w1_ch4: Care for Older Adults

Question 1

T or F

characteristic changes in older adults progress slowly

Answer 1

True

• if rapid change occurs it is related to disease not age

Question 2

what is decompensation?

Answer 2

declining physiology function and reserves

d/t:
changes of aging + stress + outside forces

Question 3

health issues for older adults

Answer 3

• inadequate/impaired nutrition & hydration
• decreased mobility
• difficulty performing ADL
• life loss’s, stress, coping
• accidents (falls)
• drug use and misuse
• inadequate cognition
• substance use disorder
• elder neglect & abuse

Question 4

What is an age-related musculoskeletal change and potential consequences?

Answer 4

loss of bone density and muscle mass which leads to mobility and dependence problems

• difficulty with position changes, post-procedure ambulation, delayed bathroom trips, risk for falls

Question 5

What is an age-related immune system change?

Answer 5

decreased protection against infection which can manifest as non-typical signs of infection

Question 6

What are the age-related neurological changes?

Answer 6

(3 D’s)

1. Delirium
2. Depression
3. Dementia

Question 7

Delirium

Answer 7

(age-related neurological changes)

= acute state of confusion, inattentiveness, disorganized thinking, altered LOC
- most common w/ infection or when older adults are in unfamiliar environment

Question 8

Depression, d/t?

Answer 8

(age-related neurological changes)

= chronic mood disorder w/ cognitive, affective, physical manifestations

d/t –
1. endogenous: lack of neurons w/ age, cause decrease serotonin and dopamine
2. exogenous: loss of spouse, family, friend, job, social life

Question 9

Dementia
s/s? types?

Answer 9

(age-related neurological changes)

= syndrome slow, progressive cognitive decline (aka chronic confusion)

s/s
- global impairment of speech, memory, and other intellectual functions

types –
1. alzheimer’s disease
2. multi-infarct dementia (tiny vessels leak in the brain d/t HTN)

Question 10

elder neglect, example?

Answer 10

caregiver fails to provide basic needs (not intentional)

ex: malnutrition, pressure ulcers, contracture, dehydration, etc.

Question 11

elder abuse types?

Answer 11

• intentional *

1. physical = use of force leading to bodily injury
2. financial = misuse of property/finances
3. emotional = threats, humiliation, intimidation, or isolation

Question 12

signs of poor care from care facilities (4)

Answer 12

• pressure ulcers
• improper/excessive use of restraints
• freq tx w/ antipsychotic for behavioral control
• tx carried out w/ little chance of success

Question 13

interventions for older adult falls

Answer 13

• avoid multiple drugs
• promote adequate sleep (no day naps)
• reorient as many times as needed
• provide comfort
• NPSG: fall risk assessment
• assess for additional risk factors

Question 14

atypical presentations of illness in older adults (8)

Answer 14

• confusion or change LOC
• falls
• loss of appetite
• delirium
• dehydration
• atypical pain
• dizziness
• incontinence
• sleep disturbances
• failures of self care

Question 15

older adult changes with medication: absorption, distribution, metabolism

Answer 15

• absorption: thinner skin and poor GI motility
• distribution: inadequate blood flow
• metabolism: liver & kidney functional decline

Question 16

inappropriate medications to give to an older adult

Answer 16

• long-acting benzodiazepines
• long-term use of short-term drugs
• medications above dosage limitations

Question 17

complete medication reconciliation includes

Answer 17

• prescribed meds
• vitamins
• OTC meds
• dietary supplements
• herbal remedies

Question 18

s/s older adult is having adverse drug reactions (ADR)

Answer 18

• difficulty with ADLs
• cognitive changes
• falls
• anorexia, nausea, wt change

ELDERLY HAVE INCREASED RISK OF ADR

Question 19

beer’s criteria

Answer 19

• used for potentially inappropriate med use in the elderly