MIDTERM Flashcards
1
Q
what is the most important stage in Ericson’s theory for older adults
A
integrity and despair: where older adults either feel whole (integrity) with where their life’s at and how much they have accomplished or despair (disappointment) of their life’s outlook.
2
Q
S&S of integrity and despair
A
integrity
- feeling happy and accomplished about your life
- having no regrets and pride of how you’ve lived
- talking about your life to others and how well you’ve spent it.
despair
- being depressed and having a negative outlook on life
- being bitter and frustrated about the past and holding on to that
- being isolated from rest of the group because of the hopelessness and lost opportunities of the past
3
Q
what is the leading cause of disability in old age?
a. arthritis
b. cancer
c. COPD
d. injuries
A
arthritis
4
Q
what are the NI for arthritis
A
- cold or heat compresses
- warm blankets
- ROM exercises to prevent stiffness
5
Q
what is a chronic illness
A
lasts a year or more and requires ongoing medical attention it could affection your ADL’s
6
Q
give an example of a chronic illness
A
- diabetes
- osteoarthritis
- rheumatoid arthritis
7
Q
three common theories of error are
A
- wear and tear
- cross link theory
- oxidative
8
Q
changes in the integumentary (skin) are..
A
- skin becomes thin making blood vessels and bruising more easier to see
- cell’s take a longer time to regenerate
- reduced blood supply; harder for older people to heal from wounds
- melanin decreases
- collagen decreases making the skin more looser, saggy, and wrinkly
- fat decreases causing older people to be more colder
- reduced sweat glands so skin becomes more dry
9
Q
what are the changes in the hair for older adults?
A
- women get chin and facial hair
- men get stiff nose, ears, and eyebrow hair
10
Q
what are the changes in the nails
A
- they change their shape and become flat or convex
- lower cap refills and nails grow slowly
- nails become hard, opaque, and dull
11
Q
What happens to hair as men and women age, according to the sources?
a) Hair becomes thicker and more abundant all over the body
b) Both men and women in all racial groups have less hair
c) The amount of hair in the ears and nose of older women increases
d) Hair becomes softer and grows at a faster rate
A
B
12
Q
how would you promote healthy skin while aging?
A
- promote water intake
- use sunscreen and avoid excessive sun exposure
- apply moisturizer to damp skin after a bath
13
Q
what are the changes in the musculoskeletal system?
A
- reduced height because vertebral disk thin bc of dehydration
- weaker bones (because of bone mineral density (BMD)
- kyphosis (stooped posture) bc the bones get weak and start curving
14
Q
what would the nursing interventions for the musculoskeletal system be in an older adult?
A
- regular stretches and ROM exercises
- regular calcium and vitamin D intake
15
Q
musculoskeletal arthritis
A
- joint inflammation
- more severe in women
- osteoarthritis (wear and tear) is most common type of arthritis; where bones rub together
- the the spine, knees, and hips are more likely to get damaged first because they hold the weight of the person
- stuff like age (as you use your body more = more wear and tear), heredity (if someone in your family had arthritis), and obesity (puts pressure on hips, spine, knees) influence the development of arthritis
16
Q
musculoskeletal osteoporosis
A
- bone (osteo), pore (por), disease (osis) = osteoporosis
- more at risk for fractures because pores causes bones to be weaker
- common sites at forearm, pelvis, humerus, forearm, hip, vertebrae
17
Q
what are the changes with blood vessels
A
- blood vessels become stiffer and less elastic meaning less blood goes to organs like the kidney and liver
- increased resistances (meaning heart has to pump harder to get blood to the extremities like legs, feet, hands)
18
Q
cardiovascular system changes
A
- how much the hart pumps and the amount of blood it pumps decreases (stroke volume and cardiac output)
- so it takes longer for the heart to pump and return to its resting state as you get older
19
Q
what are the nursing interventions for promoting a healthy heart?
