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U of R SCHOOL OF NURSING - 372 > NUR 372 CLASS 1 AGING ADULT > Flashcards

NUR 372 CLASS 1 AGING ADULT Flashcards

1
Q

PHYSICAL CHANGES - CARDIOVASCULAR

A
  • stiffening of valves
  • decreased cardiac output
  • vessels less elastic
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2
Q

RESULTING IN - CARDIOVASCULAR

A
  • hypertension
  • possible falls (due to hypertension medication)
  • diminished cardiac reserve
  • poor organ perfusion
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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)
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4
Q

PHYSICAL CHANGES - RESPIRATORY

A
  • decreased pulmonary elasticity
  • limited chest expansion
  • decreased ciliary action
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5
Q

RESULTING IN - RESPIRATORY

A
  • less effective cough
  • decreased vital capacity
  • less air exchange @ bases
  • risk for URI pneumonia
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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
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7
Q

PHYSICAL CHANGES - INTEGUMENTARY

A
  • loss of subcutaneous tissue & thinning of dermis
  • decreased subcutaneous fat
  • decreased elasticity
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8
Q

RESULTING IN - INTEGUMENTARY

A
  • tissue fragile
  • decreased sensation to heat & cold
  • loss of moisture, wrinkling
  • pressure ulcers
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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
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10
Q

PHYSICAL CHANGES - MUSCULOSKELETAL

A
  • decreased muscle fibers
  • decreased bone calcium
  • decreased joint cartilage
  • ligaments & tendons more rigid
  • narrowing intraveterbral space
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11
Q

RESULTS IN - MUSCULOSKELETAL

A
  • decreased strength
  • vulnerability to fracture
  • decreased height
  • decreased flexibility
  • osteoporosis
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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
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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
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14
Q

RESULTS IN - GENITOURINARY

A
  • decreased GFR
  • increased residual volume
  • difficulty urinating
  • UTI
  • increased incontinence
  • decreased creatinine clearance
  • decreased drug metabolism
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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
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16
Q

PHYSICAL CHANGES - GASTROINTESTINAL

A
  • decreased salivary gland secretion
  • decreased taste buds
  • decreased thirst
  • decreased gastric secretions/GI motility
    weakened intestinal walls
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17
Q

RESULTS IN - GASTROINTESTINAL

A
  • dry mouth
  • loss of appetite
  • malnutrition/dehydration
  • vitamin deficiency
  • constipation
  • risk of ulcers
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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
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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
NURSING INTERVENTIONS - NERVOUS
- 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
PHYSICAL CHANGES - SENSORY
- 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
PHYSICAL CHANGES - REPRODUCTIVE
- 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
NURSING INTERVENTIONS - REPRODUCTIVE
- 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
PHYSICAL CHANGES - ENDOCRINE
- decreased insulin response to glucose load - decreased thyroid activity - diminished sex hormones
30
RESULTS IN - ENDOCRINE
- diabetes - hypothyroidism - BPH - vaginal dryness
31
PSYCHOSOCIAL CHANGES
- some individual cope with psychosocial changes - others experience extreme frustration and mental distress - fearful of: death, chronic illness, loss of function, pain
32
NURSING INTERVENTIONS - PSYCHOSOCIAL
- active listening - patience - understanding - provide support - activities - socialization - pictures of family in room - great communication skills
33
SYMPTOMS OF CONFUSION AND DISORIENTATION
- 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
DEPRESSION
- 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
SYMPTOMS OF DEPRESSION
- appetite/ weight changes - depressed mood - sleep disruption - fatigue - loss of interest in things they enjoyed
36
DELIRIUM
- delirium is not a disease - sudden change in the way a person thinks and acts - deviation from their cognitive baseline.
37
SYMPTOMS OF DELIRIUM
- fluctuating confusion: calm to aggressive - inattention – reduced ability to focus - disorganized thinking - altered level of consciousness – alert to somnolence
38
INITIAL ASSESSMENT FOR DELIRIUM
- 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
DEMENTIA
- NOT normal part of aging | - broad term: general decline in higher brain functioning—reasoning
40
TYPES OF DEMENTIA
- alzheimer’s disease: chronic irreversible disease deteriorating over time - vascular dementia: caused by problems in supply of blood to the brain).
41
SYMPTOMS OF DEMENTIA
- 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
CARING FOR PATIENT WITH DEMENTIA
- 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
HOW TO IMPROVE COMMUNICATION WITH A PATIENT WITH DEMENTIA
- 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
DRUGS TO BE USED IN CAUTION WITH ELDERLY PATIENTS
- anticholinergic - diphenhydramine, hydroxyzine, scopolamine - decongestants - demerol, propoxyphene - benzodiazepines/Barbiturates - muscle relaxants (soma, flexaril)
45
EXTRINSIC FALL RISK FACTORS
- floor surfaces - equipment - poor lighting - bathrooms - physical restrains - inappropriate foot wear
46
INTRINSIC FALL RISK FACTORS
- lower ext weak - history of prior falls - gait /balance deficit - assistive device - impaired ADL’s - visual deficit - medications - urinary Incontinence - cognition -sensory - arthritis
47
FALL PREVENTION
- 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.

U of R SCHOOL OF NURSING - 372 (12 decks)

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