midterm from quizlet Flashcards
What is SIGECAPS?
Sleep
Interest
Guilt / worthlessness
Energy
Concentration / difficulty making decisions
Appetite
Psychomotor activity
Suicidal Ideation
IS PATH WARM
Ideation
Substance abuse
Purposelessness
Anxiety
Trapped
Hopelessness
Withdrawal
Anger
Recklessness
Mood change
Depression in older adults can present as what?
May present as the onset to dementia
Depression in older adults may include a strong delusional component true or false?
True, and it is not easily treatable with antipsychotic medications
Give 5 examples of care approaches that are not helpful when caring for cognitively impaired adults
Being aggressive / domineering
Being vague with instructions / being broad
Using a singular approach to all patients
Talking down to them / diminishing their value / diminishing their abilities
Acting like we know best / Acting like they are children
Give 5 examples of nursing interventions that are informed by theories of aging
Harm reduction / quitting smoking - Environmental theory
Provision of education related to functional abilities as they age - Functional consequences theory
Encourage physical activity as tolerated - Activity theory
Encourage participation in groups of similarly aged / stage of lifed adults - Age stratification
Encourage a diet higher in fresh vegetables, fruits, fibre - nutritional theory
Preservation of function on manipulation of environment / activities of daily life
Name 4 types of dementia
Vascular dementia
Alzheimer’s disease
Lewy bodie’s diease
Frontal Temporal dementia
What is vascular dementia
Onset is slow, post-stroke
Caused by significant lack of oxygen to the brain
Progresses in steps
Alzheimer’s disease
Most common type of dementia (75%)
Cause unknown (several theories)
Reduction in brain acetylcholine
Serious head trauma
Genetic factors
Presence of plaques and tangles
Lewy body disease
Earlier occurrence of visual hallucinations (NOT in Alzheimer’s)
Faster onset than Alzheimer’s
Caused by the presence of Lewy bodies present in the brain
Frontal temporal dementia
EARLY ONSET
Causes people to have problems with speech, forgetting meaning of words
Atrophy of frontal temporal lobes
Behavioural symptoms (Dis-inhibition)
Explain what medications are typically used in the treatment of delirium, dementia, depression
Delirium - Identify underlying cause, treat accordingly. I.E antibiotics, analgesics though also antipsychotics (Haldol)
Dementia - Cholinesterase inhibitors - boosts chemical messangers
Depression - SSRI’s other antidepressants
Explain normal changes related to aging in the metabolism and urinary system
Metabolism - Increased body fat, increased metabolic diseases (type 2 diabetes, hypertension)
Urinary - Decreased kidney mass, decreased GFR, decreased BPH
Explain PIECES
P - physical
I - intellectual (Dementia)
E - emotional (Poor adjustment to changes)
C - Capabilities (Knowing limitations and strengths)
E - Environment
S - Sociocultural
Person-centered framework
Capabilities is a key addition
Name 5 communication strategies with cognitively impaired older adults
Sit in front of patient
Speak at a natural rate
Speak at eye level / make eye-contact
Use simple wording
Rephrase statements
Explain normal changes related to aging in body composition and cellular system
Body composition - Decrease in: Body mass, muscle mass, skeletal mass, body water, creatinine production
Increase in: Adipose tissues,
Decline in strength and function, increases effects level of drugs
Cellular systems - Increased: DNA damage, cell aging, senescence (WHICH MEANS AGING) fibrosis
What is Senescence
Aging
Changes in circulatory and respiratory
Circulation is reduced
Respiratory - Decreased in capacity (reduced lung elasticity), increased in residual volume
Name 5 characteristics of depression in older adults
Weight loss or lack of appetite
Decreased sleep
Somatic presentations
Resistance or aggression
Prominent cognitive problems (Such as problem solving)
How do you differentiate depression and delirium
Rule out underlying medical disorders / infections that may otherwise explain delirium
Assess onset of mood (Delirium is sudden onset and fluctuates, depression less so)
Utilize depression screening tools (PHQ9 etc)
What is delirium
Acute fluctuating syndrome of attention, cognition, awareness, sudden change
How is delirium treated
Always determine underlying cause
Nursing priorities for delirium
SAFETY (It’s step number one)
Treat pain, infection, dehydration
Ensure adequate nutrition, early mobilization
Re-orient
Explain person-centered approaches to adult care
Person-centered care is a philosophy that acknolwedges the individuality, and right to dignity of the individual
4 major elements
Person-centered focused
“If something doesn’t work, what would you do?”
