midterm from quizlet Flashcards

Question

Compare primary and secondary aging

Answer 1

Primary aging - Physiological aging related to time Secondary aging - Changes related to trauma or disease process

Answer 2

Nutrition Smoking Alcohol Sunburn Sleep hygiene Oral care Social support systems Regular medical checkups Injury protection

Answer 3

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

Answer 4

passed down from parent to child

Answer 5

is the process by which a cell looses its ability to divide, grow, and function. This loss of function ultimately ends in death.

Answer 6

Cells divide only a certain number of times and then die

Answer 7

Aging has a biological timetable or internal clock

Answer 8

Aging is a result of internal and external assaults that damage cells Random processes accumulate over time and inflict damage

Answer 9

*Programmed Senescence *Gene Theory *Endocrine Theory *Immunologic Theory *Nutritional Theory

Answer 10

*Wear and Tear *Cross-linking Theory *Free Radicals *Somatic Mutation *Environmental Theory

Answer 11

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.

Answer 12

Biological clocks act through hormones to control the pace of aging. Dysfunction of the hypothalamus in regulating endocrine activity, causing age-related changes

Answer 13

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.

Answer 14

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

Answer 15

Parts of the body eventually wear out from repeated use killing the parts and then the body.

Answer 16

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

Answer 17

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

Answer 18

A number of environmental factors are known to threaten health and may be associated with aging such as smoking, lead ingestion, arsenic poisoning.

Answer 19

*Role Theory *Person-Environment Fit Theory *Activity Theory *Continuity Theory *Disengagement Theory *Age-stratification Theory *Selective Optimization with Compensation *Gero-transcendence

Answer 20

As people evolve through the stages in life, their roles evolve as well.

Answer 21

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

Answer 22

*Activity is necessary to maintain life satisfaction and positive self-concept: It is better to be active than inactive An individual is the best judge of their needs and success

Answer 23

Old age is not a separate phase of life, but rather a continuation Individuals tend to develop and maintain a consistent pattern of behaviour, replacing one role for a similar one as one matures.

Answer 24

talks about how old people deatch from society and become more introspective

Answer 25

Age is a way of regulating behavior of a generation

Answer 26

*Individuals develop strategies to manage and cope with losses of function that occur over time through: optimizing existing skills / abilities, and compensating by developing adaptations.

Answer 27

*As people age they gain better understanding of self, shift their attention to others, and develop the importance of transcendent connections (spirituality)

Answer 28

physiological, safety, love/belonging, esteem, self-actualization

Answer 29

Havighurst's tasks for late life: *Adjustment to decreased strength and health *Adjustment to retirement and reduced income *Adjustment to loss of spouse *Establishment of relationships with peers *Adaptation to changing social roles *Establishment of satisfying living arrangements

Answer 30

*Environmental and biopsychosocial consequences of aging impact functioning.

Answer 31

Maintaining self care Preventing complications of aging or of existing conditions Delaying decline Achieving the highest possible QOL

Answer 32

is the broad term used to define the study of aging and / or the aged.

Answer 33

when describing behaviors of individuals with dementia the terms responsive and protective behaviors are preferred.

Answer 34

An unmet need

Answer 35

The person's attempts to protect themselves

Answer 36

seeks to arrange an environmental fit between the person with dementing illness and the physical space, the programs, and the significant people with whom the person must interact

Answer 37

Practice personal and team de-escalation techniques that are compassionate, respectful, person-centered, safe, and self-protective. Avoid restraints! Manipulate the environment:

Answer 38

when the person is resistive to care - stop, pause and re-approach

Answer 39

Personhood involves the support, respect, and trust given from one person to another in a caring relationship The person with dementia has a unique history, the capacity for interpersonal relationships, many remaining strengths and abilities, and the need for supportive environment

Answer 40

There is a meaning behind each behavior Most behaviors are time limited Most responsive behaviors are the result of unmet need Because the behavior has meaning, the person will respond to our behavior based on how they interpret it

Answer 41

*Learn what makes the person happy and provide it *Concentrate on the person, not the task *Sometimes doing nothing is the best thing *Allow personal space *Remember that many behaviours are time limited

Answer 42

Person with dementia will often instinctively grab on when something comes in close contact

Answer 43

An approach to care developed by Dr. Bill Thomas. It utilizes children, plants and animals to fight loneliness, helplessness and boredom experienced by the elderly living in care facilities

Answer 44

It utilizes two distinct teams: a support team and a larger multidisciplinary team, and a staged process to develop and implement an individualized plan for each patient.