A
- stop smoking (can cause plaque build up in the blood vessels)
- low sodium diet (puts less pressure on the heart eases the contractions)
- stress management (yoga, medication, or playing sports)
20
Q
what are the changes in the respiratory system
A
- reduced cilia meaning more waste enters the lungs higher chance of infections and respiratory diseases
- lungs lose their elastic recoil meaning some air is still trapped inside
- harder to expand the chest bc the chest wall is less flexible and stiff
- more resistance to the lungs causing them to be narrow and harder to breath
21
Q
what would you do promote healthy lungs
A
- get immunized or vaccine for influenza and pneumonia
- medical asepsis (wash hands, wear masks if you’re around a sick person)
- have good oral health because bacteria in the mouth could lead to the lungs
- don’t smoke
22
Q
what are the normal changes in the renal system
A
- the kidney shrinks
- we lose 50% of our nephrons which help filter the waste
- the blood flow in the kidneys decrease meaning they don’t function as well as they should
- urine creatinine declines because nephrons decline and they filter the creatinine out
23
Q
what is creatinine clearance?
A
creatinine clearance tells us how well the kidneys are working and how well medications taken by the patient can process out through metabolization
24
Q
The nurse administers and antibiotic and Naproxen to an
older female adult. Which laboratory test should the nurse monitor to gauge if the older adult’s kidneys are able to metabolize the medications?
a) Urine Creatinine
b) Bilirubin
c) White Blood Cells (WBC)
A
a) urine creatinine is assessed through kidney function through the filtration process
b) assesses liver function
c) assesses for infection and inflammation
25
what changes happen with the endocrine system
- in the PANCREAS as we get older the cells like muscles and fats stop responding to insulin being insulin resistant
- in the THYROID GLAND it produces less TSH and T4 hormones that make you have less energy and could be at risk for hypo/hyperthyroidism
26
what changes happen in the mouth
- teeth decay
- if you don't floss the gums can have periodontal disease
- taste buds decline
the mouth is connected to the brain poor health in the mouth could lead to issues in the brain
27
what happens in the gastrointestinal - esophagus
- peristalsis slows down making chocking a hazard
- GERD (gastroesophageal reflux disease), acid reflux, and hiatal hernias are common
28
gastrointestinal changes in the intestine include
- villi become less functional and shorter affecting the nutrients being absorbed
- peristalsis slows down
29
gastrointestinal - accessory organs (liver and gallbladder)
- liver decreases in size and slows its metabolism process (meaning the drug stays in body for longer time)
- gallstones increase
30
how would you promote healthy digestion
- drink lots of water, eat balanced meals
- wear fitting dentures
- east meals in relaxed environment
- avoid sitting down for long periods of time let you food digest
31
An older adult has been diagnosed with a nutrition imbalance. Which age-associated intestinal problem
should the nurse be aware of when planning goals and interventions to improve this older adult’s nutritional
status?
a) Older adults have less intrinsic factor secretion
b) Older adults have short, broad, small intestinal villi
c) Older adults have decreased gastric smooth muscle
d) Older adults have decreased large intestinal motility
B, villi helps with the absorption of nutrients and reduced villi will cause an imbalance
32
age related changes in the neurological system - CNS are what?
- decrease in brain weight and size
- dendrites "wear out" affecting memory, reaction time, and learning
33
age related changes in the neurological system - PNS are what?
- loss of sensations and tactile senses (bc there's a loss of nerve endings)
34
what does senile ptosis mean
eyelids drooping
35
age related changes in extraocular (outside the eyeball)
- eyelids start drooping
36
age related changes in ocular (meaning eye)
- cornea becomes flatter, less smooth, thicker, and dull in appearance
37
age related changes in intraocular (meaning inside the eyeball)
- retina has less distinct margins (end of retina become less sharp making vision more blurry)
- colour clarity diminishes (means colours start looking faded and not as vibrant)
- number of rods is reduced (meaning cant see at night time/ in the dark)
38
how would you promote healthy eyes in older adults?
