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Geriatrics > Unit 4 > Flashcards

Unit 4 Flashcards

1
Q

Computers can be found at the bedside, in nurses’ pockets, and in strategic
locations around the unit. Nurses are given passwords that may be more
important than their name tags. Bar codes and even fingerprints are scanned
both for access to records, the administration of treatment and medications
and the identification of patients

A

Electronic Medical Record

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2
Q

▪ involves formal symptom assessment and treatment, aid with
decision making and establishing goals of care
▪ practical support for patients and their caregivers, mobilization of
community support and resources to ensure secure and safe living
environments
▪ collaborative and seamless models of care (hospital, home, nursing
homes, and hospice).

A

Palliative Care

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3
Q

When a thiazide or loop diuretic
therapy is prescribed, electrolytes
should be checked within 1 week
after initiation and at least
annually.

A

Monitoring diuretic
therapy

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4
Q

a.k.a., health care proxy
* A document that designates a surrogate (also called an “agent,” “proxy,” or
“attorney-in-fact”) to make medical decisions on a person’s behalf should
that person become unable to make a decision.

A

Durable power of attorney (DPA)

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5
Q

sequential, with each discipline applying their assessment and intervention
within their own silo

A

Multidisciplinary teams

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6
Q

An act to maximize the contribution of senior citizens to nation building, grant
benefits and special privileges and for other purposes.

A

Republic Act 7432

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7
Q

Annual TaxabIe does
not exceed P60k or such
amount determined by
NEDA

A

RA 7432

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8
Q

The patient is assessed (usually with a checklist); problems are identified and
care plans of interventions are developed.

A

Problem-oriented notes

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9
Q

include such basic functions as
eating, bathing, dressing, getting into and out of bed or a chair, and using
the toilet.

A

Activities of daily living (ADLs)

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10
Q

Words backed by actions help develop trust. A relationship built on trust and
concern for the welfare of others is critical to optimal health outcomes.

A

Follow up and follow through

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11
Q

s a tool that empowers the family of the dying patient to
provide the best care possible
- Based from the GSF, patients are identified based on this premise
that they have at most 6 months to live

A

Gold Standard Framework

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12
Q

Assesses and treats functional, sensory, and perceptual deficits
that impact ADLs. Assesses need for assistive devices. Assesses
and treats cognitive deficits. Provides rehabilitative services in
geropsychiatric services.

A

Occupational
Therapist

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13
Q

Allows identification and
elimination of duplicate
therapies, corrects drug
interactions, and streamlines the
drug regimen to improve
adherence.

A

Medication list

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14
Q

the concept that each person has a right to make independent choices and
decisions. It is reflected in guidelines and laws regarding patient rights and
self-determination.

A

Autonomy

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15
Q
  • An act granting additional benefits and privileges to senior citizens amending for
    the purpose Republic Act 9257.
A

.Republic Act 9994

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16
Q

Gerontological nurses are responsible for assessing the older person and
the environment for hazards that threaten safety, as well as planning and
intervening appropriately to maintain a safe environment. Gerontological nurses
collaborate with the older person and care partners in acknowledgement of their
right to live at risk and need for autonomy

A

STANDARD V: SAFE CARE

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17
Q

are additional tasks
necessary to maintain independence, such as preparing meals, managing
medications, shopping for groceries, and using transportation.

A

Instrumental activities of daily living (IADLs)

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18
Q

Provides primary care including history and physical, and
chronic disease management

A

Advanced
gerontological
nurse practitioner

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19
Q

function as a group (multiple) of professionals who work loosely in the same
area or with the same client.

A

Multidisciplinary teams

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20
Q

If older adult does require the
therapy for control of seizures, do
not use barbiturates.

A

Avoid barbiturates

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21
Q

also provides the communication needed to ensure that a person
continues to receive continuity of care—from one shift to another and one caregiver to
another and across settings.

A

Documentation

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22
Q

Assists with coping and problem solving as individuals and
families adjust to and face changes with aging and chronic
illness.
Provides counseling and psychotherapy.

A

Social worker

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23
Q
  • A document describing a patient’s preferences for the initiation, continuation,
    or discontinuation of particular forms of treatment
A

Living will

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24
Q

Skills and Techniques

A

S is for SIMPLIFY
A is for ASSURE
G is for GIVE information
E is for EASE into it.
A is for ACKNOWLEDGE. In
D is for DISCOVERY
V is for VALUE
I is for INDIVIDUALIZE
C is for COMMUNICATE
E is for EMPATHIZE

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25
Q

general care generated from assessment, ACP
discussions and any recorded wishes/choices

A

Plan

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26
Q

.Republic Act 9994

A

Expanded Senior Citizens Act of 2010.

