test 3 Flashcards
normal age related changes for respiratory
loss of elastic recoil bc of stiff,
can’t take big breath, atelectasis, diminish chest cavity, residual capacity increase
risk factors for COPD
smoking, pollution, age, hx of asthma, genetics, female
risk factors for asthma
smoke, seasonal allergies, asthma as a kid, genetics
dementia
neurocognitive disorder, slow onset, may have hallucinations, movement disorder
delirium
acute onset memory and cog. changes, medical emergency
alzheimers
memory loss, can’t get new info, depression, brain atrophy, AA at risk
parkinsons
asymmetrical resting tremor, challenge test with levodopa, decreased dopamine and NE, neuron loss, muscle rigidity- throat, and speaking
what causes delirium?
meds, procedures, restrains, events, sleep, depression, pain, environmental factors
how to communicate with someone experiencing delirium
know past patterns, nonverbal, slow and calm, explain and smile, reassure safety
most common autoimmune disorders in older adults
diabetes,
diabetes decreases what functions in older adults?
mobility, falls, cognitive, incontinence, muscle weakness, fatigue
how is diabetes monitored
A1C, blood glucose, polyuria, polyphagia, polydipsia
what meds are used for diabetes in older adults?
metformin
complications of diabetes
heart disease, incontinence, weight loss, delirium, lower extremity problems, hypoglycemia, organ damage
what cardio problems are diabetics at risk for
heart disease, heart attack, stroke, dementia
osteoporosis
most common bone disease, bone frailty, menopause women, DEXA scan
risk factors for osteoporosis
white women, small, prev, broken bone, genetics, estrogen def., calcium def.,
difference between OA, RA and gout
oa is unilateral, pain better after rest, ra is autoimmune, bilateral, stiffness after activity and gout is red pain uric acid
risk factors for OA
older age, obesity, female, previous injury, joint disformitiy, genetics
how to help during gout attacks
pain relief, nsaids, steroids
consequences of untreated pain
falls, functional impairment, slowed rehab, caregiver strain, sleep, anorexia,
how to assess pain in older adults
high comprehensive assessment, quantitative measures, same as reg
non-pharm methods used for pain
heat/cold, TENS, acupuncture, relaxation, use least invasive
potential factors in older adults that alter mental health
changes and illness, family, death of others, functional and sensory and memory impairment, pain, no driving, retirement, agism, mobility,
most common mental health disorder in older adults
depression
nursing interventions for anxiety in older adults
SSRIs, CBT, therapies, listening, encourage expressions, screen for other mental illness
risk factors for depression in older adults
chronic illness, disability, dementias, female, socioeconomic, family hx, prev. episodes, meds, substances, living alone, death of others
what patients are at high risk for suicide
depression and other problems, death of spouse
how many alcoholic drinks are appropriate for older adults
one glass of anything
autonomy
independent decision making capacity
beneficence
actions to benefit others
nonmaleficence
no intentional harm, avoid/ minimize the risk of harm
justice
people are to be treated equally and fair
when is a durable power of attorney for health care utilized
when the patient is unable to make decisions for themselves
living will vs advanced directives
living will- a type of advanced directive
AD- more comprehensive
what older adults are at higher risk for maltreatment and abuse
cognitively impaired adult, physically impaired, women living alone
what factors increasing the risk of mistreatment of older adults in the community
poor physical and mental impairment, women,
what are the cues of physical abuse
bruising, any lacerations or broken bones, behavior changes, wounds in different stages of healing
what are the cues of sexual abuse
blood, unexplained diseases, pain
what are the cues of emotional abuse
change in behavior around caregiver, caregiver speaks mostly
what are the cues of psychological abuse
same as emotional
what are the cues of neglect
malnutrition, dehydration, unclean, urine smell, dirty clothing,
what is required of nurses for suspected abuse
report!!!
what predicts successful retirement in older adults
good income, living environment, support systems, and relationships,
what are common reactions to death of a spouse in older adults
neglect to self, can’t share grief, loss of social
what is the importance of friendship in older adults
support, promote health and wellbeing,
what circumstances associated with caregiver stress
Responsibility, age, intensity, resources, financial, length of care
how do nurses work with caregivers to create a partnership
monitoring, teaching, provide info, psychological support, coordinating
the importance of touch
stronger than verbal or emotional
what are the zones of touch
social, consent, vulnerable, intímate
physical changes in sexual responses in older adults
female- decrease lubricaiton, less expansion,
male- slow erection, difficult regain erection, fewer contraction, decrease muscle
how do older adults with chronic conditions have sex
when high energy, caution in heart pts, use lube, counciling
how do nurses approach a patient masturbating
suggest privacy, cover up
what nursing actions to older adults having sex in a nursing home
allow them in privacy, inform that its normal
tips for best practice screening for sexually transmitted diseases among older adults
test for aids, regular screening, hiv
hospice vs palliative care
hospice is for the dying with 6 months to live, palliative is to help with what they have to prolong life
what factors affect grieving
coping strategies, ability to handle dying
“good coper”
Acknowledge the loss and try to make sense of it, optimistic
indicators of a good death
care received, communication, hope, closure
what older adult is most likely to re-marry after a death quickly
men
nursing skills needed for the practice of palliative or end of life care
communication, knowledge about symptoms and teach, comfort, deal with own feelings, advanced directives, legal challenges,
self-actualization
highest expression of ones individual potential and implies inner motivation that has been freed to express the most unique self or the authentic person
what are traits of older adults who meet self-actualization
courage, altruism, humor, self-renewal, collective self-actualization, wisdom, creativity, recreation
what are some spiritual nursing actions
environment, touch, listening, encourage family, praying, meet religious needs, councilor
some hope-promoting activities for older adults
sun, share, nature, journal, letters, music, relationships
define a legacy and list examples of legacies
assets that are transferred to another and may be treasured as a symbol of immortality
ex.- histories, autobiography, videos, shared memories, art, music, organs, objects, talents, traditions
