Unit 2 Geriatrics Flashcards
Many older adults continue to work to postpone retirement, Why?
1) Because the discontinuation of the work role causes a change in lifelong habits.
2) Many individuals self-worth is directly associated with their work roles.
The job market continues to show preference to what?
The young worker over the older more skilled worker.
What contributes to how a person adjusts to retirement?
The state of the individual’s health
When a person retires, their income is usually—?
reduced
What can change a persons income at retirement?
1) The access and cost of healthcare and medications
2) Maintenance of the home.
3) Travel and leisure activities may have to be cancelled.
What affects how we cope w/ our changing bodies?
How we view aging
What has a strong impact on our self-concept?
Physical appearance
What is gradual and allows you time to adjust to the changes?
Most aging
Those individuals who can’t cope well may become what, once physical changes and chronic illnesses start?
Depressed
What may cause frequent role changes in the family?
Physical or emotional illness
Older adults begin to face the reality of dying as what happen?
Their friends and loved ones die.
What is a big adjustment that is associated with aging individuals?
Income is often reduced.
What can stress and change cause anyone to have?
Difficulties remembering appointments or to be distracted easily.
Is 65 years of age the clinical basis for the dividing line for old and young?
No, there is no established age for old and young.
Define gerontology
The study of the normal effects of aging and age-related diseases on the human body.
Define Aging
A complex phenomenon that begins w/ birth and continues throughout the life span until death.
Define gerontologist
Geriatric specialists in advanced-practice nursing, geriatric psychiatry, medicine, and social services.
Old is divided into what 3 periods and what is the age ranges?
1) Young old 65-74
2) Old 74-90
3) Very old 90+
What causes irreversible damage to the brain?
Alzheimer’s disease or other conditions
Eric Erickson is most famous for coining the phrase?
“Identity crisis”
Who coined the phrase “identity crisis”
Eric Erickson
What was Erickson’s greatest concern in his life as well as in this theory?
Development of identity
In Psychosocial Theories of Aging, which theory does this describe, “Personality and coping remain constant with aging. Aging is seen as a part of the life cycle, not as a separate terminal state.”
Continuity-Developmental Theory
Each of Erickson’s stages are marked by a _____, for which successful resolution will result in a ______?
Conflict
Favorable outcome
Favorable outcomes are sometimes known as?
1) Virtues
What is the crisis of aging years?
Integrity vs despair
Integrity vs despair is a phase that occurs during ______ and is focused on ____?
old age
Reflecting on life
Name the 3 definitions related to despair.
1) Life has been wasted.
2) Experience many regrets.
3) Feelings of bitterness
What is the favorable outcome of aging years?
1) A sense of integrity and fulfillment.
2) Willingness to face death.
Which life stage has to adjust to the death of a spouse?
Late maturity stage
Name the 4 ways a person might feel relating to integrity.
1) Feel proud of their accomplishments.
2) Few regrets
3) General feeling of satisfaction.
4) Attain wisdom, even w/ confronting death.
What is Robert J. Havighurst most famous book?
Human Development and Education
Activity Theory is part of the Psychosocial Theories of Aging, define it.
Age-related changes which decrease activity must be replaced.
Each human has 3 sources for developmental task, what are they?
1) Tasks that arise from physical maturation.
2) Tasks that arise from personal values.
3) Tasks that have their source in the pressures of society.
Havighurst’s developmental task model is _____ dependent and all serve _______ depending on their _______.
Age
Pragmatic functions
Age
There are 6 major stages in human life. What is the age range for the Later Maturity Stage?
60 years old and over
Later Maturity stage have to adjust to decreased ____ and ____.
Physical strength
Health
Based on Biological Theories of Aging, describe the Clockwork Theory or Programmed Aging Theory.
Connective tissue have an internal clock that genetically program the length of one’s life.
Which major stage of human life has to adjust to retirement and reduce income?
Later Maturity Stage
According to Biological Theories of Aging, name the theory(s) that connect to “free radicals in the atmosphere cause breakdown in the aging process.”
Free-radical theory
Somatic mutation theory
Describe Disengagement Theory.
Individual and society gradually withdraw from each other.
People in Later Maturity Stage have to establish an explicit affiliation with?
One’s age group
According to the Biological Theories of Aging, define the Wear-and-Tear (stress theory and cross-linkage or collagen theory).
After repeated injury, cells wear out and cease to function.
