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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

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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
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.

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

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