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Gerontology > Week 2 - All 3 parts > Flashcards

Week 2 - All 3 parts Flashcards

1
Q

Falls

A

unintentionally coming to rest on a lower surface such as ground or floor

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2
Q

Presbyopia

A

Structural changes in eye shape cause reduction in the eye’s accommodation.
Difficulty encountered with ascending or descending steps
or diminished ability to focus on close objects (arm’s length) such as newspaper

Instruction must be given to watch door edges & landing steps.

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3
Q

Eye Glare

A

tendency of the lens to become cloudy & form cataract
Instruct the patient to wear wide-brimmed hats or sunglasses and to shade indoor windows.

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4
Q

Presbycusis

A

atrophy of the ossicles in the inner ear which causes
changes in sound conduction including loss of high-tone frequency

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5
Q

Age-related Changes Contributing to Falling
(Cardiovascular system)

A

Loss of tissue elasticity  which affects the arteries decrease tissue recoil, resulting in changes in blood pressure (postural hypotension).

Nursing Interventions
Educate patient to change position slowly and to dangle the legs a few minutes when arising from supine position.
Encourage older adults to wait between position changes and to hold onto the side of the bed.

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6
Q

Osteoarthritis

A

occurs in weight bearing joints, causing pain, eroding joint stability and loss of supportive cartilage

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7
Q

Nursing Interventions - Osteoarthritis

A

Identify the problem, encourage and assist in ambulation, and joint range of motion.
Encourage patients to use assistive device to aid mobility and avoid further joint damage.
Use of ice and hot packs.
Use of anti-inflammatory agent and
Pain killer as prescribed.

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8
Q

Risk Factors for Falls
1.Intrinsic Factors

A

Normal age related changes
Disease &
Medication effects

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9
Q

Risk Factors for Falls
2. Extrinsic Factors

A

Environmental hazards
& Restraint

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10
Q

Restraint (cont’d)What to consider before deciding to restrain?

A

Physical examination – identify potential underlying causes of behavior

Assess environment – identify irritants that may escalate behavior

Identify patient specific problems – (forgetfulness) to determine

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11
Q

Fall & Injury prevention Gerontologic nurse should

A
  1. Identify the individuals who are at risk for serious injury,
    2.Educate them about the importance of
    Behavioral modification.
    Physical modification
    Environmental safety
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12
Q

Principles for use of assistive devices

A

Every assistive device should be adjusted to individual height.

When using walker, step down with weak then strong leg,
Don’t climb stairs with walker.

Place your cane firmly in the ground before taking a step,
Do not place it too far ahead from you,
Put all of your weight on unaffected leg then move the cane and affected leg.
When using cane on the stairs, step up with the stronger leg and down with the weaker leg
Replace cane tips frequently and choose one with flat bottom.

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13
Q

Prevention of Burn Injuries
Nurses must instruct older adults to:

A

Use thermometer and container with safety handle to check the hot water temperature.

Adjust the hot water tank accordingly , temp should not be above 120 F (480C).

When space heaters are used , an emergency shutoff must be operable & keep it at 3 m from flammable items.

The electrical cords must be intact and appropriate for the electrical outlet.

Have fire extinguisher available for use, and make sure smoke detectors are working

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14
Q

Non-Burn Injuries in the Home:

A

Carbon Monoxide toxicity from use of heating oil or natural gas

Skin exposure or ingestion of household chemicals , herbicides, pesticides

Fan injuries when air conditioner is unavailable.

Use of knives in the kitchen

Food borne disease.

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15
Q

Hyperthermia / Heat stroke

A

is a life threatening problem that must be treated immediately

Risk factors:
Thyrotoxicosis
CVA
Dehydration

Extensive use of occlusive clothing
Heat syncope & heat exhaustion

Malignant hyperthermia
Alcohol abuse
Delirium tremor
Salicylic acid intoxication

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16
Q

Management of Hyperthermia

A

Fast and effective cooling is the corner stone of treatment for heat stroke.

Heat-related deaths and illness can be prevented by drinking plenty of fluids.