Name the 3 Psychosocial Theories of Aging.
1) Disengagement theory
2) Activity Theory
3) Continuity-Developmental theory
Those who are in Later Maturity Stage have to learn to adopt and adapt to social _____ in a ________ ______.
- Roles
- Flexible Way
In the Biological Theories of Aging, what theory(s) are described by “A decline in the immune functions of the body, causes the body to slow.”
Immune-System Failure Theory
In Biological Theories of Aging describe the Autoimmune Theory
Results from the weakening of the immune system not recognizing the body’s own tissues and destroying itself.
Those who enter into Later Maturity Stage have to establish satisfactory what?
Physical living arrangements
How much height does a person lose per decade after the age of 30?
1 cm
The bladder wall elasticity will _____ with age?
decrease
50% of people will have what at the age of 50?
Gray hair
As a person ages, they will lose muscle mass loss in the deltoids. What will effect or cause will this have?
Shoulders will decrease in width
A person’s cardiac output with _____ 1% per year between the ages of 20 and 80. This will result from what?
- Decrease
_ The loss of cardiac muscle stregth.
Due to the gallbladder emptying less often, there is an increase in incidence of what?
Stones
Does anything happen to your posture or bones as you age? If yes what?
- Posture changes
- Bones loss mass
As you age what two colors are harder to distinguish between?
Green and blue
What is a normal result(s) that happen from your bladder capacity decreasing?
- Frequent urinations
-Nocturia
Grandma’s peripheral vision _____ and her sensitivity to glare will ____.
- Diminish
-Increase
Is it normal for the bladder and perineal area muscle strength to increase w/ age?
No, it’s normal for it to decrease
What happens to an elderly person’s ligaments and tendons?
They become less elastic.
As you age your head circumference will ____ and your ____ and ____ will lengthen.
- Decrease
- Nose/Ears
What are some physical factors that can cause a person to act in a bizarre way.
1) Illness
2) High or low blood sugars
3) Insufficient oxygen
When an elderly individual becomes disoriented, caregiver may assume _____ that this is a normal aging process.
assume
Clarification of the differences between ___, ____, and ____ can provide guidance for effective interventions
Dementia
Delirium
Depression
What does Dementia refer to?
Refers to the loss of cognitive abilities.
They may not know what a pen is called but they know that you should write with it.
What is the leading cause of dementia in the older age group?
Alzheimer’s disease
Only one in eight people will develop what?
Alzheimer’s disease
What disease does a pt have if they can’t remember the name of a chair but they know you should set on it.
Dementia
What should become a routine part of your assessment in an older individual?
Cognitive functioning assessment
Many early onset dementias are missed because what assessment isn’t done?
Cognitive functioning assessment
Medications, vitamins, and disease can cause dryness of what?
Lacrimal ducts (tear ducts)
What 3 things result when a women’s estrogen level decreases?
1) Deepening of the voice
2) Thinning pubic hair
3) Atrophy of breast tissue
As a man ages prostate gland will ____, causing a difficulty in ____.
- Hypertrophy
- Voiding
As you get older your incidence for glaucoma and cataracts will increase or decrease?
increase
True or False
Only the hair on your head will thin for men starting in their 30s and women after menopause.
False, it’s not confined to the head.
Is it normal for your liver to increase in size as you age?
No, it should be decreasing in size.
An older heart needs more rest between beats. What does this cause?
A slower heart rate
What changes delay wound healing?
Circulatory
What things can happen as a result of a normal decrease in peristalsis?
1) Constipation and increased flatus.
2) Delayed emptying of the esophagus, stomach and lower intestines.
What things can result in a person getting delirium.
Malnutrition
Electrolytes imbalance
Infection
Acid-based imbalance
Change in blood glucose
Hypoxia
Drug reactions
Dehydration
Head trauma
Delirium refers to?
Refers to a situation in which a person has a rapid change in behavior and thinking ability.
What condition usually results from an acute problem with physiological causes and is reversible?
Delirium
Define delirium
An acute problem which usually inhibits one’s ability to recall where he is, time of day or even their name.
Short term memory may or may not be intact.
Hallucinations or delusions may be present.
What things may result in delirium?
- Malnutrition
- Electrolyte imbalance
- Infection
- Acid-base imbalance
- Change in blood glucose
- Hypoxia
- Drug reactions
- Dehydration
- Head traumas are the most common
Define depression
A prolonged feeling of profound sadness and worthlessness.
