do not lose their interest in or capacity for sexual activity because of age-related changes,
-Sexual dysfunction in men and women: Erectile dysfunction, defined as the inability to achieve or maintain an erection sufficient for satisfactory sexual function in men.

158
Q

Issues Associated with HIV/AIDS in Older Adults

A

-Older adults are likely to be diagnosed at a later stage
-Older adults have a shorter interval before progression to AIDS, particularly if HIV was diagnosed after the age of 60 years.
-increased risk for dying due to AIDS
-Older adults with HIV/AIDS have high rates of depression.
more likely to have less social support due to ageism, living alone, perceived stigma and nondisclosure of HIV status.
-Caregivers of people with HIV/AIDS experience significant levels of stress,

159
Q

scaffolding

A

a normal process that involves the development and use of complementary and alternative neural circuits to achieve a cognitive goal.

160
Q

mild cognitive impairment

A

heterogeneous syndrome characterized by cognitive functionthat is impaired beyond “normal aging” but does not meet thecriteria for mild dementia.

161
Q

paradox of wellbeing

A

the phenomenon of older adults suffering significant losses of health, cognition and social functioning but reporting high levels of well-being and positive emotions

162
Q

Age-Related Changes That Affect Cognition

A

-degenerative brain changes
-decreased reaction time
-slower processing of information
-Decreased cerebral blood flow and volume
-Reduced brain weight, enlarged ventricles and wider sulci, loss and shrinkage of neurons, reduced neurotransmitters or their binding sites
-Current research emphasizes that brain maturation and associated cognitive abilities continue to develop throughout adulthood and can be improved even in older adults

163
Q

risk factors that affect cognition

A

-myths about aging and cognition
-decreased vision and hearing
-adverse effects of alcohol and medication (anticholinergics)
-diseases (dementia, depression)
-Nutritional deficiencies (low levels of β-carotene, and vitamins B, C and D)
-mental health (stress)
-Occupational, environmental exposure (secondhand smoke)
-Diminished brain volume and loss of white matter (caused by pathological processes like diabetes/hypertension)

164
Q

fluid intelligence

A

-Capacity to solve new problems, adapt to new situations, and think abstractly and logically.
-It involves reasoning, pattern recognition, and the ability to manipulate informatio
-Characterized by the ability to handle unfamiliar tasks and find solutions to problems
-Peak in early adulthood and then gradually decline with age
-Fluid intelligence involves tackling new, abstract, and unfamiliar tasks

165
Q

crystallized intelligence

A

-Knowledge and skills that a person has acquired over their lifetime through learning and experience
-Focuses on vocabulary, information, and verbal comprehension
-person’s ability to use their accumulated knowledge and expertise to solve problems and make decisions
-It is the result of years of learning, education, and experience
-Crystallized intelligence continues to develop during adulthood because of accumulated experiences and learning
-does not decline with age, and it may even increase

166
Q

primary memory

A

short duration, small capacity

167
Q

secondary memory

A

longer duration, important for retrieval and storage

168
Q

memory

A

-Both types of memory decline equally but older adults have a larger store of information about events of long ago
-memory skills in older adults are better when the information is highly interesting, emotionally positive or personally relevant.

169
Q

metamemory

A

refers to self-knowledge and perceptions about memory, cognitive function and development of memory. Metamemory is important in everyday activities because if people know what they can remember and how much effort they will need to remember certain things, they can plan efficient and effective strategies for remembering.

170
Q

Functional Consequences Affecting Cognition

A

-Age-related declines in some cognitive skills begin around the age of 40
-Age-related cognitive changes generally occur at a slow linear rate; any major or rapid changes are due to pathologic processes.
-Many studies suggest that cognitive function is increasing in successive cohorts of older adults
-Pathologic processes, such as those related to inflammatory processes and cardiovascular diseases, are associated with greater degrees of cognitive impairment.

171
Q

Cognitive Abilities in Healthy Older Adults

A

-Skills that stay the same: improve wisdom, creativity, common sense, coordination of facts and ideas, and breadth of knowledge and experience
-Skills that decline slightly and gradually: Calculation, word fluency, verbal comprehension, inductive reasoning
-Word finding may be more difficult but total vocabulary increases.
-Remote memory remains intact and holds a large store of information about the past.