- go to the eye doctors regularly and if you notice any changes in your vision
- protective eye wear especially if your out in the sun
- protect your eyes from injury (like eye protection for golf)
- eating more vitamin A rich foods like carrots
- stop smoking
39
age related changes in hearing
- too much cerumen
- shape of the ear changes ear lobes sag and become longer
- ear hairs become thick and stiffer
- there is conductive (smt blocking the sound waves from entering like cerumen or fluid can be fixed or treated) and sensorineural hearing loss (damage to the inner ear happens (cochlea) usually from genetics or loud sounds this is permanent not fixable)
40
age related changes in the immune system
- more infections could happen bc skin is thinner
- increase risk of UTI (common S&S for older adults is delirium)
- reduced cilia more changes of infections in the lungs and pneumonia
41
what is functional assessment and what is your role as a LPN
is how you function on a day to day with your ADL's, as a nurse we are to assess the older adult and how well they can perform their ADL's bc one patient with arthritis could be performing their own basic care while another is 2PA
42
what are ADL's and give 3 examples
- dressing
- grooming
- eating
- walking
- eliminating
43
what are IADL's and give 3 examples
- how to cook
- shop for groceries
- use a phone
- use the laundry
- take medications
- use transportation
44
how can you prevent or manage chronic illnesses?
- through lifestyle choices like eating healthy and exercising
- early detection; going to the doctors on a regular to get check ups
- and following a medical treatment plan if necessary
45
nursing intervention for chronic illnesses
- pain management
- promote regular check ups
- importance of balanced diet and fluid intake
- patient teaching of their condition (on going assessment with check ups)
- emotional support or external support like therapy, support groups
- pt goal planning and acceptance to their new condition and life
46
what is the wellness model
holistic care, caring for the whole patient and not just their condition (their mind, body, and sprit)
47
what is palliative care
symptom management, improving their quality of life though ongoing treatment, pt and family teaching of what's going on
48
what is hospice care
hospice care is end of life care to keep them comfortable where they have less than 6 months to live
49
NI for the dying patient
- pain management; opioids can also cause constipation watching out for that
- family involvement
- keep them and their appearance clean
- emotional support of the fear and anxiety of death
- skin integrity turn pt q2h
- nausea; its normal for a dying person to not want food so don't force them
- ease their confusion
50
how does iron deficiency anemia occur
happens from a diet that's too low in iron or the body doesn't absorb enough iron from the gastrointestinal tract or blood loss
51
symptoms of iron deficiency anemia
pallor, fatigue, and in some cases orthostatic hypotension
52
what are the nursing interventions for iron deficiency anemia?
- encourage high iron foods
(dark leafy greens) = spinach, kale, and broccoli
(poultry)= chicken or turkey
(whole grains, nuts, and legumes)= whole wheat rice, bread, cashews, almonds, chickpeas, lentils
(sea food)= oysters, tuna, sardines, shrimp
- get prescribed medication of ferrous sulfate
- encourage rest between tasks to avoid being tired
53
what is pernicious anemia (vitamin B12 anemia)
body lacks a protein called "intrinsic factor", which leads to not enough vitamin B12 being absorbed from food we eat, if pt has had gastrectomy (part of stomach removed) the stomach can't absorb vitamin B12 properly
54
symptoms of pernicious anemia (vitamin B12 anemia)
pallor, fatigue, weakness, numbness of hands and feet, and sore tongue
55
nursing interventions of pernicious anemia (vitamin B12 anemia)
- B12 injections (cyanocobalamin)
56
what is sickle cell anemia
when RBC become from disk shaped to sickle shaped (chilly shaped), this chilly shape makes it hard for blood to pass through small capillaries causing blockages stopping blood and oxygen from going to the organs it needs to
- genetic disease most commonly in African American's
- must get gene from both mother and father to have sickle cell anemia
57
how can sickle cell anemia be caused
through stressors like dehydration, infections, too much alcohol or smoking and cold weather
58
what are the symptoms of sickle cell anemia
depends on where the blockage is could be chest pain, hypoxia occurs causing severe pain, also causes fatigue, constant low RBC count, and jaundice
59
what are the NI for sickle cell anemia
- monitor VS q4hr
- pain assessment and management (analgesics = pain reducer)
- assess for fever, infection, and dehydration because these are symptoms of sickle cell
- emotional support relating anxiety to this new condition, provide pt teaching like avoid smoking and drinking
- provide blankets if patient feels too cold
- monitor for orthostatic hypotension and pt teaching of changing positions slowly
60
what is hemophilia
a genetic disease that affects ones clotting factor making them bleed out for longer than usual
61
what are the symptoms of hemophilia
- uncontrolled bleeding that can occur after a trauma or for no reason
- internal bleeding between the joints causing swelling and severe pain
- can have uncontrolled bleeding in the mouth, gums and lips so pt teaching of careful when brushing teeth don't brush hard get a soft bristle toothbrush
62
nursing interventions for hemophilia
- ASSESS FOR BLEEDING AND PIAN (pain assessment)
- pt teaching of careful when brushing teeth don't brush hard get a soft bristle toothbrush
- assess urine and stool for blood and internal bleeding
- pt teaching of no cure only symptomatic
63
Sickle cell anemia is a genetic disease occurring
almost exclusively in:
a) African Americans
b) Native Americans
c) Hispanics
d) Caucasians
A
64
Incidence of hypothyroidism increases with age, especially among women.