Surviving losses is a part of what process?
Aging
Depression is more prevalent in ___ as they age.
Men
Many medications can produce a ____ deression
Pseudo
What is likely the oldest and still one of the most frequently diagnosed psychiatric illness?
Depression
Name some Signs of depression and suicidal thoughts
- Crying spells
- Insomnia
- Eating disorders
- Social isolation or withdrawal
- Feelings of hopelessness
- Unexplained physical symptoms
- Loss of interest in appearance
- Giving away of possessions
- Acting-out behaviors
Delirium onset is_____ and duration is ____.
Rapid
Short
Delirium night symptoms
May worsen
Delirium cognitive functions are
variable
It is ____ for delirium pt’s to have physical and recent changes.
Common
It is ____ for delirium pt’s to have low self-esteem or a suicidal ideation.
Rare
It is ______ for delirium pt’s to have a Hx of psychiatric symptoms.
Not usual
Dementia comes on ____ and has a _____ duration.
Slow
Long
To differentiate between dementia and delirium, you should as what 2 questions?
1) How long has this been going on?
2) How abruptly did it start?
Depression has a _____ onset and a _____ duration.
Rapid
Short or long
Cognitive functions on a dementia pt are _____.
Stable
Dementia pt’s have ____ physical or recent changes.
No
It is ____ for a pt with dementia to have suicidal ideation, low self-esteem, or a Hx of psychiatric symptoms.
Rare
It is _____ for a pt with depression to have suicidal ideation, low self-esteem, or Hx of psychiatric symptoms.
Common
The cognitive functions of a pt with depression are _____ and physical changes _____.
Variable
Are possible
How do depression symptoms do at night?
Usually doesn’t worsen
What is a normal change to a pt’s BP as they age?
1) Systolic pressure will slightly increase.
3) Diastolic pressure will remain same.
Name the 2 things that relate to a normal change in BP as you age.
1) Increased peripheral resistance
2) An accumulation of collagen and lipofuscin in the vessels with a narrowing diameter.
True or False:
Its normal for elderly people to have an increase incidence of diverticulitis
True, its due to a decreased nerve sensations.
True or False:
Tooth loss is a consequence of aging.
False, It is not a consequence of aging.
Dyspareunia is a result of what decreasing after menopause?
Lubrication and vaginal secretions
What are some directions that may aid in the treatment of depressed pts?
- Therapy
- Exercise
- Exposure to the sunlight
- Improving the diet
- Medications
What is the only conclusive way to diagnoses Alzheimer’s Disease?
An autopsy
What are some normal results from a decrease in gastric secretions?
1) Increased indigestion
2) Decreased total stomach capacity.
3) Less hunger and appetite
Define presbyopia
The loss of the ability to visually focus.
What will decrease slowly after the age of 55?
Body wt
Decreased nerve sensations can happen as you age. This can cause a _____ in the signal to defecate and a ____ of the external sphincter.
- Delay
- Weakening
Tooth loss is a result of ____ and ___ can lead to it.
- Poor care
- Disease
What age group do visual changes usually start?
Middle age
Your grandpa’s integumentary system is more susceptible to what?
Changes in temp, pressure, moisture and infection.
As a male ages, it is normal for their testicular mass to gradually what?
Decline
By the age of 40, how much more light do you need to see?
20% more light
Why does grandma have irregular pigmentations of her skin?
Because a decreased amount of melanocytes as well as an uneven distribution.
It is normal for your bile to thicken and your cholesterol to increasek but why?
Elderly people’s gallbladder empties less often.
What 2 things happen to your musculoskeletal system as you age?
1) Decrease muscle mass
2) Decrease muscle strength
You have a diminished ____ ____ due to a decrease in alveoli number and an increase in their size.
Gas exchange
Describe what you should expect to happen to your teeth as you age.
1) Natural signs of wear and tear
2) Loss of enamel
3) Lengthening of the tooth
4) Decreased ability to cut and chew efficiently.
Define cataracts
Opacity (clouding) of the lens of the eyes
Blockage of the lacrimal duct (tear duct) may cause the eyes to what?
Water excessively
Your total stomach capacity will ____ due to a decrease in gastric secretions.
decrease
Will grandma’s motor response stay the same as she ages?
No, it will be slowed by 30%.
What touch changes occur w/ age?
