Older Adults Flashcards
What is the number one causes of death in older adults
Cancer and heart disease
T or F older adults need more nutrient dense meals and less calories
True
What vitamins should be prioritized for older adults?
Vitamin D and Calcium for osteoporosis
Brain plasticity
Exercising the brain
What are factors affecting older adults sleep?
Menopause, prostatic hyperplasia, nocturia/illnesses, Alzheimer’s
What vital signs are altered for older adults
- lowered cardiac output
- increased residual lung volume
-lowered renal and hepatic function - subq fat decreases
- increase in systolic BP
- decreased perspiration
What are reccomended strategies for older adults
-planning for retirement
- finding new friends
- discovering new ways to fill time
T or F older adults need activities to increase self efficacy
True
What are recommended strategies for including the family in the older adults care/ alleviate stress with care?
-educational skills building with treatment plan
- cog-behavioral therapy
- family meetings related to care/stress of care giving
Fluid intelligence
-new information/short term memory
- peaks at adolescence then declines
Functions of Fluid Intelligence
-working memory, processing speed, reasoning, cog control, inhibition, complex skills, attention tasks, creativity
Crystallized Intelligence
- stored info/ long term memory
-slows with aging, but stabilizes or continues to increase throughout life
Crystallized intelligence function
-procedural (practical)
-declarative (functional)
- general knowledge
- specialized knowledge
- wisdom
polypharmacy
use of multiple medications from multiple different pharmacies, OTC, that is common among older adults
American Geriatric Society Beers Criteria do
list medications that might not be safe for older adults w/ alcohol use
Geriatric Syndromes
-impaired mobility
- dizzy
- falls/falling
- urinary incontinence
- increase susceptibility to infection
- atypical response
- altered emotional impact
- altered systemic response
What can you do to reduce impaired mobility
-encourage to stay active
- bed rest to a minimum
- encourage ROM
- frequent position change
What can you do to reduce dizziness in older adults?
-check for earwax impaction
What can you do to reduce falling in older adults?
- exercise daily
- eye exam
- home modifications for safety
- mental health concerns: ( loss of confidence, becoming fearful)
What can reduce urinary incontinence in older adults
- anticholinergics (with caution)
- bladder training
T or F is there a connection between dementia and urinary incontinence?
True
Atypical reponses in older adults
- less pain sense
- MI s/s are different
- fevers at 37.8
- severe infection at 38.3
Altered Emotional Impact in Older Adults
- high risk for disorientation
- confusion
- delirium
- anxiety
- fear related to hospitals
- burden to family
What are the best things to encourage in older adults
- early mobilization
- autonomy
- independent decision making
What is the most common type of abuse is older adults
neglect
Older adults make up how much of the population and how much of the percentage of people in hospitals
15% of the population make up 38% of healthcare
Home Health Care
-specialty area of practice that provides nursing services in the home setting
Hospice Services
Hospice and Pallative
Hospice
improve quality of life by focusing on symptom management, pain control, and emotional support
-pts not expected to live longer than 6months
Pallative Care
patients at any stage of serious illness focusing on pain relief/symptoms and maintain quality of life
-condition does not have to be incurable
Vascular dementia
dementia from a stroke/HTN
Dementia
Chronic and gradually progressive cognitive impairment
What is the most common form of dementia
- Alzheimer’s disease
Fulmer SPICES tool
- sleep disorder
-problems with eating - incontinence
- confusion
- evidence of falls
- skin breakdown
Delirium
temporary confusion state brought by an acute illness w/ specific underlying causes
What do you do with delirium?
-focus on reorientation and preventative measures
Depression
distinct change of behavior with extreme or prolonged sadness brought by life events stressors
What can you do about depression
therapy/counseling
antidepressant medications
How many older adults report alcohol abuse?
7-14%
PQRST Pain Scale
Provoke
Quality
Region and Radiation
Severity and S/s
Time of onset
Risk factors for Alzheimer’s Disease
-age
-environmental (air pollution)
-dietary/inflammatory (high cholesterol, HTN, infection)
-TBI
-family history
What are the pathophysiological signs of Alzheimer’s
cortical shrinkage
neurofibrillary tangle
amyloid plaques
enlarged ventricles
What is a cause of Alzhiemer’s
ACh break down
Increase in glutamate level = Ca++ influx = neurons rupture
What are clinical manifestations of Alzheimer’s disease
-loss of memory and impulse control
- can’t name familiar objects
-rambling
- disorientation to person, place, and time
- depression, irritability, aggression, hostility
- slowly become more dependent
How can you diagnose Alzheimer’s disease?
-after death
- rule out all other diseases
What is medical management of Alzheimer’s
- cholinesterase inhibitors Donepezil, Rigastigimine, neostigimine
- NMDA antagonist Memantine (blocks glutamate increase = stop cell rupt.)
Nursing management of AD
-support cognitive function through games, exercise
- safety precautions
- promote independence in self care
- reduce anxiety and agitation
- improve communication with client
- provide socialization and intimacy needs ( pt-pt, family)
-promote activity in the am = better sleep
- home, community, and transitional care