172
Q

Factors that can cause cognitive impairment

A

anxiety, depression, diminished sensory input, poor health, negative beliefs, ageist attitudes, pathologic processes (e.g., dementia)

173
Q

Factors that improve cognitive function

A

good nutrition, physical exercise, mental stimulation, challenging leisure activities, strong social networks, and activities that provide a sense of control and mastery

174
Q

Nursing Interventions to Promote Cognitive Wellness

A

Eat foods high in antioxidants
omega-3 fatty acids
limit salt, cholesterol and saturated fat.
Maintain a healthy weight.
Engage in regular physical activity,
Engage in new learning experiences that are appealing and challenging.
Practice body–mind activities
Participate in leisure activities, such as dancing, playing board games
Choose activities in which there is a sense of control and mastery, such as playing computer games or learning a new skill.
Maintain strong and frequent social relationships
Encouraging participation in mentally stimulating activities

175
Q

Improving Concentration and Attention

A

-Techniques, such as relaxation, imagery and meditation.
-Mindfulness (also called mindfulness meditation),
-Self-help books describe techniques for meditation, mindfulness and relaxation as ways of maintaining or improving cognitive function and opening the mind to new learning.

176
Q

delirium

A
  • rapid onset
    -Course (duration) short - diurnal fluctuations – worse at night, in dark
  • Duration - hours to < 1 month
    -Possible Causes:
    Infections, serious illness, fever, lack of vitamins, seizures, lack of oxygen, head injury, medications, alcohol, advanced age, dementia, depression, functional dependency, polypharmacy, surgery, and physical restraints
    After surgery, falls
177
Q

Functional Consequences of Delirium

A

Longer hospital stays
Increase mortality
Increase dependency
Short/long-term functional impairment
Higher rates of permanent residency in long-term facilities

178
Q

Confusion Assessment Method (CAM)

A

delirium is diagnosed on the basis of a four-point algorithm
1. Acute onset or fluctuating course:
2. Inattention
3. Disorganized thinking
4. Altered level of consciousness

179
Q

Nursing Interventions for Delirium

A

Provision of aids to orientation (e.g., clock, watch, calendar) and aids to improve sensory function (e.g., eyeglasses, hearing aids)
Frequent verbal orientation and reminders about daily events
Environmental modification (e.g., noise reduction, familiar objects)
Psychological support (e.g., cognitive and social stimulation)
Identification of adverse medication effects
Promotion of physiologic stability (e.g., low-dose oxygenation, maintenance of fluid and electrolyte balance)
Adequate pain management
Promotion of normal sleep–wake pattern
Maintenance of optimal bowel and bladder function
Physical activity (e.g., ambulation, physical therapy, occupational therapy)
Provision of cognitively stimulating activities
Encouragement of family and support people to be with the person

180
Q

dementia

A

a group of diseases.
a group of brain disorders characterized by a gradual decline in cognitive abilities (e.g., memory, understanding, judgment, decision-making, communication) and changes in personality and behaviour.
Two or more types of dementia can develop at the same time or sequentially.

181
Q

Alzheimer

A

-Insidious onset
-Progressive over 5-10 years
-60-80% of all dementias
Memory loss that disrupts daily life
-Challenges in planning or solving problems
-Difficulty completing familiar tasks at home, at work or at leisure
-Confusion with time and place
-Trouble understanding visual images and spatial relationships
-Changes in language or writing skills
-Misplacing things and losing the ability to retrace steps
-Impaired judgment
-Withdrawal from work or social activities
-Changes in mood and personality

182
Q

vascular dementia

A

-abrupt onset
-history of vascular risks (stroke, hypertension)
-improvement possible depending on causative factors
-based on the area of the brain that’s affected
-aphasia, memory impairment, apathy, depression, emotional lability, sensory motor deficits (gait, hemiparesis, incontinence)

183
Q

Lewy body dementia

A

-Insidious onset with progressive decline in cognitive behavioural and motor symptoms
-manifests similar to parkinsons
-significant cognitive impairment
-fluctuating levels of cognition
-parkinsonisms
-hallucinations, sleep disturbances
-loss of postural stability
-sensitive to neuroleptic medications and anticholinergics
-may decompensate rapidly with other comorbid conditions

184
Q

frontotemporal degeneration

A

-Early and progressive changes in behaviour, motor abilities, and/or speech language skills
-memory impairments occur later

185
Q

Self-Awareness of People with Dementia

A

Research showing persons with dementia are aware of deficits

186
Q

Behavioural and Psychological Symptoms of Dementia

A

Agitation
Psychiatric symptoms (delusions, hallucinations)
Personality changes
Mood disturbances
Aberrant motor movements
Changes in sleep, eating and appetite
Hypersexual behaviour

187
Q

environmental modifications for dementia

A

Modify the environment to compensate as much as possible for sensory deficits and other functional impairments.
Use clocks, calendars, daily newspapers and simple written cues for orientation (e.g., day, date, names, place, events).
Use simple pictures, written cues or colour codes for identifying items and places (e.g., toilet, bedroom).
Use simple written cues to clarify directions for operating radios, televisions, appliances and thermostats (e.g., on, off, directional arrows).
Place pictures of familiar people in highly visible places, but use nonglossy pictures and nonglare glass in picture frames.
Turn lights on as soon as, or before, it gets dark.
Use nightlights, or leave dim lights on during the night.
Provide adequate environmental stimuli while avoiding overstimulation.