Decrease in feeling light touch, pain and temp chagnes.
True or false:
Your grandma sweats less then you. Why?
True, they have a decrease in the number and function of the sweat glands.
Younger adults have _____ more cells than an elderly person
30%
All body tissues are affected by what changes in the endocrine system?
1) Decreasing hormone levels
2) Secretory cells are replaced w/ connective tissue.
What is Presbycusis?
Age related hearing loss
As a women ages, what happens to the vaginal wall?
It becomes thin and less elastic
What normal age process of the gastrointestinal system will result in an increased risk of choking?
Diminished gag reflex
What are the 2 main endocrine disorders affecting the elderly?
1) Diabetes mellitus
2) Thyroid dysfunction
As you age it is normal for your heat valves to become ____ and more ____.
- Thicker
- Rigid
What will atrophy as you age.
Body fat
By the age of 50, where has a person’s hearing frequency decreased to?
13 kHz
Your skin is prone to skin breakdown especially following what?
Minor bruising or injury
What can cause xerostomia and dysphagia?
Decrease in saliva
As you age your cells mass becomes ____ active and you have a loss of body _____.
- Less
- Surface
How much hearing is normal for a person to have at the age of 60?
5 kHz
What olfactory changes occur with age?
Diminished sense of smell
What will decrease in blood flow due to changes in the circulatory system.
The cerebral
True or False:
It is normal for less semen to be released at ejaculation as a man ages.
True
Older people have a _____ appetite than younger people due to a ____ in gastric secretions.
- Smaller
- Decrease
What is the best pitched and tones you should use to talk to older people?
- Low pitch
- Moderate loud tones
Following periods of disuse, the musculoskeletal system will experience what 2 things?
1) Pronounced stiffness
2) Diminished range of motion
It is normal for your blood vessels to lose what?
elasticity
Nerve and circulatory changes result in an increase of conductive hearing loss, w/ symptoms of ____ resulting from obstruction or reduction in the passage of sound in the inner ear.
- Fullness
- Itching
- Tinnitus
What will normally happen to your skin as you age?
- Loss of elasticity
- Becomes thinner, drier, and more fragile
As you age your sodium conserving will ____ and your BUN will _____.
- Decrease
- Increase
Name some of the things that happen in the respiratory system that can result in an pt’s increased susceptibility to infections.
1) Alveoli will decrease in number and increase in size.
2) Increase in rigidity of chest wall due to calcification
3) Decrease cough efficiency.
4) Decrease in pulmonary elasticity and ciliary action.
What changes occur to your taste as you get older?
1) loss in the number of taste buds.
2) Increased threshold for salt and sugar.
3) Diminished ability to perceive bitter, salt and sour tastes.
As a man ages, where will hair increase?
Eyebrows
Nose
Ears
True or False:
Possible bowl incontinence isn’t normal as you age.
False, it is normal to have a possibility of bowel incontinence
After menopause, what part(s) of the reproductive system atrophies?
Ovaries
Uterus
Fallopian tubes
What happens to your renal function when you lie down?
It will increase
It’s normal for your nails to grow _____ and become ___, ____, and ____ as you age.
- Slower
- Brittle, dull and yellow
At the age of 10 we hear high frequency at what?
20 kHz
Where will grandma get unwanted hairs?
Face and chin
What has a decreased capacity to transmit messages to and from the brain?
Neurons
At what age range will your brain’s wt peak?
2-25
How much brain mass will be lost by the age of 80?
7%
The tympanic membrane does what with age?
Thickens
What calcifies w/ age?
Bones
Grandpa’s cerumen (ear wax) does what w/ age?
increases
Homeostasis is defined as?
A balance between the external and internal environment.
Vitamin D helps facilitate the absorption of what?
Ca (calcium)
As a person ages, common age-related changes make it more difficult for us to maintain what?
Homeostasis
What controls your sleep-wake patterns?
CNS
What are some risk facts that lead to osteoporosis?
- Family history
- Inactivity
- Low Ca intake (below 80 mg)
- High caffeine intake
- Smoking
- Fair skin
- Low body weight
-Early menopause - Long-term use of anticonvulsant
- Gastric or small bowel resection
How often do you need a TD boster?
Every 10 years
Research has shown that ____, ____ ___ ___ can improve muscle strength and muscle size in the frail older adults.
- High-Intensity
- Progressive resistance training
Osteoporosis results in greater risk of what?