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27
Q

the personal quest for understanding answers to ultimate questions about life, about
meaning, and about relationships that are sacred or transcendent

A

Spirituality

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28
Q

Every new drug prescribed on an
ongoing basis (e.g., for a chronic
condition) should have
documentation of response of
therapy within 6 months.

A

Response to therapy

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29
Q

Risk of hypokalemia because of
diuretic therapy

A

Monitoring diuretic
therapy

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30
Q

When warfarin is prescribed,
international normalized ratio
(INR) should be evaluated within
4 days and at least every 6 weeks

A

Monitoring warfarin
therapy

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31
Q

This therapy is associated with an
increased risk for delirium and
may be associated with the
development of seizures.

A

Avoid meperidine as an
opioid analgesic

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32
Q

Geropsychiatry. Evaluates, treats, and manages mental health
issues faced by the elderly. Includes pharmacotherapy,
evaluation of cognition, and psychotherapy.

A

Psychiatrist

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33
Q

is a system-focused approach formalizing best practice for
individuals in their last year of life.
▪ It provide tools and resources that can be used by professionals to
identify, assess and plan care in more coordinated and
communicated way

A

Gold Standard Framework

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34
Q

the foundation of a humanistic approach to
provide high-quality care for older people and their care partners and is dependent
upon empathy and understanding

A

. Relationship-centered care

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35
Q

Assesses, plans, provides, coordinates, and evaluates care,
which
focuses on health, optimal wellness, disease prevention, and advocacy

A

Registered nurse

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36
Q

Gerontological nurses develop and preserve relationship care.
Gerontological nurses understand that reciprocal communication and respectful
interactions are central to the central human enterprise of nursing

A

STANDARD I: HUMANISTIC AND RELATIONAL CARE

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37
Q

is a tool encompassing assessment and care plan for patients
identified as dying

A

Liverpool Care Pathway

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38
Q

the last year of life (6-12 months) and list those
identified patients for the MDT to proactively plan care.
The care plan is based on the stage of the disease that is
predicted using the needs Based Coding:
✓ All from diagnosis; stable; years plus prognosis
✓ benefits; unstable/advanced disease; months
prognosis
✓ continuous care; deterioration; needs prognosis
✓ days/final days; terminal care; days prognosis “After
Care”

A

Identify

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39
Q

We must be open minded and provide opportunities for the individual to
share their thoughts with us. It means allowing time to communicate and
focusing attention on the person at the time of the conversation.

A

Maximize understanding

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40
Q

Long-term care supports older adults in two distinct realms:

A

Activities of daily living (ADLs)
Instrumental activities of daily living (IADLs)

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41
Q

When prescribing a new drug, the
patient or caregiver should be
educated about the optimal use
of the therapy and the
anticipated adverse events

A

Patient Education

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42
Q

The GSF comprises:
One aim

A

to deliver a “gold” standard of care for all patients nearing
the end of life

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43
Q

Health care professionals have an ethical obligation to good stewardship of both
the patient’s and the organization’s funds—fiduciary responsibility. This refers to
using both fiscal reserves and caregiving resources wisely, potentially requiring a
cost-benefit analysis to facilitate decision making

A

Fiduciary Responsibility

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44
Q

s distinct from acute or episodic medical interventions because care must be
integrated into an individual’s daily life over an extended time period.

A

Long-term care

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45
Q

basic principles of Communicating with Older Adults

A

invite, arrange environment, maximize communication, maximize understanding and follow
through

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46
Q

has become a new phenomenon encompassing all aspects of care at the
end of individuals life. It is now a preferred term when identifying a person who is in
the final stages of life which may last years, months, weeks or days.

A

End-of life Care

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47
Q

refers to the use of facial gestures, body
posture, eye contact, and touch as a means of communication.

A

Nonvocal nonverbal communication

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48
Q

refers to the tone, pitch, speech rate, or fluency
of verbal communication.

A

Vocal nonverbal communication

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49
Q

gerontological nurses seek
to connect to the human experience of sickness, suffering, recovery, transitioning
and death through provision of care that is artful, person-centred, and grounded in
evidence-informed, ecopsychosocial practices. Gerontological nurses understand
that environmental strategies are effective in supporting the delivery of
person-centered care and can have a strong potential in making positive impact on
aging experiences. Gerontological nurses understand that the ‘experience’ of care is
highly influenced by the social and physical environment within which care is
delivered.