a)True
b) False
A
65
what is HYPOthyroidism
primary hypothyroidism = thyroid gland is not producing enough hormones caused by an autoimmune disease like thyroiditis that attacks the body or if you consume foods that contain goitrogens (foods that suppress the thyroid hormone production) soya products, broccoli, cabbage, cauliflower
secondary hypothyroidism = the pituitary gland (in the brain) makes less TSH which doesn't signal the thyroid gland to make hormones T3 and T4
66
what are the signs and symptoms of HYPOthyroidism?
- myxedema; swelling in the lips and eyelids
- dry, thick skin
- hoarseness (voice changes)
- feeling extremely cold and slow pulse
67
what are the nursing interventions for HYPOthyroidism
- allow for rests between task
- avoid scratching skin and use moisturize or lotion
- teach patient about the coldness they may feel so keep layers on
- for constipation encourage a high fiber diet with fruits and veggies
68
what is HYPERthyroidism
too much thyroid hormone is being produced most common is graves disease or multinodular goiter
69
what are the signs and symptoms of HYPERthyroidism
- weight loss and nervousness for the mild cases
- in severe cases fatigue, hair loss, sleep disturbances, irritability,
- swelling of the neck, eyes protruding out, tachycardia and high BP
70
nursing interventions for HYPERthyroidism
- pt teaching of feeling too warm so wear light layers
- monitor for eyes protruding out and assess for pain around the eyes
- teach patient of importance of taking the medication
- and report signs of fatigue or depression (signs of hypothyroidism)
71
what is diabetes
type 1 diabetes; autoimmune disease where the body starts attacking itself resulting in no insulting production by the pancreas, it is juvenile onset, no cure just insulin therapy
type 2 diabetes; the pancreas still makes insulin but the body has developed resistance to the insulin making it not effective, happens through lifestyle choices like diet, exercise, and following the care plan, usually occurs in older ages
72
what are the signs and symptoms of diabetes for type one and two
assess the 3 P's polydipsia, polyuria, and polyphagia, fatigue
73
nursing intervention for diabetes
- proper balanced meals and hydration (meal with too many carbs and processed fats will bring your sugars up)
- pt teaching of how to assess blood sugars
- holistic teaching of incorporating cultural foods into teaching that the patient may eat
- involving family that the patient may be around so they could be aware of how to assess for hypo and hyperglycemia
- taking medications and insulin on time
- exercise for at least 30 mins
- be within the target rage of 4.4-6.1mmol
74
how much blood the heart pumps per minute is called
a) stroke volume
b) cardiac output
c) cardiac cycle
B
75
what is when the heart rests and contracts to make up one heartbeat?