Answer 45

The Guided Care model involves nurses who work in partnership with physicians and others in primary care to provide patient-centered, cost-effective care to patients with multiple chronic conditions.

Answer 46

Acutely ill older patients often experienced. a permanent decline in their ability to perform basic activities of daily living.

Answer 47

*Care is patient-centered *Care team is interdisciplinary *Planning for discharge is part of care *Hospital environment is elder friendly

Answer 48

Engage key stakeholders: (patient, caregivers, hospital staff) Assess risk and develop a comprehensive transition plan throughout the hospitalization. Enhance the safe management of medications. Place an emphasis on daily communication among the multidisciplinary team focused on a coordinated transition

Answer 49

An approach for people with cognitive impairments and dementia

Answer 50

*Older people struggle to resolve unfinished issues. To work through these issues, they will express past conflicts in disguised forms, retreat inward, and potentially shut out the world. *To help them resolve past issues, validation practitioners listen, showing empathy and respect so the person feels valued, not judged. *Validation can apply to an individual or a group's needs.

Answer 51

Rephrase *"Your wedding ring is gone", "You think I've stolen it" *"You think I am your sister. You miss her" Utilize the visual / sense memory *"It was a beautiful white gold ring" *"How does she look like?" Facilitate reminiscing *"How did you meet your husband?" *"What do you like the most about your sister? What don't you like about her?"

Answer 52

Physical: pain and physical conditions can cause changes in behavior Intellectual: dementia affects the person's memory, thinking, language, self-awareness Emotional: a person may experience problems adjusting to changes occurring in his/her life Capabilities: knowing what the person can and can't do will help to build on his/her strengths Environment: a supportive environment will help the person maintain his/her abilities Social & Cultural: each person has unique social and cultural needs that can be met only through an individualized approach

Answer 53

Delirium is defined as an acute, fluctuating syndrome of altered attention, awareness, and cognition. It is common in older persons in the hospital and long-term care facilities and may indicate a life-threatening condition.

Answer 54

Hypoactive Hyperactive Mixed

Answer 55

Most prevalent Referred to as 'quiet delirium" Lethargic, drowsy, quiet and withdrawn

Answer 56

Agitated, combative Disoriented Psychotic features (hallucinations, delusions / paranoia, illusions)

Answer 57

hyper/hypo

Answer 58

A psychiatric disorder almost always lacks the disorientation, memory loss, and cognitive impairment found in delirious patients.

Answer 59

Advanced age Preexisting cognitive dysfunction Taking multiple medications Infection Chronic illnesses & comorbidities Recovering from surgery Concussion

Answer 60

P Pain R Restraint / Retention I Infection S Sensory Impairment / Sleeplessness M Medication (new, change in dose, withdrawal) / Metabolic disturbance E Emotions / Environment It's used to determine underlying causes for delirium

Answer 61

Drug toxicity or interactions Substance abuse / misuse Dehydration Acute illness Exacerbation of chronic disease Elimination problems

Answer 62

SUDDEN onset of altered behavior (different from a baseline) Decreased ability to focus and pay attention. Perceptual disturbances and impaired cognition

Answer 63

Yes. Because the sudden onset of confusion can be the FIRST or ONLY sign of acute illness in the older adult, nurses must ASSUME that sudden changes are abnormal and begin investigations immediately.