- Leave it and come back rather than insisting
- See the world through the patient’s perspectiv
Compare primary and secondary aging
Primary aging - Physiological aging related to time
Secondary aging - Changes related to trauma or disease process
Give examples of risk factors for aging
Nutrition
Smoking
Alcohol
Sunburn
Sleep hygiene
Oral care
Social support systems
Regular medical checkups
Injury protection
Name 5 issues related to hospitalization for older adults
Increase risk for infection
Increase risk for delirium
Increase risk for falls
Physical deterioration
Increased risk for DVT
Depression
Quality of discharge planning / continuity of care
Recent hospitalization - puts people at risk for going back into the hospital
What does Hereditary mean?
passed down from parent to child
What does senescence mean?
is the process by which a cell looses its ability to divide, grow, and function. This loss of function ultimately ends in death.
What is the Hayflick limit?
Cells divide only a certain number of times and then die
What are programmed theories?
Aging has a biological timetable or internal clock
What are damage / error theories?
Aging is a result of internal and external assaults that damage cells
Random processes accumulate over time and inflict damage
Name 5 programmed theories
*Programmed Senescence
*Gene Theory
*Endocrine Theory
*Immunologic Theory
*Nutritional Theory
Name 5 Damage / Error Theories
*Wear and Tear
*Cross-linking Theory
*Free Radicals
*Somatic Mutation
*Environmental Theory
What is the Gene theory?
The gene theory states that aging is programmed due to one or more harmful genes within each organism
The gene theory suggests that human life span is an inherited trait.
What is the Endocrine theory?
Biological clocks act through hormones to control the pace of aging.
Dysfunction of the hypothalamus in regulating endocrine activity, causing age-related changes
What is the immunological theory?
The immunologic theory explains age-related decline in the immune system.
The autoimmune theory of aging stipulates that cells undergo changes and the body identifies them as foreign.
What is the nutritional theory?
Nutritional theory focuses on the idea that diet affects how one ages.
Calorie Intake Theory: Low calorie diet combined with high nutrient intake and exercise leads to metabolic efficiency and slows aging
What is the Wear and tear theory
Parts of the body eventually wear out from repeated use killing the parts and then the body.
What is the Cross-linking Theory
Some proteins in the body become cross-linked, thereby not allowing for normal metabolic activities
Connective Tissue Theory:Cell molecules from DNA and connective tissue interact with free radicals to reduce the ability of tissue to regenerate
What are Free radicals?
Free radicals cause cell damage
Free radicals are byproducts of metabolism; can increase as a result of environmental pollutants
When they accumulate, they damage cell membrane, decreasing its efficiency
What is the Environmental Theory?
A number of environmental factors are known to threaten health and may be associated with aging such as smoking, lead ingestion, arsenic poisoning.
Name the Psychosocial Theories of Aging
*Role Theory
*Person-Environment Fit Theory
*Activity Theory
*Continuity Theory
*Disengagement Theory
*Age-stratification Theory
*Selective Optimization with Compensation
*Gero-transcendence
What is the Role theory?
As people evolve through the stages in life, their roles evolve as well.
What is the person-environment fit theory?
Individuals have personal competencies that assist in dealing with the environment; i.e. ego strength, level of motor skills, individual biologic health, cognitive & sensory-perceptual capacities