older adults (333 E2)

Question 1

when does old age begin

Answer 1

65

Question 2

affects of ageism

Answer 2

-undermine the self confidence
-limit access to care
-takes away personal traits

Question 3

what defines quality of life in an older person

Answer 3

perception of well being (take of themselves and can do their own ADLs)

Question 4

universal aging signs during a general survey

Answer 4

-facial wrinkles
-gray hair
-loss of body mass in extremities
-increased body mass in the trunk

Question 5

normal aging: neurological system

Answer 5

-degeneration of nerve cells
-decrease in neurotransmitters
-decrease in rate of impulse conduction
-voluntary reflex are slower
-less ability to respond to multiple stimuli
-alterations in the quality and quantity of sleep

Question 6

normal aging: facial features

Answer 6

loss of SubQ fat and skin elasticity

Question 7

normal aging: vision

Answer 7

-visual acuity declines
-decrease accommodation to near/far vision (presbyopia)
-difficulty adjusting to light changes (from light to dark)
-yellowing of lens
-altered color perception
-increased sensitivity to glare

Question 8

normal aging: hearing

Answer 8

age related hearing loss (presbycusis), losing the ability to hear high pitched sounds. more common in men

Question 9

normal aging: taste

Answer 9

-decreased salivary secretion
-taste buds atrophy and loss sensitivity
-often difficult to recognize between salt/sweet/bitter/sour
-health condition & meds can alter taste

Question 10

normal aging: smell

Answer 10

-loss of smell
-nutrition is a challenge

Question 11

normal aging: heart / vascular system

Answer 11

-decreased contractile of myocardium (lower CO)
-slight enlargement of heart
-stiffening of heart wall & valves
-HR changes (lowers & doesn’t increase as much w/ exercise)
-BP is sometimes abnormally high

Question 12

is HTN a normal or abnormal part of aging

Answer 12

common but not a normal part of aging

Question 13

normal aging: lungs

Answer 13

-strength and lung expansion decreases (cough is less deep & wont clear)
-more susceptible to pneumonia or other infections
-AP diameter of thorax increases
-decrease in # of alveoli & cilia

Question 14

normal aging: thorax

Answer 14

-kyphosis r/t osteoporosis (preventable)
-calcification of costal cartilage causes decrease mobility of ribs
-chest wall stiffens so less recoil

Question 15

normal aging: GI system & abdomen

Answer 15

-increased amount of fatty tissue in trunk & abdomen
-Abd more protuberant
-slows of peristalsis
-decreased production of saliva & digestive enzymes
-less tolerant to foods

Question 16

normal aging: urinary system

Answer 16

-hypertrophy of prostate gland leading to urinary retention, frequency, incontinence & UTIs
-decrease bladder capacity
-urinary incontinence (mainly women)

Question 17

risk factors for incontinence

Answer 17

age, menopause, DM, hysterectomy, stroke & obesity

Question 18

normal aging: integument

Answer 18

-decreased turgor, subQ fat & connective tissue
-loses resilience & moisture
-epithelial layer thins
-elastic collagen fibers shrink & become rigid
-wrinkles
-lesions & spots
-sparse hair
-nails growth slows & thickens

Question 19

normal aging: MS system

Answer 19

-diminishes in proportion to the decline in muscle mass
-osteoporosis

Question 20

normal aging: repro system - women

Answer 20

-reduced estrogen and progesterone
-dryness of vaginal mucosa, irritation & pain w/ sex
-decrease libido

Question 21

normal aging: repro system - men

Answer 21

-erection less firm & less forceful ejaculation
-testosterone lessens leads to decrease libido
-no definite cessation of fertility

Question 22

normal aging: immune system

Answer 22

-slower
-reduced production of B&T cells
-decrease in body core temp
-decreased stress response
-decreased response to immunizations

Question 22

normal aging: breasts

Answer 22

-estrogen production diminishes
-breast tissue becomes firmer
-decreased muscle mass, tone and elasticity
-gynecomastia (enlarged breasts in men)
-both men and women are at risk for breast cancer

Question 23

IADLs

Answer 23

transportation, meal prep, shopping

Question 24

common misconception about aging & cognitive impairments

Answer 24

-confusion or disorientation
-forgetfulness
-loss of language skills or ability to calculate
-poor judgment
these are not normal and need further assessment

Question 25

normal aging: cognitive

Answer 25

reduction of brain cells & changes in neurotransmitter levels

Question 26

normal aging: psychosocial

Answer 26

-retirement
-social isolation
-sexuality
-housing and environment (moving out)
-death

Question 27

acute care setting is

Answer 27

the hospital

Question 28

pay special attention to

Answer 28

-basic needs of comfort
-safety
-nutrition/hydration
-skin integrity

Question 29

common complications in acute care

Answer 29

-delirium
-malnutrition & dehydration
-HAIs
-urinary incontinence
-falls

Question 29

nutritional recommendations

Answer 29

-increase intake of vit D, B12, E, folate, fiber & calcium (multi vit)
-increase fluid intake if not contraindicated
-limit Na, fat, refined sugar & alc intake

Question 29

intrinsic risks for falls

Answer 29

-hx of falls
-fear of falling
-muscle weakness
-postural hypotension
-problems w/ balance and gait
-adverse med rx
-chronic conditions

Question 30

extrinsic risks for falling

Answer 30

-poor lighting
-lack of handrails
-poor design of stairwells
-lack of bathroom grab bars & nonslip surfaces
-hazards & obstacles
-slippery or uneven surfaces
-improper use of assistive devices
-inappropriate footwear

Question 31

what is an important way to manage polypharmacy

Answer 31

one HCP manages all medications (medication reconciliation)
review meds monthly

Question 32

illness indicators in older adults

Answer 32

-changes in mental status
-occurrence & reason for falls
-dehydration
-decrease in appetite
-loss of function
-dizziness
-incontinence

Question 33

what is the first sign on a UTI in older adults

Answer 33

confusion then incontinent

Question 34

confusion is the first sign of what in older adults

Answer 34

-UTI
-pneumonia
-MI (+anxious & dyspnea)

Question 35

elder mistreatment

Answer 35

intentional act or failure to act that causes or creates a risk for harm to an older adult
-physical, emotional, sexual abuse
-financial exploitation
-neglect or abandonment