Answer 64

Focus and safety Employ the least restrictive measures Remove all tubes and drains as soon as it is possible Utilize Haldol for psychosis / agitation - it produces sedation without causing amnesia

Answer 65

Delirium: -Confused and inattentive -New, acute onset -Fluctuating course -Reversible -Caused by many triggers -Sleepy or hyper alert Sometimes preventable Dementia: -Confused but attentive -No different from baseline -Minimal fluctuation -Irreversible -Caused by one disease -Alert -Not preventable

Answer 66

Requires the two following: 1. Evidence of acute change in mental status 2. Inattention, difficulty focusing attention, or keeping on track And one of the following: 3. Disorganized thinking OR 4. Altered level of consciousness

Answer 67

Identify older adults at risk for delirium Detect delirium promptly when it occurs Assess causative and contributing factors Treat underlying causes Reduce the older adults anxiety and fear

Answer 68

Initiate non-pharmacological measures Establish a routine and provide comfortable surroundings Provide reassurance and emotional support (delirium is frightening Reduce sensory stimulation (excess noise, etc.) Promote rest and sleep Promote orientation, calendar, clock, eye glasses, hearing aids etc. Ensure adequate nutrition and fluids

Answer 69

1. Prevent sleep deprivation 2. Monitor hydration / prevent dehydration 3. Prevent stimuli deprivation / Ensure vision and hearing

Answer 70

NICE: -Name: use preferred name -Introduce yourself every time -Contact: apply firm pressure -Eye Contact EASY: -Explain what you are doing BEFORE you do it -Avoid Arguments: try later if resistance interferes -Smile: remain calm and reassuring -You are in control: change your approach if necessary

Answer 71

Mild Cognitive Impairment (MCI) involves cognitive decline beyond that normally expected in a person of the same age with preservation of function. This is not a normal part of aging

Answer 72

Neglect of personal hygiene Becomes impulsive Becomes easily distracted Forget important events Experience difficulty with abstract thinking

Answer 73

*Most types of dementia are non-reversible, chronic and progressive. *Symptoms occur slowly over months to years. *Cognition, mood, functional ability and behavior are affected.

Answer 74

The cognitive deficits must be sufficiently severe to cause impairment in occupational or social functioning, and must represent a decline from a previously higher level of functioning. Neurocognitive disorders, delirium and depression can co-exist. Older adults with major neurocognitive disorder are at increased risk for delirium.

Answer 75

1.Anosognosia (from Greek: without knowledge of disease) 2.Amnesia (from Greek amnestia - oblivion) 3.Apathy (from Greek without feelings) 4.Agnosia (from Greek: without knowledge) 5.Apraxia (from Greek: without action): 6.Aphasia (from Greek without speech) 7.Altered Perception & Attention Deficit

Answer 76

*The person is unaware of the changes caused by the disease process. *The person does not recognize the effects of the disease on their daily functioning.

Answer 77

*Loss of sensory memory, short-term memory, habitual memory. The person may forget and not remember later, especially things that happened more recently

Answer 78

*The person has lost the ability to begin an activity on their own *The part of the brain controlling initiation of activity is damaged

Answer 79

*Apathy is sometimes interpreted as a symptom of depression. *The difference is that the depressed person will participate if engaged by someone else.

Answer 80

*Loss of recognition crosses all senses *The person has trouble understanding the meaning of what is seen, heard, smelled, touched, and tasted. *The person may not recognize familiar faces or objects

Answer 81

*The person loses the ability to plan, sequence and carry out the steps of particular tasks even though the person is physically capable of performing the activity *Every task has an order and the person loses the ability to organize the sequence *The person knows what they want to do but is unable to execute the task

Answer 82

*The person may have difficulty expressing themselves and understanding of what is said. *These losses are unique to that person. Loss of language

Answer 83

Loss of depth perception Misperception (delusions / illusions) Hallucinations

Answer 84

*the most common; memory loss and mood and behavior progressive changes; characterized by neuritic (senile) plaques and neurofibrillary tangles in the brain

Answer 85

Antecendent (trigger) Behaviour Consequence

Answer 86

Increases in behavioral problems that begin at dusk and last into the night

Answer 87

*End-of-day exhaustion (both mental and physical) *An upset in the "internal body clock" *Reduced lighting and increased shadows causing people with Alzheimer's to misinterpret what they see *Disorientation due to the inability to separate dreams from reality when sleeping Little activity during the day

midterm from quizlet Flashcards

(113 cards)