Nursing Care Older Adults (Final) Flashcards
Developmental Tasks for Older Adults
Adjusting to Changes in health and physical strength
Retirement and reduced or fixed income
Death of loved ones
Acceptance of themselves as they age
New living environments
Redefining relationhips
Placement Decisions: Postive things to look for
- Does not feel like a hospital. Personal room with privacy
- Medicare and Medicaid certified
- Adequate and qualified staff who pass background checks
- Quality of care and recreational activities
- Quality of food and mealtime choices
- Staff encouragement of family involvement
How can nurses help with placement decisions
-Encourage collaborative involvement
-Answer questions
Educate on options
-Medicare website that helps determine quality
Acute Care: Pay special Attention to the patients
-Needs of comfort
-Safety
-Nutrition/hydration
-Skin integrity
Common of complications in Acute Care
-Delirium
-Malnutrition and Dehydration
-HAI’s
-Urinary Incontinence
-Falls
Delirium: Related to nursing care
Multiple reasons for increased risk
-Encourage family visits
-Provide memory cues
-Compensate for sensory deficits
-use reality orientation techniques
Acute care setting pose increased risk for these adverse events
Health care associated infections
Urinary continence
Falls
Restorative Care
Types of ongoing care:
-Continues recovery from acute illness
-Support of chronic conditions that affect daily functioning
Both types take place in private homes and long-term care settings
Goal of Restorative Care
To regain or improve prior level of independence, ADLs, instrumental activities of daily living (IADLS)
Leading cause of fatal injury
FALLS
Health Concerns of Older Adults
-Heart Disease (HTN and CAD)
-Cancer (Screening and mimimize risk factors)
-Chronic Lung Disease (Stop smoking or decrease smoking)
-Stoke
-Smoking (Risk factor for 4 most common deaths. First 4)
-Alcohol Abuse
More Health Concerns
SLIDE
Pain
Not an normal part of aging
Nutritional recommendation for Older Adults
-Increase intake of certain vitamins
-D, B12, E, Folate, Fiber, calcium
Take a multivitamin
Increase fluid intake if it is not contraindicated
Limit bad foods
Medications
One of the biggest problems. Polypharmacy
Recommendations to improve nutritional intake in healthcare setting
-Eat with others
-Ensure food is accessible during day
-Ensure patient is comfortable
-Hygiene
-Environment
-Promote activity
Risk Factors for falls in Older Adults: Intrinsic
-History of fall
-Fear of fall
-Muscle weakness
-Imparied vision
-Posturla hypotension
-Problems with balance and gain
-Adverse medication reaction
-chronic conditions
Risk factors for falls in Older Adults: Extrinsic
Poor lighting
Lack of handrails
Poor stairwell design
-ETC
Illness Indictors in Older Adults
Changes in mental status, occurrence and reason for falls, dehydration, decrease in appetite, loss of function, dizziness, and incontinence
Polypharmacy
Concurrent use of medications by patient
-Affects about 40% of older adults
-One HCP should prescribe manage all medications
Assessing the Needs of Older Adults
-Obtain a complete assessment takes time
-May need to make adjustments based on changes
-It is important to recognize early indicators of acute illness in older adults
Disease Presentation in Older Adults
PP slide on Second Voice over
What can you do to prevent falls
-Talk to doctor
-Check eyes
-Make home safer
-Keep moving
-Speak up
Confusion =
Some type of illness or infection
Altered Presentation of Illness in Different Settings: Hospital
Confusion: Look for acute illness, neurological events, new meds, risk factors fo delirum
Chronic Dehydration: Exacerbated by acute illness is common
Infection: May not have a fever, look for increase in RR, falls, incontinence, confusion
Altered Presentation of Illness in Different Setting: Home care
-Investigate all falls, balance and gait issues
-Loss of appetite with late-stage heart disease is early symptom of impending failure
Altered Presentation of Illness in Different Settings
-Under-treatment of pain: Look for nonverbal cues
-Decline in function
-Watch for drug toxicity
-New intontience
Altered Presentation of Illness in Different Settings: Ambulatory Care
SLide
Early indicators of Acute ilness in older adults
-Mental Status changes
-Falls
-Dehydration
-Decrease in appetite
-Loss of functions
-Dizziness
-Incontinence
General Preventive measures to recommend to older adutls:
-Participation in screening activities
-Regular exercise
-Weight reduction if overweight
-Eating a low-fat, well balance diet
-Moderate alcohol use
-Smoking cessation
Elder Mistreatment
Intentional act or failure to act that causes or creates a risk for harm to an older adult
Psychosocial health interventions
-Therapeutic Communication
-Touch
-Reality orientation
-Validation therapy
-Reminiscence
-Body image interventions
Teaching Older Adults
-Assess readiness to learn
-Speak clean, slowly with a normal tone while they can read your lips
-Present 1 idea at a time
-Allow for extra time to process information
-Minimize environmental distraction
-Utilize teach back method
Teaching Older Adults with Hearing Deficit
-Get attention
-Reduce background noise
-Speak clearly and loudly
-Repeat yourself
-Have good lighting