a) stroke volume
b) cardiac output
c) cardiac cycle
C
76
how much oxygen does the heart need routinely for myocardial oxygen consumption
a) 100% so the heart shows its working
b) 50-65%
c) 70-75%
C, oxygen is delivered to the heart by the coronary arteries
77
patches/ stickers are put on the body to detect the electrical impulses sent from the heart
a) ECG
b) ambulatory ECG
c) MRI
A
78
risk factors for heart disease
- age; being above 55 for a man and above 65 for a women
- family Hx of heart conditions
- hypertension
- no physical activity
- diabetes
- dyslipidemia (excessive fat in the blood)
79
which of the following is a portable ECG that monitors results for 24-48 hours
a) loop recorder
b) holter recorder
c) multiple-gated acquisition scan
B
80
which of the following creates images of the heart
a) Electrocardiogram (ECG)
b) Holter monitor
c) Stress test
d) Echocardiogram
D
a= pads/patches against the body to measure electrical impulses from the heart
b= portable ECG
c= exercise during ECG monitoring
81
blockage of the vessels that supply the heart with blood is called
a) CHD/CAD
b) arteriosclerosis
A
b means hardening or thickening of arteries
82
explain the relation of arteriosclerosis, CAD/CHD, and myocardial infraction
the arteries become thick, hardened, and blocked because of ARTERIOSCLEROSIS, which leads to oxygen not reaching the heart bc of the blockage, which leads to a MI
83
S&S of a silent myocardial infraction
- mild discomfort to the back, abd, either arms, and shoulders
- heartburn
- N/V
84
what angina is this: chest pain leaves during rest but is there during any activity or exercise
a) stable
b) unstable
c) variant
A
85
what angina is this: chest pain is constant and there even during rest, its not predictable or managed with nitroglycerin (reduces the hearts workload)
a) stable
b) variant
c) unstable
C
86
how many doses of nitroglycerin can we give
3 doses of sublingual sprays max after the 3rd call the physician
87
what angina is this: pain occurs with coronary artery spasm
a) stable
b) variant
c) unstable
B
88
what is CHF/HF
heart failure or congestive heart failure is where the heart can't pump as effectively to meet the body's needs, causing backflow of the blood
89
what are the signs and symptoms of LEFT sided heart failure
LEFT= LUNGS
tachycardia, wheezing, dyspnea, and crackles
90
what are the signs and symptoms of RIGHT sided heart failure
RIGHT=rest of the body
- jugular vein distension causing pressure in the vessels
- rest of the body also has ton of pressure and fluid buildup causing edema
- weight gain
- low urine output
91
what side of the heart fails first
left side
92
what is hypertension
means high blood pressure
93
what type of hypertension is this: high BP due to age, genetics, and lifestyle factors usually develops over time
a) primary hypertension
b) secondary hypertension
A
94
what type of hypertension is this: underlying factors or medical conditions like diabetes or pregnancy causes high BP
a) primary hypertension
b) secondary hypertension
B
95
age related changes with hypertension
- normal for the systolic to be a bit higher because the aorta is not as flexible as it once was needing to work harder
- pressure increases in the arteries because of the buildup plaque that makes it harder for blood to pass though
96
signs and symptoms of hypertension
- lightheadedness
- nose bleeds epistaxis
- monitor for impaired function in the eyes, kidneys, brain (stroke), and blood vessels
97
NI for hypertension
- stress management (like yoga or meditation)
- assess baseline bc this 96/54 could be normal for them
- limit sodium and alcohol intake
- assess vs and teach patient how to check their own
- medications
- stop smoking
- incorporate physical activity
98
The nurse emphasizes that the lifestyle change that has the greatest effect on reducing the average systolic range is:
a) Dietary sodium reduction
b) Aerobic physical activity
c) Moderation of alcohol
consumption
d) Weight reduction
D) even a small amount of weight lost can lower the systolic significantly
99
what would some NI for a geriatric patient with hypertension be?