A

STANDARD IV: AESTHETIC/ARTFUL CARE

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50
Q

Provides a rationale for
continuation of the therapy if
effective, or change or
discontinuation if ineffective.

A

Response to therapy

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51
Q

Gerontological nurses understand the importance of the ethical
underpinnings of nursing. Gerontological nurses are consciously aware of and think
critically about what ought to happen, what should be done and what is fair and just.
Gerontological nurses are respectful of the person’s right to self-determination,
choice and collaborative decision-making.

A

STANDARD II: ETHICAL CARE

52
Q

When prescribing an oral
hypoglycemic agent,
chlorpropamide should not be
used.

A

Avoid use of
chlorpropamide as a
hypoglycemic
Agent

53
Q

Assesses hearing including audiometric studies, evoked
potentials, and other diagnostic procedures and treatment of
hearing loss

A

Audiologist

54
Q

Assesses mobility and functional capacity of the elderly.
Treatment includes rehabilitation, strengthening, mobility, and
use of assistive devices

A

Physical
Therapist

55
Q

Annual TaxabIe does not exceed the
poverty level as determined by NEDA

A

RA 9257

56
Q

Do not prescribe drug therapies
with a strong anticholinergic
effect if alternative therapies are
available.

A

Avoid drugs with strong
anticholinergic
Properties

57
Q

supplements documentation with more details regarding a person’s
wishes and include who they want involved in their care, who they want to have access
to their records, and their wishes related to everything from organ donation to the use
of cardiopulmonary resuscitation (CPR) and the handling of their bodies after death.

A

nursing records

58
Q

Standards of Gerontological Nursing Practice

A

STANDARD I: HUMANISTIC AND RELATIONAL CARE
STANDARD II: ETHICAL CARE
STANDARD III: EVIDENCE-INFORMED CARE
STANDARD IV: AESTHETIC/ARTFUL CARE
STANDARD V: SAFE CARE
STANDARD VI: SOCIO-POLITICALLY ENGAGED CARE

59
Q

These therapies are potent
central nervous system
depressants, have a low
therapeutic index, are highly
addictive, cause drug
interactions, and are associated
with an increased risk for falls
and hip fracture

A

Avoid barbiturates

60
Q
  • These concepts of do good and do no harm are integral to healthcare. Nurses intend to do good for their patients.Nurses are also
    concerned about situations thatcan result in harm to p
A

Beneficence/Nonmaleficence

61
Q

Annual drug regimen review.

A

Periodic drug review

62
Q

Geropsychology. Assesses, consults, intervenes in, and manages
conditions related to adaptation, bereavement, counseling, and
treatment for clinical, cognitive, and behavioral needs

A

Psychologist

63
Q

the right to privacy.
- requiring that only persons with a need to know access the patient’s record or
receive information about the patient.

A

Confidentiality

64
Q

Gerontological nurses recognize that nursing care of older people and
their care partners must reflect aesthetic practices, the art of nursing. Gerontological
nurses recognize the importance of searching for the deeper meaning of the older
person’s health/illness/dying experience.

A

STANDARD IV: AESTHETIC/ARTFUL CARE

65
Q

A holistic common assessment is essential:

A

o Patient-centered
o Continuous process

66
Q
  • are an interconnected group of professionals who have common and
    collective goals.
  • have an interactive approach to care.
A

Interdisciplinary teams

67
Q

quoted as saying, “When a person is born we rejoice,
and when they’re married we jubilate, but when they die we try to pretend nothing happened.”

A

Anthropologist Margaret Mead

68
Q

Monitoring may prevent the
development of renal
insufficiency and hyperkalemia

A

Monitor renal function
and potassium in
patients
prescribed
angiotensin-converting
enzyme
inhibitors

69
Q

These therapies are associated
with adverse events such as
confusion, urinary retention,
constipation, and hypotension

A

Avoid drugs with strong
anticholinergic
Properties

70
Q
  • refers to myriad services designed to provide assistance over prolonged periods to
    compensate for loss of function due to chronic illness or physical or mental
    disability.
  • varies in frequency and intensity according to the needs of the recipients, and it
    includes both hands-on, direct care as well as general supervisory assistance.
A

Long-term care

71
Q

gerontological nurses are sophisticated in their ability to
interact with older people and their care partners to create a holistic environment
that is pleasing, comforting and supportive. I

