Midterm Review Flashcards

1
Q

Describe the phenomenon of aging.

A

There is a higher average age that people are expected to live due to a decrease in fertility rates and and/or an increase in longevity. If somebody makes it to a certain age, they are expected to live a certain number of years afterwards.

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2
Q

Describe individual aging.

A

An individual person is multidimensional and the focus is on their own lifespan. Associated theories are: wear-and-tear and free radicals.

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3
Q

Describe population aging.

A

The focus is on a wide range of the population, particularly on those who are considered to be elderly. This group faces a lot of stereotypes and stigmas. Associated theories are: chronological, social construction, and phenomenological.

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4
Q

Describe the components of the nursing process.

A

Assess, Diagnose, Plan, Implement, Evaluate

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5
Q

Describe strengths of the nursing process.

A

It is effective, quick and easy to develop, and is very structured/straightforward.

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6
Q

Describe critiques of the nursing process.

A

It has a quick-fix mentality, it requires context, it can be prescriptive, and it requires a commitment to collaborative planning.

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7
Q

Describe person-centered care.

A

It can be between anyone, and it involves: respect, self-determination, and understanding.

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8
Q

Describe the self-actualization tendency.

A

It is a drive towards growth and fulfillment involving the conditions of self-worth: genuineness, positive regard, and empathy.

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9
Q

Describe patient-centered care.

A

It is an understanding of the personal meaning of illness, with a particular focus on patients concerns and needs.

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10
Q

Describe the core concepts of person-centered care.

A

Being in relation, being in a social world, being in place, and being with self.

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11
Q

Describe the components of the person-centered nursing framework.

A

Prerequisites/attributes of the nurse, the care environment/context, person-centered outcomes, and the person-centered process.

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12
Q

Describe the characteristics of the nurse in person-centered care.

A

Committed to being authentic and trustworthy, approaching a patient with respect, seeks to understand and listen to the patient, and communicates the patients’ worth.

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13
Q

Describe the characteristics of the patient in person-centered care.

A

They may be experiencing anxiety, sensory deprivation, or are very cautious, all of which can affect the information that they give.

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14
Q

Describe services that are accessible through Provincial funding.

A

Family doctor/health team, walk-in clinics, and drug programs.

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15
Q

Describe services that are accessible through LHIN funding.

A

Hospitals, LTC, and community care/services.

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16
Q

Describe services that are accessible through Federal funding.

A

Veteran services, first nations payments, and employment support.

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17
Q

Describe the GAIN team and the components of the Comprehensive Geriatric Assessment that they conduct.

A

The GAIN team is an interprofessional team of practitioners that work as an outpatient clinic that assess seniors and help to facilitate/direct care. The CGA includes things like: medical, physical, social, functional, cognitive, and safety assessments, as well as a fall risk assessment.

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18
Q

Describe the normal physiological changes in the nervous system.

A

Decreased nerve conduction, decrease in size and weight of the brain, loss of neurons, slower learning and retrieval, changes in sleep patterns, reduced response of the hypothalamus, and the reduced ability to sweat.

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19
Q

Describe the normal physiological changes in the senses.

A

Reduced pupil size, slow pupil response, flattened cornea, diminished lens transparency, decreased retinal function, less elastic lens, stiffening of the tympanic membrane and the ossicles, loss of hair cells for balance, and diminished taste.

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20
Q

Describe the normal physiological changes in the GI system.

A

Decline in lingual taste buds, delayed liquid emptying, decrease in Ca absorption, structural pancreatic changes, increased rate of gallstones, and increased risk of constipation.

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21
Q

Describe the normal physiological changes in the GU system.

A

Change in renal function, decline in renal blood flow, decreased ability to concentrate urine, and a delayed response to Na.
MEN: decreased blood flow to sexual organs, declining sperm count, increase in prostate size
WOMEN: no reproductive capacity after menopause, reproductive organs atrophy, and there is weakening of the pelvic floor muscles.

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22
Q

Describe the normal physiological changes in the integument system.

A

Thin/dry skin, decreased sunburning and sweating, thick and brittle nails, and sparse grey hair.

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23
Q

Describe the normal physiological changes in the musculoskeletal system.

A

Decrease in height, loss of bone mass, decreased muscle strength, skeletal/bone loss

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24
Q

Describe the normal physiological changes in the cardiovascular system.

A

Increased stiffness of the vessels, decreased catecholamine response, decreased HR during activity, and decreased diastolic ventricular relaxation.

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25
Q

Describe the normal physiological changes in the respiratory system.

A

Decrease in VO2 max, loss of elastic recoil in lungs and chest wall, decrease in PO2.

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26
Q

Describe the normal physiological changes in the endocrine/immune system.

A

Altered function of helper T cells, diminished immune response.

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27
Q

Describe the challenges associated with physiological changes.