- making sure they take their medications on time
- provide ROM exercises
- monitor their weight
- falls prevention
- monitor diet and fluid intake
100
what two diseases make up COPD?
emphysema and bronchitis
101
what happens with COPD
where theres too much mucus, airways are trapped making it harder to breath "feels like their drowning in their own mucus"
smoking is the number one cause to COPD
102
according to the in test readings what ethnicity group is higher at risk for COPD
a) Indigenous
b) African Americans
c) South Asians
A, COPD is 3 times higher in indigenous peoples groups
103
what are the signs and symptoms of COPD
- patients with EMPHYSEMA and COPD are called "pink puffers" bc they produce little sputum and appear to be pink because they breath fast to make up for the low oxygen
- patients with BRONCHITIS and COPD are called the "blue bloaters" they have chronic sputum production, constantly coughing and become pale and cyanotic as well as edema due to right side HF
- ACUTE episode of COPD happens from a trigger like not taking meds, pollen, strong smells like perfume make the symptoms worse increased sputum, worsened troubled breathing
104
what are the nursing interventions for COPD?
- hydration
- reposition for better lung expansion
- oxygen therapy
- pt teaching of how to use medication
- monitor the amount and colour of the sputum
- breathing exercises
- tube feeds may be needed if patient has cor pulmonale
105
what condition is this: airways become narrowed and inflamed making it harder to breath, its triggered by allergens or irritating products
some S&S include...
wheezing, tachycardia, tachypnea, dyspnea
medications to help are: bronchodilators, and anti-inflammatory drugs
asthma
106
what condition is this: lasts for at lease 3 months for 2 years its where there's constant sputum and coughing, the cilia become damaged and aren't sweeping the trapped dust out
caused: by inhaled irritants like smoke
S&S: productive cough (wet cough), trouble breathing while moving around, and wheezing
COR PULMONALE: right sided heart failure bc the right side of the heart pumps blood to the lungs but now right side has to work extra hard (most serious complication of COPD)
chronic bronchitis
107
The most serious complications of chronic obstructive pulmonary disease (COPD) are:
a) Respiratory failure and heart failure
b) Respiratory failure and infection
c) Infection and heart failure
d) Pulmonary embolism and spontaneous pneumothorax
A, cor pulmonale is the most serious side affect of COPD
108
what condition is this: transmitted through droplet precautions, older adults, younger kids, immunocompromised, and health care staff could have this, commonly called the flu
TREATMENT: rest, fluids, antipyretics, analgesics, proper diet
PREVENTION: yearly vaccines
influenza
109
what condition is this: a communicable disease which is transmitted through droplet, tested by a protein injected skin testing that shows if you are a positive or not
- infected person must remain in a isolated room during the diseases active form
- disease never leaves, stays in body as a inactive form
TB / tuberculosis
110
falls are also called what:
a) accidents
b) trauma
c) geriatric syndrome
C, falls are called geriatric syndrome related to another underlying cause like medications, balance issues, poor lighting, mental state (intrinsic and extrinsic factors)
111
which gender tends to fall more:
a) women
b) men
A, women have a high rate of osteoporosis which weakens the bone strength
112
what fall risk assessment is this: higher the score, higher the risk it is for you to fall, for older adults
a) morse fall scale
b) hendrich II fall risk model
c) the berg balance scale
B, this is where you ask the patient to sit in a chair, stand, walk, and sit back down as you determine their balance and gait and score them accordingly
113
what is the test that's a part of the hendrich fall risk model, where you assess how well an older adult can sit in a chair
get up and go
114
What is the minimum score that indicates a high fall risk in the Hendrich II Fall Risk Model?
