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Nursing 4 Exam 2 > Unit 9 Chronic Issues in Geriatric Care > Flashcards

Unit 9 Chronic Issues in Geriatric Care Flashcards

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1
Q

What is the model of care for older adults?

A

Restoring physiological homeostasis

Preventing functional decline

Preventing iatrogenic complications (hospital acquired illnesses)

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2
Q

What is important to assess on admission for the older adults?

A

Current functional status

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3
Q

How do we prevent functional decline?

A

Ambulation

Proper nutrition

Encourage independency

Ensure they have proper support (hearing aids, walkers, etc)

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4
Q

What is NOT an expected sign of aging?

A

Change or decrease in cognitive function is not a normal sign of aging.

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5
Q

What are changes in organs, tissues, and cells as you age?

A

Decreased peristalsis

Live is less efficient in metabolizing drugs

Visual and hearing impairments

Height decreases

Loss of skeletal muscle and strength

Increased fat

Baroreceptors less responsive

Most things decrease

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6
Q

What is Maslow’s hierarchy of human needs from most to least important?

A

Physiological (food, water, sex, sleep)

Safety (security of body, employment)

Love/Belonging (family, friends, sexual intimacy)

Esteem (confidence, respect of others, achievement)

Self-Actualization (morality, creativity, spontaneity)

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7
Q

What is Erikson’s stage for the older adult? What does this mean?

A

Integrity vs Despair

Reviews life, accomplishments, deals with loss and preparation for death

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8
Q

How can you help an older adult through transitions?

A

Assessment using standardized tools

Encourage reminiscence

Role supplementation (help them maintain relationships)

Creation of healthy environment

Mobilization of resources

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9
Q

What age and older needs a comprehensive assessment?

A

65 and older

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10
Q

What tools of assessment are used in the geriatric population?

A

SPICES: for common syndromes of the elderly

  • Sleep disorders
  • Problems w/eating and feeding
  • Incontinence
  • Confusion
  • Evidence of falls
  • Skin breakdown

Mini-Cog: Clock drawling used to detect Dementia

CAM: evidence based tool that recognizes delirium quickly and accurately. Has four features.

Geriatric depression scale: 30 item questionnaire of yes or no questions.

Braden Scale: Predicts pressure ulcer risk. The lower the number the higher the risk.

Hendrich fall risk assessment: specific to geriatric population. quick to administer.

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11
Q

What is the frail elderly criteria? How many does one need to have to be considered frail elderly?

A

Unintentional weight loss (10lbs or more in a year)

Exhaustion

Weakness (test hand grips to determine)

Decreased function

Slow walking speed

Reduced tolerance for medical interventions

**3 or more = frail elderly

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12
Q

What are geriatric syndromes caused by?

A

Normal aging

Co-Morbidity and adverse effects of therapeutic interventions

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13
Q

What is the sleep disorder geriatric syndrome? What are some causes and what does it result in?

A

More daytime naps, less sleep at night (less REM)

Less tolerant to changes (light, temperature, etc)

Causes: diseases: BPH, HF, overactive bladder, pain, meds, etc

Results in: forgetfulness, disorientation, sundowning

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14
Q

What is sun downing syndrome and what is something that should be encouraged?

A
  • PT in the evening becomes disoriented/confused
  • Could be from sleep deprivation, not always meds

Encourage being awake in the day time, sleep at night.

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15
Q

What are eating/feeding issues in the elderly?

What does it result in?

A
  • Dietary limitations because of decreased metabolic rate, dyspnea, tooth problems, difficulty swallowing.
  • Mealtime is more lonely (encourage family, or someone to eat with PT
  • Increase need for Vitamin D, B6, Fiber

Results in: malnutrition, dehydration, vitamin and mineral deficiency

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16
Q

Describe Pain in the elderly.

What does pain contribute to?

A
  • Not a normal sign of aging
  • Pain is what the PT says it is
  • Need smaller doses of opioids in elderly
  • They may not be able to express if cognitively impaired
  • Contributes to depression, anxiety, decreased socialization and functional ability
17
Q 
Define the following types of urinary incontinence in the elderly.
Function
Overflow
Stress
Urge
What are some causes?
What does it result in?
A

Function - PT cannot get to bathroom
Overflow - Not emptying as often
Stress - Cough/sneezing/increased abdominal pressure
Urge - Abdominal contaction

Caused by:

  • Pelvic floor laxity
  • Constipation
  • Diabetes
  • Injury
  • Infection
  • Depression
  • Medications

Results in:
-Physical, psychological, social and occupational impairments

18
Q

What is a better way to ask elderly PT if they are incontinent or continent?

A

Ask PT, “Do you dribble?”

19
Q

What are interventions for urinary incontinence?

A

Encourage q2h emptying

Keegle exercises

Reduce nightly fluid intake

Avoid caffeine/nicotine

Treat infections

Change environment

20
Q

Describes Dementia syndrome in the elderly. What med should the PT avoid?

A
  • Affects short term then long term memory
  • Gets worse with stress
  • Assess PT for delusions
  • Avoid anti-cholinergic because they cause confusion
    ex: exvil, detrol, atrovent
21
Q

Describe Delirium syndrome.

How is it treated?

A 
Could be from:
D rug use
E lectrolyte imbalance
L ack of drugs (withdrawal or pain)
I nfection
R eduction sensory input (no hearing aids, glasses)
I ntracranial events
U rinary incontinence
M yocardial infarction

and sleep deprivation.

No treatment itself, treat cause!

22
Q

What can skin breakdown result in the elderly?

A

Can add ~ 16 days to hospital stay

Can result in sepsis, cellulitis

23
Q

What can cause sensory impairments in the elderly? What does it contribute to?

A

Not having their glasses or hearing aids.

Contributes to falls

24
Q

When are the elderly most at risk for their health?

A

Between healthcare transitions

25
Q

What are the components of the Braden scale?

A

Sensory perception

Skin moisture

Activity

Mobility

Nutrition

Friction / shear

26
Q

What are the components of the hendrich fall risk assessment?

A

Gender

Mental and emotional status

Dizziness

Medications that increase risk

Nursing 4 Exam 2 (6 decks)

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