A

There is an increased risk for hypo/hyperthermia, increased risk for aspirations, increased risk for urinary incontinence, increased vulnerability to falling, more vulnerable to hypo/hyperthyroidism, reduced immunity, increased frailty, the skin is more prone to tearing/bruising/breakdown, thus increasing the risk for pressure ulcers and delaying response to topical medication.

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28
Q

Describe general nursing actions that can be done to promote health and safety.

A

Perform routine assessments and compare to a baseline, make any necessary services/aids available, and keep a regular routine in hygiene.

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29
Q

Describe nursing actions that can be done in relation to the senses.

A

Allow time to adjust to light, have visual contrast, relax vocal cords and speak at a normal volume, repeat and rephrase if needed, use bodily gestures, use the person’s name, approach people from the front, reduce background noise, discuss food preferences, and ensure that any and all aids are in use.

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30
Q

Describe nursing actions that can be done in relation to oral hygiene.

A

Provide regular care, maintain nutrition, and provide water daily.

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31
Q

Describe nursing actions that can be done in relation to aspirating.

A

Position the patient at 90 degrees, feed them at eye level, ensure that food is at the correct thickness, avoid mixed consistencies, check for swallowing and pocketing, offer water before and after meals, sit the patient at 60 degrees after meals, and provide oral care after meals.

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32
Q

Describe nursing actions that can be done in relation to fungal infections.

A

Limit moisture, don’t use powders, dry well, promptly manage episodes of incontinence, use loose-fitting cotton clothing, and ensure the proper use of incontinence products.

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33
Q

Describe nursing actions that can be done in relation to respiratory changes.

A

Ensure that the head is elevated, allow for frequent rests, consider the environment relevant to fall prevention, and encourage the patient to do exercises as tolerated.

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34
Q

Describe nursing actions that can be done in relation to frailty.

A

Conduct the appropriate assessments, treat and manage chronic illnesses, modify environment if possible or needed, set goals, and offer support and comfort.

35
Q

Describe the RNAO BPGs related to oral hygiene.

A

Allow the resident to be as independent as possible, modify the routine according the patient abilities [stages of dementia, task breakdown, only use toothpaste if they can spit, etc.]

36
Q

Describe the RNAO BPGs related to constipation prevention.

A

Obtain a bowel history, conduct a physical examination, ensure proper hydration, administer proper medications, ensure proper intake of fiber, encourage exercise, ensure proper position during defecation, monitor regularity of bowel movements, administer laxatives if needed, and only resort to an enema or impaction removal if necessary.

37
Q

Describe the RNAO BPGs related to promoting continence.

A

Conducting an assessment, maintaining a 3-day diary of [in]continence, initiate prompted voiding or individualized toileting, determine cognitive ability to toilet self, ensure the bathroom is accessible and lighting is adequate, ensure the use of little to no restraints, and ensure an adequate intake of liquids.

38
Q

Describe the RNAO BPGs related to the Braden Skin Assessment.

A

This assessment measures the sensory ability and perception of the skin, as well as the level of moisture, the level of activity, the nutrition, and the risk of friction/shear of the individual. A score of 4 is no risk.

39
Q

Describe the RNAO BPGs related to physical activity.

A

Ensure two and a half hours of activity each week, spread out the exercises, it is beneficial to include muscle and bone strengthening twice per week, and be sure to include exercises for: posture, balance, and flexibility.

40
Q

Describe frailty.

A

The physiologic syndrome that is characterized by a decreased reserve and resistance to stressors, resulting from a cumulative decline across multiple systems, thus causing vulnerability.

41
Q

Describe the Rockwood Clinical Frailty Scale.

A

It is a tool used to assess the degree of frailty; one must receive a score of 6 or higher in order to receive PSW visits.

42
Q

Describe the predictors of frailty.

A

Extreme age, visual loss, impaired cognition/mood, limb weakness, abnormal gait and balance, use of sedatives, and the presence of multiple chronic illnesses.

43
Q

Describe the early clues of frailty.

A

Weight loss, weariness, low exercise tolerance/level, slow walking speed, cognitive impairment, and depression.

44
Q

Describe the ABCDE method of determining melanomas.

A
A = asymmetry
B = border
C = color
D = diameter
E = elevation
45
Q

Describe the stages of pressure ulcers.

A

Stage 1 = redness, no skin breakage
Stage 2 = through the epidermis
Stage 3 = through the dermis, exposed fat
Stage 4 = through the skin, exposed muscle and potentially bone

46
Q

Explain the disengagement theory of aging.

A

This theory is not accepted. Describes the idea that it is normal for an older person to separate from society as they age.

47
Q

Explain the activity theory of aging.

A

A person aims to remain as active as possible while they age.

48
Q

Explain the continuity theory of aging.

A

Focuses on adapting to the changes associated with aging. This is a fluid concept.

49
Q

Describe frailty.