a) 3
b) 4
c) 5
d) 6
C, score of 5 or higher = higher risk of falls
115
what are restraints
they are either PHYSICAL, CHEMICAL, ENVIRONMENTAL tactics used to control the physical or behavioral aspect of a person
116
physical restrains limit what
a persons movement like all 4 bed rails up doesnt allow a person to get up
117
give an example of an environmental restraint
locking an older adult who has dementia in their room so they don't wander
118
what are chemical restraints used for
to sedate the person you can only use it with a doctors order and if the person is a danger to others and to themselves
119
what are some alternatives to using restrains
- using bed or chair alarms to be alerted
- if patient is constantly getting out of bed make sure their so clutter surrounding them that could make them fall
- have small lights on if patient likes to get up in the middle of the night
- if patient is a wandering risk at night keep them by the nursing station
- if person is able allow them to walk themselves with out assistance
120
what are some NI for someone with a fall risk
- provide assistive devices like walkers so they could make their way around with out losing balance
- make sure their space is clutter free
- make sure they have proper foot wear or at least grippy socks at might if they want to go to bed
- medication review some medications could make you drowsy
- exercise to promote balance
121
which one is the cushioning
a) bones
b) cartilage
c) tendons
d) ligaments
B, supported around the joints and helps moves bones smoothly
122
which one is the hard tissue makes up most of our skeletal system
a) bones
b) cartilage
c) tendons
d) ligaments
A
123
which one is the one that connects bone to cartilage also a strong and flexible band like a resistances band at the gym
a) bones
b) cartilage
c) tendons
d) ligaments
D
124
which one is the one that connects bones to bones
a) bones
b) cartilage
c) tendons
d) ligaments
C
125
what condition is this where the more you use your body it breaks down and bones start to rub together,
- major site of this condition is the knees but could also be at the hands and hips
- big loss of cartilage, and intense pain
S&S:
- pain when moving, stiffness, limited movement, swelling of the joints
osteoarthritis
126
what are some NI for osteoarthritis
- patient teach about osteoarthritis
- ROM exercises
- pain assessments \ management
- encourage rest between activities and schedule activities around your peak time like after taking pain medications
- provide heat or cold packs
- provide aids like walkers to keep pressure off joints
- weight management to not put pressure on joints
127
what condition is this a autoimmune chronic inflammatory diseases that can affect multiple joints at once causing joints to swell up with fluid and inflamed synovial tissues (joints become all swollen like a bouncy ball)
S&S:
morning stiffness lasting more than 1 hour, joint changes ate symmetrical so happen on both sides of the body, organs can be affected and inflamed as well.
rheumatoid arthritis
128
what are some NI for rheumatoid arthritis
- body image is impacted because of the swelling in the joints -> provide emotional support
- allow patient time to get up and do ADL's slowly because of the stiffness -> assess how ADL's are affected
- provide aspirin or NSAID's anti-inflammatory medications (to reduce the pain with swelling between the joints)-> pain assessment and management
- pt will be scared of pain so limited movement will be present -> support patient through their fears and anxiety about this condition by teaching them
129
A nurse at a long-term care facility has received a report on a newly admitted resident. The resident has been diagnosed with rheumatoid arthritis (RA). The nurse is aware that RA is:
a) Characterized by the degeneration of articular cartilage with hypertrophy of the underlying and adjacent bone
b) A chronic, progressive inflammatory disease
c) When bone absorption surpasses bone formation
d) A rare, acute inflammatory disease that primarily affects skeletal muscle
B
A, is osteoarthritis where cartilage is broken down and bones start to rub together
C, osteoporosis
130
what condition is this your more at risk for fractures because pores causes bones to be weaker, the common sites are forearm, pelvis, humerus, forearm, hip, vertebrae, bones are constantly being formed and absorbed leading to imbalance and pores start to form
result of this condition is loss of bone strength and mass
S&S:
- chronic pain due to hunch back (kyphosis)
- dentures fit poorly because of the jaw shape changing because of the bone mass lost
- spine compresses causing kyphosis (hunch back)
- more incline to have fractures
osteoporosis
131
NI for osteoporosis
- increase physical activity
- give calcium supplements to help with strength
- pain assessment and medication for the back pain
- cold or hot compresses
- pt teaching of risk for fractures to be careful when moving around
132
Factors that increase the risk of osteoporosis include all of