Placing a fan near the client

Decrease the room temperature

Placing ice packs on the groin & axilla together with cooling blankets

Antipyretics

Bed rest to reduce heat production

Nurses should identify older adults who are living without air conditioning to keep their homes cooled to a safe temperature zone.

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17
Q

Hypothermia

A

Household temperature below 65o F (18.33o C) are associated with hypothermia in older adults.
Older adults fail to sense the cold when air temperature remains below optimum levels for even short periods.
Thermoregulatory impairment will lead to failure of the body to perform adequate constriction and shivering in response to cold.

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18
Q

Risk Factor of Hypothermia

A

Accidental immersion in water
Exposure to cold temperature

Alcohol, substance abuse, Drugs
(Opioids, benzodiazipines, barbituarate…

Excessive heat loss and impaired production
Surgery & trauma
Nutritional deficiency
Sepsis
Stroke & Spinal cord injury
Anoxia &Uremia
Hypoglycemia & hypothyroidism
Adrenal insufficiency

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19
Q

Clinical Manifestation
of hypothermia

A

Fatigue &Apathy (most important)
confusion & lethargy
Shivering &Numbness
Slurred speech
Impaired coordination
Coma

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20
Q

A decline in an older adults ability to drive safely may be a result of

A

Presbyopia,
Decrease dark adaptation,
Decrease depth perception,
Susceptibility to glare,
General slowing reflexes.

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21
Q

An example of an intrinsic factor for falls in the older adult is:
1. Having a cat as a pet
2. Weakened muscles in the lower extremity.
3. Glaring lights in the hallway
4. The use of cane

A

2

22
Q

Which nursing intervention best demonstrates the understanding that older adults are at increased risk for falls because of normal age-related changes?
1. Speaking in a loud voice when warning the client about safety hazards
2. Turning on lights so the client can see objects such as furniture in the immediate area.
3. Encouraging the client to use a walker while climbing the stairs
4. Advising the client to avoid exercising painful joints

A

2

23
Q

Ptosis

A

Eye lids lose tone

24
Q

True or false
Age-related Changes in the Structure and Function of vision -
Cornea : become yellow with a ring of fat deposit (arcus senilis)

Tears : are Diminished quality and quantity of production

Pupils : Decrease in the size and less ability to constrict

The conjunctiva thins and becomes yellow in appearance

Sclera : brown spot may develop

A

All are True

25
Q

Common Complaints of vision

A

1.Floaters:
Appears (seen by the person as dots, wiggly lines or clouds. Caused by the degeneration of the vitreous gel

  1. Flashers:
    Illusion of flashing lights or streaks
    Occur when Vitreous fluid inside the eye rub on the retina or There is spasm in the blood vessels in the brain (e.g. like in migraine)
  2. Dry Eyes:
    called keratoconjunctivitis: decrease tear production
    Cause:
    Age, Menopause
    Diseases: DM, Arthritis, Lupusالذئبه, thyroids, Vitamin A deficiency
26
Q

Ectropion and Entropion

A

Malposition of the lower lid
Caused by tissue laxity
lead to eye irritation (outward or inwards)
So cause tearing, redness, infection
RX ; A minor surgery can treat these conditions

27
Q

Blepharitis

A

Caused by seborrheic dermatitis or infection
Eyelid :
Red,
swollen,
with crusting along the eye lash with small ulceration

28
Q

Glaucoma

A

The second leading cause of blindness in USA
Can cause partial vision loss before it is detected
Results from:
blockage in the drainage of the aqueous humor in the anterior chamber of the eye.
If the fluid cannot flow out of the anterior chamber through the channel of schlemm >
it accumulates and pushes on the optic nerve >
where irreparable damage or total blindness can occur.