A

The physiologic syndrome that is characterized by a decreased reserve and resistance to stressors, resulting from a cumulative decline across multiple systems, thus causing vulnerability.

50
Q

Describe the Rockwood Clinical Frailty Scale.

A

It is a tool used to assess the degree of frailty; one must receive a score of 6 or higher in order to receive PSW visits.

51
Q

Describe the predictors of frailty.

A

Extreme age, visual loss, impaired cognition/mood, limb weakness, abnormal gait and balance, use of sedatives, and the presence of multiple chronic illnesses.

52
Q

Describe the early clues of frailty.

A

Weight loss, weariness, low exercise tolerance/level, slow walking speed, cognitive impairment, and depression.

53
Q

Describe the ABCDE method of determining melanomas.

A
A = asymmetry
B = border
C = color
D = diameter
E = elevation
54
Q

Describe the stages of pressure ulcers.

A

Stage 1 = redness, no skin breakage
Stage 2 = through the epidermis
Stage 3 = through the dermis, exposed fat
Stage 4 = through the skin, exposed muscle and potentially bone

55
Q

Explain the disengagement theory of aging.

A

This theory is not accepted. Describes the idea that it is normal for an older person to separate from society as they age.

56
Q

Explain the activity theory of aging.

A

A person aims to remain as active as possible while they age.

57
Q

Explain the continuity theory of aging.

A

Focuses on adapting to the changes associated with aging. This is a fluid concept.

58
Q

Describe frailty.

A

The physiologic syndrome that is characterized by a decreased reserve and resistance to stressors, resulting from a cumulative decline across multiple systems, thus causing vulnerability.

59
Q

Describe the Rockwood Clinical Frailty Scale.

A

It is a tool used to assess the degree of frailty; one must receive a score of 6 or higher in order to receive PSW visits.

60
Q

Describe the predictors of frailty.

A

Extreme age, visual loss, impaired cognition/mood, limb weakness, abnormal gait and balance, use of sedatives, and the presence of multiple chronic illnesses.

61
Q

Describe the early clues of frailty.

A

Weight loss, weariness, low exercise tolerance/level, slow walking speed, cognitive impairment, and depression.

62
Q

Describe the ABCDE method of determining melanomas.

A
A = asymmetry
B = border
C = color
D = diameter
E = elevation
63
Q

Describe the stages of pressure ulcers.

A

Stage 1 = redness, no skin breakage
Stage 2 = through the epidermis
Stage 3 = through the dermis, exposed fat
Stage 4 = through the skin, exposed muscle and potentially bone

64
Q

Explain the disengagement theory of aging.

A

This theory is not accepted. Describes the idea that it is normal for an older person to separate from society as they age.

65
Q

Explain the activity theory of aging.

A

A person aims to remain as active as possible while they age.

66
Q

Explain the continuity theory of aging.

A

Focuses on adapting to the changes associated with aging. This is a fluid concept.

67
Q

Explain the age-stratification theory of aging.

A

Focuses on the structure of society, effect of birth cohorts, and the structural lag between generations.

68
Q

Explain the social exchange theory of aging.

A

Follows a cost-benefit model, addresses the imbalance of socialization between generations which causes withdrawal or isolation.

69
Q

Explain the modernization theory of aging.

A

Describes that older adults’ contributions are devalued by the younger and more dominant populations.

70
Q

Explain the symbolic interactions theory of aging.

A

Focuses on the interactions between the environment and the individual, attends to the meaning of activities.

71
Q

Explain the psychological theory of aging.

A

Aging is a developmental and dynamic process.

72
Q

Define alertness.

A

The mental state of being aroused.

73
Q

Define obtundation.

A

Less than full alertness.

74
Q

Define lethargy.

A

The pathological state of sleepiness or deep unresponsiveness and inactivity.

75
Q

Define somnolence.

A

A state of strong desire for sleep or sleeping for a long period of time.

76
Q

Define stupor.

A

A state of impaired consciousness where the patient requires continual stimulation to be aroused.

77
Q

Define coma.

A

The state of deep unconsciousness.

78
Q

Define cognition.

A

The process of acquiring, storing, sharing, and using information. It is complex and multi-faceted.

79
Q

Describe the importance of spirituality in aging.

A

It is a source of hope, aids in adapting to illness, and is a positive influence on quality of life. It involves faith, and searching for meaning or connection.

80
Q

Describe normal cognitive changes.

A

Some decline in attention, memory, and executive function. Not fully understood on a neural basis.

81
Q

Describe the informal approach to cognitive screening in elders.

A

A minimally structured observation of interactions; consider the impact of external factors.

82
Q

Describe the formal approach to cognitive screening in elders.

A

Testing, but must also consider any external factors [the environment, timing, etc.]

83
Q

Describe the anticipated social changes with aging.

A

Withdrawal, activity participation, identity, cohorts, and pay-back.