Fractures
What are the 2 types of sleep that everyone needs to experience every night?
REM
NREM
How many Tdap boosters do you need?
At least one
The emphasis on health maintenance is no longer solely preventative but is placed in _____ in the elderly
Maintenance
Good hygiene and grooming are an important part of older individuals’ ___ and ___.
- Self-esteem
- Confidence
What should be regularly maintained when we are young and even more as we age to insure homeostasis?
Regular checkups and screenings
Which type of flu shot do elderly people get?
High dose vaccine which has 4x the antigen then the regular one.
A lack of activity results in ____ ____ in older individuals.
Physical decline
There are how many states of sleep and how many of each?
4 NREM
1REM
Name the 2 types of osteoporosis and which sex they are found in.
- Type I: Found primarily in women after menopause
- Type II: Occurs in both sexes as a result of aging.
When it comes to good hygiene, ____ needs to be made to ____ the aging body.
- Adaptations
- Accommodate
How often do elderly need glaucoma screenings?
Yearly
Name some factors that may affect or influence grandma’s health.
- Lifestyle
- Inflation and fixed incomes
- Culture
- Family structure
- Levels of education
- Changes in body composition
- Social situations (Living alone/ w/ others)
What is the range of CA men and women should have daily?
1000 to 15000 mg
How much CA is in 1 cup of milk?
300 mg
What do you call the bodies response to the day-night cycle of the sun?
Personal circadian rhythm
Exercise can ___ well-being and helps reduce the risk of____.
- Enhance
- Depression
Exercise can help ____ muscle strength, endurance, and flexiblitiy.
Build
What was once accepted as the normal deterioration of old age is now considered what?
Disuse
As one ages, one tends to sleep less than ___ hours per night.
8
Older people have an impaired capacity to maintain____.
Sleep
Decribe osteoporosis
When bone mass is decreased because bone is absorbed faster than it is formed.
What are some ways a person can reduce the risk of osteoporosis?
- Avoid tobacco
- Avoid caffeine
- Regular exercise
- HRT
- Limit alcohol
- Increase Ca intake w/ vit. D
- Maintain a safe environment
Exercise should be ____ but not unduly ___.
- Habitual
- Strenuous
True or False:
You don’t need permission from a PCP prior to initiating exercise on a pt.
False, you always need permission
Exercise helps reduce the risk of ___ ___ disease.
coronary heart
In elderly people it is common to ____ earlier, resulting in daytime fatigue from normal changes in the ____ rhythm.
- Wake
- Circadian
What does a person need to increase w/ illness and/or surgery?
Protein intake
What decreases on the T cell with age?
Function
What are 2 consequence of when the immune system loses its ability to fight off infections as we get older.
1) Increases the risk for infection.
2) May make immunizations less effective.
When does the thymus begin to shrink?
Adolescence
The probability and possibility of a person becoming ill will ____ w/age.
Increase
If an elderly person has a respiratory infection, what s/s might you see?
- Cough
- Increased mucus
- Abdominal pain
- Chest pain
- Loss of appetite
- Generalized weakness
- H/A
The immune system’s ability to detect and correct ___ ___ also declines.
Cell defects
As we age, the immune system also seems to become less tolerant of the body’s ___ ___.
Own cells
What kind of infection might an elderly person have who presents with s/s of flank pain, new incontinence, pain and frequency w/ urination, weakness, and blood in urine.
Urinary infection
Aging is a ____ process and illness is a ____ process, which often occur at the same time.
- Normal
- Pathological
Although illness affects all dimensions of a person, regardless of age, older adults deal w/ a ___ of problems.
Variety
What infection might be present in an elderly person who presents w/ s/s of redness, warmth, pain or tenderness on a section of their arm.
Skin infection
The changes of aging and the needs imposed by chronic illness interrelate to ___ in all areas of life.
Increase the risk for problems.
Chronic health problems or disabilities may also result from _____ or ___.
- Acute illness
- Accidents
Diagnosing the elderly w/ an ______ can be difficult.
infection
Classic symptoms of an infection such as ___, _____, and _____ are less likely to show up in older people.
- Fever
- Chills
- Vomiting
What are some of the symptoms you might see in an elderly person w/ an infection.
- Subnormal temp
- Unexplained dehydration
- Increased pulse rate
- Confusion
- Poor appetite
- Fatigue w/ increased aces and pains