A

STANDARD IV: AESTHETIC/ARTFUL CARE

72
Q

Principles of Gerontological Nursing

A
  1. Aging is a natural process.
  2. Various factors influence the aging process.
  3. Nursing of the elderly requires unique information and skills.
  4. There are common needs shared by the elderly and all age.
  5. Gerontological Nursing’s goal is to promote optimum levels ofphysical, psychological,
    social and spiritual health.
73
Q

Three steps of Gold Standard Framework:

A

identify, assess, plan

74
Q

Five Domains of Assessment: These form an essential part of the Gold
Standard Framework

A

i. Background information and assessment preferences
ii. physical needs
iii. social and occupational needs
iv. Physical well-being
v. spiritual well being and life goal

75
Q

Medical records (outpatient or
hospital) should contain a current
medication list

A

Medication list

76
Q

standards for clinical gerontological nursing include

A

assessment, diagnosis, outcome
identification, planning, implementation, and evaluation (

77
Q

The medication may have been
prescribed for an indication that
was unclear or transient.

A

Indication

78
Q

“There may be no single thing more important in our efforts to achieve
meaningfulwork and fulfilling relationships than to learn to practice the art of
communication

A

Max DePree

79
Q

the major means for the nurse to demonstrate the quality of care he
or she provides.

A

Documentation

80
Q

The End-of-Life Strategy

A

Step 1 – Discussion as the end of life approaches
Step 2 – Assessment, care planning, and review
Step 3. Coordination of Care
Step 4. Delivery of high quality services
Step 5. Care in the last days of life
6. Step 6. Care after Death

81
Q

refers to loyalty and a championing of the needs and interests of others requiring
the nurse to educate patients and their families so that they know their rights,
are fully informed, and are able to access all the benefits they are entitled to

A

Advocacy

82
Q

Assesses nutritional status and implements nutritional plan.

A

Dietician

83
Q

This therapy has a prolonged
half-life that can result in serious
hypoglycemia and is more likely
than other agents to cause the
syndrome of inappropriate
secretion of antidiuretic
hormone.

A

Avoid use of
chlorpropamide as a
hypoglycemic
Agent

84
Q

refers to keeping promises or being true to another; being faithful to
commitments and responsibilities

A

Fidelity

85
Q

▪ focuses on comfort rather than cure
▪ focuses on the treatment of symptoms rather than disease
▪ focuses on quality of life left rather than quantity of life

A

Palliative Care

86
Q

is one’s personal perception of the conditions of life

A

Quality of life

87
Q

Communicating with Older Persons includes

A
  1. Information Sharing
  2. Non-verbal Communication
  3. Communicating with Older Adults
  4. Barriers to Communication
  5. Skills and Techniques
88
Q

Provides an opportunity to
discontinue unnecessary therapy
or to add needed drug therapies.

A

Periodic drug review

89
Q

is a feature of integrity concerned with the ability to be true to one’s self while
respecting and supporting the values and views of another.

A

Reciprocity

90
Q

Education may improve
adherence, clinical outcomes,
and alert patients or caregivers
to potential adverse events.

A

Patient Education

91
Q

refers to behaviors or gestures that convey a message without the use of
verbal language.

A

Non-verbal Communication

92
Q

a set of instructions indicating a competent person’s preferences
for future medical care should the person become incompetent or unable to
communicate. Advance directives typically focus on the conditions of being terminal,
comatose, or in a state of irreversible suffering

A

Advance directive

93
Q

is interdisciplinary care focused on the relief of suffering and
achieving the best possible quality of life for patients and their loved ones.
- It is offered simultaneously with life-prolonging and curative therapies for persons
living with serious, complex, and eventually terminal illness.

A

Palliative Care

94
Q

means truthfulness and refers to telling the truth, or, at the very least, not
misleading or deceiving patients or their families.

A

Veracity

95
Q

standards of professional
gerontological nursing performance include

A

quality of care, performance appraisals, education,
collegiality, ethics, collaboration, research, and research utilization

96
Q

focus of care at end of life should center on living with terminal illness—with
medical care, support, and interventions geared toward quality of life and
comfort, rather than on prolonging suffering or the dying process—if that is what
patient wants.

A

End-of life Care

97
Q

most important aspect of the holistic assessment is verifying

A

verifying levels of
understanding of the diagnosis, treatment options, and prognosis

98
Q

An act granting additional benefits and privileges to senior citizens amending for
the purpose Republic Act 7432.