the following EXCEPT:
a) Estrogen deficiency
b) Increased physical activity
c) Inadequate calcium
d) Long term Corticosteroid therapy
B
133
pain in a limb (or extremity) that has been amputated is called what
phantom pain
134
you feel sensations like warmth, cold, itchiness at the site of the amputated leg is called what
phantom limb sensation
135
which type of amputation is this: body part is left open to heal this could be because of infection present or other things present that would make it unsafe to close site
a) open
b) closed
open
136
which type of amputation is this: after the body part is removed the site is closed with stiches and left to heal
a) closed
b) open
A
137
when do amputations occur
after a intense trauma like motorcycle accident or severe frost bite or through diseases like gangrene, poor circulation, diabetes, or infections
138
how long after can the patient put their full weight on the prosthesis limb
a) 1 year
b) 3 months
c) 5 months
d) 10 weeks
B, 3 months
139
what is the main purpose of a prosthesis
to restore mobility and function to the patient
140
NI for amputations and prosthesis
- emotional support -> provide extra support of social worker
- pt education on phantom pain and sensation
- decline in self-image
- depression
- pain management
- assess site for infection occurrence
- pt teaching of new aids and lifestyle changes that need to be made
141
xerosis means what
a) infection
b) extremely dry cracked skin
c) oily skin
B
142
what skin condition is this
-its a symptom of other skin conditions
- means itchy
- and can cause infection if dry skin leads to open wounds
things like heat, temp changes, perfumed detergents, fabric softeners, tight clothing can all be triggers
pruritus
143
what are NI for pruritus
- keep skin moisturized
- reposition q2h
- keep patient hydrated
- avoid tight clothing
- topical creams
- shower with lukewarm water rather than hot or cold
144
what skin condition is this:
virial infection in older adults known as shingles causes intense itching and pain effects half side of face or back, is transmittable, have a greater risk of getting this condition if you had chicken pox's
herpes zosters
145
what are the NI for herpes zosters
- inspect skin for further breakdown
- pain assessment and management
- antiviral medication
- be vaccinated for shingles
146
what skin condition is this:
thick crusty/scaly patch of skin found on the face, neck, forearms, and back of hand due to frequent exposure to sun
keratosis
147
NI for keratosis
- regular skin assessments
- pt teaching of limiting sun exposure
- use sunscreen
- wear UV protective hats
148
Which of the following is incorrect about Pruritis (sensation of itching)?
a)Prominent symptom with dermatitis, eczema and insect bites
b)Can be seen following systemic conditions: renal failure, diabetes mellitus
c)Stress management may help control pruritus
d)Treatment is directed at correcting the symptoms
d, pruritus is the symptom the condition would be like xerosis
149
which skin cancer is this:
grows slowly, has shinny bump like appearance and rarely spreads the most common type of skin cancer
basal cell carcinoma
150
which skin cancer is this:
the least common type of skin cancer but most dangerous, caused by melanocytes which are pigment producing cells
melanoma
151
what are NI for melanoma
- use sunscreen; limit sun exposure
- wear protective clothing
- assess melanoma site to see if it's getting bigger or metastasizing
152
what stage pressure ulcer is this: non-blanchable erythema, can happen in health people within a few hours
stage one
153
what stage pressure ulcer is this:
partial thickness loss (first layer of skin affected the epidermis), skin is open has a shallow crater or in blister form
stage 2
154
what stage pressure ulcer is this:
full thickness epidermis, dermis, subcutaneous layers affected, slough may be present, as well as undermining
stage 3
155
what stage pressure ulcer is this:
full thickness loss tendons, bones, and ligaments visible, eschar (narcosis present (dead tissue)
stage 4
156
what stage pressure ulcer is this:
unstageable, don't know how deep the damage is
stage 5
157
NI for pressure ulcers
- skin assessments for infections
- keep skin dry and clean
- reposition q2h
- stay hydrated and eat proper meals that help with the healing process like high protein foods
158
When administering iron supplements, the nurse should:
a) Give them with milk for better absorption
b) Administer with vitamin C to enhance absorption
c) Suggest taking them on a full stomach to prevent nausea
d) Recommend taking them right before bedtime
B, vitamin C is good for absorbing iron so taking orange juice is recommended
159
Which of the following is NOT typically considered a normal age-related change in the cardiovascular system? a) Veins stretching and dilating
b) Decreased cardiac output
c) Silent myocardial infarction (MI)
d) Increased time for the heart to return to a resting state after exertion
C, a MI is a serious medical event caused by an underlying heart condition
