NUR 372 CLASS 1 AGING ADULT Flashcards
1
Q
PHYSICAL CHANGES - CARDIOVASCULAR
A
- stiffening of valves
- decreased cardiac output
- vessels less elastic
2
Q
RESULTING IN - CARDIOVASCULAR
A
- hypertension
- possible falls (due to hypertension medication)
- diminished cardiac reserve
- poor organ perfusion
3
Q
NURSING INTERVENTIONS - CARDIOVASCULAR SYSTEM
A
- avoid strenuous exercise or over exertion
- periods of rest
- support stockings, anti-embolism hose
- ROM
- diet low in salt
- decrease fat intake
- avoid fast positional changes (dangle first)
4
Q
PHYSICAL CHANGES - RESPIRATORY
A
- decreased pulmonary elasticity
- limited chest expansion
- decreased ciliary action
5
Q
RESULTING IN - RESPIRATORY
A
- less effective cough
- decreased vital capacity
- less air exchange @ bases
- risk for URI pneumonia
6
Q
NURSING INTERVENTIONS - RESPIRATORY
A
- alternate activity with periods of rest
- proper body alignment & positioning
- sleep in semi-fowlers position (pillows)
- coughing and deep breathing
- ambulation
- incentive spirometers
- oxygen
- bronchodilators
7
Q
PHYSICAL CHANGES - INTEGUMENTARY
A
- loss of subcutaneous tissue & thinning of dermis
- decreased subcutaneous fat
- decreased elasticity
8
Q
RESULTING IN - INTEGUMENTARY
A
- tissue fragile
- decreased sensation to heat & cold
- loss of moisture, wrinkling
- pressure ulcers
9
Q
NURSING INTERVENTIONS - INTEGUMENTARY
A
- use mild soap to avoid dryness
- bath oils or lanolin lotion
- bath or Shower once or twice a week
- brush hair daily
- care for skin injuries immediately
- socks, sweaters, lap blankets, and layers of clothing will help alleviate the feeling of coldness
- no heating blankets
- positioning Q 2 hours PRN
10
Q
PHYSICAL CHANGES - MUSCULOSKELETAL
A
- decreased muscle fibers
- decreased bone calcium
- decreased joint cartilage
- ligaments & tendons more rigid
- narrowing intraveterbral space
11
Q
RESULTS IN - MUSCULOSKELETAL
A
- decreased strength
- vulnerability to fracture
- decreased height
- decreased flexibility
- osteoporosis
12
Q
NURSING INTERVENTIONS - MUSCULOSKELETAL
A
- nutritional guidance
- exercise
- ambulation: rest periods, seek out help with ambulation from others
- ROM
- PT
- patients may be reluctant to move or initiate new activity due to a fear of falling
- allow patient to perform tasks at his or her own rate
- maintain limbs in functional alignment
13
Q
PHYSICAL CHANGES - GENITOURINARY SYSTEM
A
- decreased bladder tone/capacity
- loss of nephrons
- BPH
- laxity of supporting tissues in females
- atrophy of vaginal lining
- decreased renal function
- labs: BUN, creatinine
14
Q
RESULTS IN - GENITOURINARY
A
- decreased GFR
- increased residual volume
- difficulty urinating
- UTI
- increased incontinence
- decreased creatinine clearance
- decreased drug metabolism
15
Q
NURSING INTERVENTIONS - GENITOURINARY
A
- increase fluid intake 2-3 L/day - toileting schedule every 2 h - easy to remove clothing - absorbent pads - bedside commode positioned near bed
16
Q
PHYSICAL CHANGES - GASTROINTESTINAL
A
- decreased salivary gland secretion
- decreased taste buds
- decreased thirst
- decreased gastric secretions/GI motility
weakened intestinal walls
17
Q
RESULTS IN - GASTROINTESTINAL
A
- dry mouth
- loss of appetite
- malnutrition/dehydration
- vitamin deficiency
- constipation
- risk of ulcers
18
Q
NURSING INTERVENTIONS - GASTROINTESTINAL
A
- good oral hygiene
- be sure dentures are in correctly
- relaxed eating atmosphere
- may need to assist pt with eating (cut up food, feed pt)
- high-fiber with different tastes and textures
- increased fluid intake
19
Q
ROLE OF PROTEIN
A
- bone and muscle production (structural proteins & collagen)
- immunity
- acid base balance
- nutrient transportation
20
Q
PHYSICAL CHANGES - PROTEIN
A
- decrease in skeletal muscle (the most noticeable manifestation).
- decrease in organ tissue, blood components, and immune bodies.
- impaired wound healing
- loss of skin elasticity (increased fragility of skin)
- decreased immune function (Inability to fight infection).
- decrease in reserve capacity (can have a longer recuperation from illness).
21
Q
RDA PROTEIN ALLOWANCE
A
- adults 0.8 grams of protein per kilogram of body weight.
- older adults at least 1.0 gram/kilogram body weight.
22
Q
PROTEIN RICH FOODS
A
- red meat (pork, beef, venison)
- fish (salmon, tuna, swordfish, mackerel, bass, trout)
- poultry (chicken, turkey, duck)
- eggs one to 2/day at most, yolk high in cholesterol.
- dairy (milk, yogurt, cottage cheese and other cheeses)
- peanut butter.