A

Republic Act 9257

99
Q

describes competent patients discussing and then
documenting their preferences for future medical care. This preserves patients’
self-determination even after they have lost decision-making capacity. The classic
mechanism to do this is an advance directive

A

Advance care planning

100
Q

Four aspects of awareness

A

i. Closed awareness
ii. Suspicion
iii. Mutual preference
iv. Open awareness

101
Q

Utilizes knowledge of normal aging as part of assessment.
Specializes in the diagnosis and treatment of the elderly

A

Geriatrician

102
Q

Exemption from Income Tax who are considered to be minimum
wage earners under RA 9504.

A

RA 9994

103
Q

fundamental part of geriatrics. Ethics, or the provision of ethical care, refers to
a framework or guideline for determining what is morally good or bad.

A

Ethics

104
Q

referring to the value of life and the right to live.

A

sanctity of
life,

105
Q

o defined as the prescription, administration, or use of more medications than are
clinically indicated in a given patient.

A

polypharmacy

106
Q

multiple medication use, often referred to as

A

polypharmacy

107
Q

environment should be comfortable, provide privacy, and minimize distractions that
could be barriers to communication, such as noise or poor lighting

A

Arrange the environment

108
Q

Gerontological nurses recognize that nursing care for older people and
their care partners is based on evidence-informed knowledge, which is
comprehensive and complex. Gerontological nurses have inquiring minds, question
the status quo, and seek new evidence-informed knowledge to answer questions
when faced with nursing care challenges.

A

STANDARD III: EVIDENCE-INFORMED CARE

109
Q

Prepares and dispenses medication. Provides clinical
consultation and education for patient and geriatric team.

A

Pharmacist

110
Q

When prescribing a new drug, the
therapy should have a clearly
defined indication documented in
the medical record.

A

Indication

111
Q

If angiotensin-converting enzyme
inhibitor therapy is initiated,
potassium and creatinine levels
should be monitored with 1 week
of initiation of therapy.

A

Monitor renal function
and potassium in
patients
prescribed
angiotensin-converting
enzyme
inhibitors

112
Q

Provides, directs, and influences care of older adults and
families in various settings

A

Clinical specialist
in gerontological
nursing

113
Q

Provide support to the client/patient, family, and others as it
relates to spiritual needs. May assist in identifying resources
from within congregation for support, visitation, or respite

A

Religious workers,
Including chaplain,
priest, rabbi, minister

114
Q

term describing that assessment should
encompass all aspects of a person.

A
  • Patient-centered
115
Q

Barriers to Communication

A
  • hearing impairment;
  • declining sight or vision;
  • declining memory and,
  • inability to read or understand.
116
Q

provides the data needed for the careful development of the
individualized plan of care and the evaluation of patient outcomes.

A

recorded assessment

117
Q

Assesses and treats communication, disorders including speech,
language, and hearing, as well as swallowing and cognitive
deficits.

A

Speech-language
Pathologist

118
Q

used to predict and document the care provided within a preestablished
trajectory and to anticipate the day of discharge

A

Care maps

119
Q

refers to the fairness of an act or situation.

A

Justice

120
Q

through holistic common assessment
✓ Assess needs for anticipatory care
✓ Assess for carers’ needs
✓ Assess if patient is entitled to some benefits

A

Assess

121
Q

When analgesia is required, avoid
use of meperidine

A

Avoid meperidine as an
opioid analgesic

122
Q

An invitation says to the other person that you are interested in them and sharing
time with them

A

Invite

123
Q

Republic Act 9257

A
  • Expanded Senior Citizens Act of 2003
124
Q

Gerontological nurses are aware of the socio-economic-political contexts
that influence all aspects of care. As such, Gerontological nurses collaborate with
older people and their care partners to advocate for equitable access to health
system resources that address their care needs.

A

STANDARD VI: SOCIO-POLITICALLY ENGAGED CARE

125
Q

serves as the basis for the determination of reimbursement in most
settings.

A

Documentation

126
Q
  • use communication strategies that maximize the individual’s ability to
    understand the message. This includes using language and terminology that
    are familiar to the patient.
  • Periodically ask the receiver to clarify what he or she is hearing as a means of
    ensuring accurate interpretation of your message.
A

Maximize communication

127
Q

Older adults are at high risk for
drug toxicity that can be
identified earlier if there is close
monitoring
for agents with a narrow therapeutic range

A

Monitoring warfarin
therapy

Geriatrics (3 decks)

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