188
Q

Techniques to Facilitate Independent Performance of ADLs

A

Keep all activities as simple and routine as possible.
Establish routines that allow for maximum independence and the least amount of frustration.
Lay out one set of clothing in the order in which the items are to be donned.
Arrange personal care items, such as grooming and hygiene aids, in a visible and uncluttered place, in the order in which the items are to be used.
Leave a toothbrush on the bathroom sink with toothpaste already on it.
Establish an individualized toileting plan that allows for maximum independence but minimal risk for incontinence episodes.
Offer finger foods and nutritious snacks if the person will not sit at the table to eat a meal.

189
Q

Facilitating Communication With People who have Dementia: Verbal Communication

A

Adapt your level of communication to the abilities of the person with dementia.
Simplify sentences
Present only one idea at a time.
Allow enough time for processing.
Avoid infantilization
Assist with word finding
Avoid shaming the person (
Paraphrase what the person says, and ask for clarification about the meaning.
repeat the statement using the same words, or simplify the wording.
Do not argue with the person, unless it is a matter of safety.
Avoid complex or sarcastic humour.
Use positive statements
Involve the person with decisions to the best of his or her ability by offering simple and concrete choices
Do not ask questions that you know the person cannot answer correctly.
Do no
Listen to the feelings the person is trying to express and respond to the feelings, rather than the statement

190
Q

Facilitating Communication with People who have Dementia: Nonverbal Communication

A

Attract and maintain the person’s attention (e.g., through eye contact, pleasant facial expressions).
Use a relaxed and smiling approach.
Reinforce verbal communication with appropriate nonverbal communication (e.g., demonstrate what you are asking the person to do).
Use simple pictures rather than written cues.
Use appropriate touch for communication
unless the person responds negatively to touch.
Be aware of your own nonverbal communication.
Closely observe all nonverbal cues exhibited by the person
Assume that all nonverbal expressions of the person with dementia are attempts to communicate needs or feelings.

191
Q

major depressive disorder

A

-depressed mood and/or loss of interest or pleasure
-at least five of the following signs and symptoms:
-weight loss, appetite change, sleep disturbances, observable psychomotor agitation or retardation (i.e., slowness), fatigue or loss of energy, feeling worthless or excessively guilty, cognitive impairment, and recurrent thoughts of death or suicide
- noticeably interferes with usual functioning and is associated with significantly diminished quality of life

192
Q

subthreshold depression

A

Same signs and symptoms as major depression but not as severe

193
Q

Late-life depression

A

onset of depression after age 65
Often unrecognized and undertreated.
Older adults are less likely to admit to depression to health care professionals.
Causative factors are more complex
Depression often occurs with other conditions.
Associated with more serious consequences

194
Q

Psychosocial theories of depression

A

-Psychosocial theories focus on the impact of loss, as well as the buffering effects of social supports and the social network in protecting against depression.
-Learned helplessness theory: Deficit in the following four areas: cognitive, motivational, self-esteem and affective-somatic.
-Depression occurs when people expect bad things to happen, believe they can do nothing to prevent them
-can help identify factors that protect older adults from depression
-The learned helplessness theory supports the use of nursing interventions directed toward improving self-efficacy and a sense of control over one’s environment.

195
Q

cognitive triad theory

A

-Depression is caused not by adverse events, but by distorted perceptions, which impair one’s ability to appraise oneself and the event in a constructive manner.
-Cognitive triad: self-image, their environment or experiences, and their future
-Depressed people judge these three realms as lacking some features that are necessary for happiness

196
Q

risk factors for depression

A

Female sex
Personal or family history of depression
Loss of significant relationships
Loneliness
Chronic stress
Recent social stressors
Stressful social environment
Loss of meaningful social interaction
Lack of social supports
Loss of significant roles
Current or previous experiences of abuse or neglect
Being a caregiver (including assuming primary care of a grandchild).
Adverse medication effects can cause a depressive syndrome
alcohol

197
Q

Functional Consequences of dementia

A

Loss of appetite
Weight loss
Digestive system complaints, particularly dysphagia, flatulence, constipation, stomach distress or early satiety
Insomnia, hypersomnia, frequent awakening, early-morning awakening and other sleep disturbances
Fatigue, loss of energy
Pain, discomfort, dyspnea, general malaise
Slowed or increased psycho-motor activities
Loss of libido or other problems with sexual function
Slowed body movements and slowed verbal responses
Feeling extremely fatigued and having little or no energy
Psychomotor agitation

198
Q

Suicide in Late Life

A

-Often overlooked; less attention in older population
-Major public health concern
-Suicidal events unreported
-Suicide rates and mechanisms vary by gender and ethnicity.
-Suicide rates higher for men than for women

Nurs 3035 (2 decks)

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