23
Q
PHYSICAL CHANGES - NERVOUS
A
- decreased neurons cerebral cortex
- changes in spinal cord
- altered pain sensation
- sleep disorders
- changes in cranial nerves
24
Q
RESULTS IN - NERVOUS
A
- decreased reflexes and coordination
- increased rigidity and fine tremors
- decreased balance
- sensory changes
- decreased short term memory
25
Q
NURSING INTERVENTIONS - NERVOUS
A
- focus is on safety of pt, preventing injury
- neuropathy in feet: 1-person assistance
- altered sensory changes: keeping hot/cold beverages only halfway full
26
Q
PHYSICAL CHANGES - SENSORY
A
- eyes: presbyopia, far sighted, cataracts, glaucoma, trouble seeing in low light/glare
- ears: loss of high pitch, presbycusis
- mouth: change in eating habit, appetite, tongue & musculature of mouth, dry mouth
- smell: olfactory cells decrease
27
Q
PHYSICAL CHANGES - REPRODUCTIVE
A
- decrease of estrogen / progesterone in female
- thinning of vaginal wall
- decrease vaginal secretions
- weakness in supporting tissue: uterus sags downward (uterine prolapse)
- decrease in Testosterone in men
- slow production of sperm
- may response to sexual stimuli slower (still have desire)
- testes smaller less firm
28
Q
NURSING INTERVENTIONS - REPRODUCTIVE
A
- understand physical and psychological sexual needs of the elderly
- allow married couples to be in the same room
- give privacy to consenting elderly
- may still have desire for sexual contact
29
Q
PHYSICAL CHANGES - ENDOCRINE
A
- decreased insulin response to glucose load
- decreased thyroid activity
- diminished sex hormones
30
Q
RESULTS IN - ENDOCRINE
A
- diabetes
- hypothyroidism
- BPH
- vaginal dryness
31
Q
PSYCHOSOCIAL CHANGES
A
- some individual cope with psychosocial changes
- others experience extreme frustration and mental distress
- fearful of: death, chronic illness, loss of function, pain
32
Q
NURSING INTERVENTIONS - PSYCHOSOCIAL
A
- active listening
- patience
- understanding
- provide support
- activities
- socialization
- pictures of family in room
- great communication skills
33
Q
SYMPTOMS OF CONFUSION AND DISORIENTATION
A
- talking incoherently
- disoriented (person, place and time)
- not recognizing others
- wandering aimlessly
- displaying hostile and combative behavior
- hallucinating
- regressing in behavior
- inability to respond to simple commands or instructions
34
Q
DEPRESSION
A
- NOT normal part of aging
- disorder characterized by feelings of sadness and despair (mild to life threatening).
- most common psychiatric disorder in the elderly.
35
Q
SYMPTOMS OF DEPRESSION
A
- appetite/ weight changes
- depressed mood
- sleep disruption
- fatigue
- loss of interest in things they enjoyed
36
Q
DELIRIUM
A
- delirium is not a disease
- sudden change in the way a person thinks and acts
- deviation from their cognitive baseline.
37
Q
SYMPTOMS OF DELIRIUM
A
- fluctuating confusion: calm to aggressive
- inattention – reduced ability to focus
- disorganized thinking
- altered level of consciousness – alert to somnolence
38
Q
INITIAL ASSESSMENT FOR DELIRIUM
A
- assess patient for signs of agitation
- assess for possible acute reasons for agitation (infection, tobacco withdrawal, adverse drug reaction, psychiatric disturbances).
- assess for physical or environmental factors that may be the causes or triggers for the agitation (hunger, toileting needs, fatigue, noise)
- assess need for bed alarm
- visible to nurses station
- interview family if present, to find out how they have coped with agitation.
- approach with a calm demeanor
- keep call bell within reach
- offer toileting, repositioning, food, and pain control routinely.
- ambulate patient to satisfy need to wander
- maintain a quiet and calm environment: minimize stimulation
- remove any items which may cause injury or increased agitation.
- collaborate with the patient and family to develop a safety plan.
- obtain 1:1 if patient is too impulsive or confused to be left alone
39
Q
DEMENTIA
A
- NOT normal part of aging
- broad term: general decline in higher brain functioning—reasoning
40
Q
TYPES OF DEMENTIA
A
- alzheimer’s disease: chronic irreversible disease deteriorating over time
- vascular dementia: caused by problems in supply of blood to the brain).
41
Q
SYMPTOMS OF DEMENTIA
A
- behavioral changes, unable to problem solve or function independently
- impaired communication
- eventual decline in ability to perform even basic activities of daily living (toileting, eating)
42
Q
CARING FOR PATIENT WITH DEMENTIA
A
- consistent daily routine is appropriate for the care of a client who has dementia. - establish routines that pt can complete
- safety measures
- short one-sentence explanations
- give time to respond
- remain calm, monitor tone & volume
- go with the flow: patient, calm reassure
43
Q
HOW TO IMPROVE COMMUNICATION WITH A PATIENT WITH DEMENTIA
A
- introduce yourself every time
- get at or below eye level
- describe what is going to happen
- use simple statements – 7 words…7 sec. pause
- offer simple, concrete choices, rather than complex commands and questions
- speak slow and low
- verify the person’s mood and energy
44
Q
DRUGS TO BE USED IN CAUTION WITH ELDERLY PATIENTS
A
- anticholinergic
- diphenhydramine, hydroxyzine, scopolamine
- decongestants
- demerol, propoxyphene
- benzodiazepines/Barbiturates
- muscle relaxants (soma, flexaril)
45
Q
EXTRINSIC FALL RISK FACTORS
A
- floor surfaces
- equipment
- poor lighting
- bathrooms
- physical restrains
- inappropriate foot wear
46
Q
INTRINSIC FALL RISK FACTORS
A
- lower ext weak
- history of prior falls
- gait /balance deficit
- assistive device
- impaired ADL’s
- visual deficit
- medications
- urinary Incontinence
- cognition -sensory
- arthritis
47
Q
FALL PREVENTION
A
- fall assessment - throughout every shift
- individualize & implement interventions to reduce fall risk factors
- staff education and training to fall reduction program.
- partner with: patient/ family – educate risk level & fall reduction program.
- individualized fall reduction strategies.