29
Q

Three types of glaucoma

A

Chronic open angle
Closed angle glaucoma
Secondary glaucoma

30
Q

Trabeculectomy

A

is a surgical procedure used in the treatment of glaucoma to relieve intraocular pressure by removing part of the eye’s trabecular meshwork and adjacent structures

31
Q

Trabeculoplasty

A

laser treatment for glaucoma

32
Q

Cataract

A

A common disorder found in the aging adult. It is clouding lens
A cataract located near the center of the lens produces more symptoms such as:
Dimmed blurred vision
The need for brighter light
Glare and light sensitivity
Loss of color perception
Recurrent eyeglass prescription changes

33
Q

Age-related Macular Degeneration (AMD)

A

Damage to the macula (the key focusing area of the retina) as a result of aging
Does not cause total blindness
Irreversible damage to the macula
Results in loss of close vision and decline in central vision

34
Q

Diabetic Retinopathy

A

Altered circulation to the eye may result in retinal edema, degeneration & detachment
Ballooning تضخم of the tiny vessels leads to hemorrhage, scarring or blindness
No early symptoms of retinal changes can be noted by the patient even if retinopathy is advanced

35
Q

Retinal detachment:

A

Occurs when the sensory layer of the retina separates from the pigmented layer
Causes: Aging, Trauma, hemorrhage, or tumor
lead to tears or holes in the retina
> fluid seepage تسرب between layers of retina
> detachment

Symptoms include :
Light flashes
Shower of floaters
Loss of vision
Veil or curtain obstructing vision

Post op. Meds :
antiemetic, مضاد للقىء
pain medication and cough medication as needed to avoid detachment of the retina after repair

36
Q

Which clinical indicators is the nurse most likely to identify when exploring the history of a client with open-angle glaucoma?
A. Constant cloudiness of vision
B. Abrupt attacks of acute pain
C. Gradual loss of vision.
D. Impairment of central vision

A

D

37
Q

What should the nurse do for a client aged 70 years who had just cataract surgery on his right eye?
A. Encourage the client to perform coughing and deep breathing exercises.

B. Advise the client to sleep on his right side

C. Instruct the client to sunglasses outdoors.

D. Inform the client to apply an Ova pad on his right eye at night.

A

C

38
Q

The nurse is performing an admission assessment for a client with a detached retina. Which of the following is associated with this disorder?
A. Light sensitivity

B. Pain in the affected eye

C. A yellow discoloration of the sclera

D. Shower of floaters.

A

D

39
Q

Describe age-related changes in hearing and balance

A

Auricle appears larger because of continued cartilage formation and loss of skin elasticity

The auditory canal narrows as a result of inward collapsing (due to aging)

Hair lining the canal becomes coarser خشونة and stiffer صلابة

Cerumen glands atrophy causing the cerumen to become drier شمع الاذن ناشف

The tympanic membrane appears retracted and gray.

40
Q

Pruritus

A

Itching within the external auditory canal
Due to age-atrophic-related changes
Itch scratch –itch cycle

41
Q

Cerumen Impaction انسداد بسبب شمع الاذن

A

Cause: Narrowed auditory canal, stiffer coarser hair, sebaceous glands atrophy
Leads to conductive hearing loss
Affect ability to hear and communicate well

42
Q

Tinnitus

A

Defined as ringing, buzzing, or hissing.
Its prevalence increases with advanced age.
Tinnitus is not a disease, but symptoms associated with many diseases.
Unilateral tinnitus is associated with serious diseases like Meniere’s, tumors, or vascular problems

43
Q

TRUE / FALSE
Hearing loss is not a part of the normal aging process and should be evaluated for further treatment

A

TRUE

44
Q

Hearing loss Is classified as

A
  1. Conductive- can be due to otitis mediaالتهاب الأذن الوسطى, Cerumen impaction, and otosclerosisتصلب الأذن
  2. Sensorineural-الحسية العصبية- is caused by malfunctioning of the auditory nerve, brainstem, or cortical auditory pathways
    resulting in improperly interpreted sound waves
  3. Mixed
45
Q

Presbycusis

A

Sensorineural hearing loss
Most common form of hearing loss
Causes :
Noise-induced hearing loss,
Head injury,
Infection,
Vascular and heart disease,
Metabolic disorders – pancreas & kidneys
Genetic factors

46
Q

Dizziness and Disequilibrium

A

Are common complaints of older adults

Should not be considered part of normal aging and necessitate thorough investigation.

Dizziness or vertigo in the elderly can occur:
With a change in head position –
(Benign Paroxysmal positional vertigo )
With rotational head movement- Ampullary disequilibrium
When rising from bed- Macular disequilibrium
During ambulation- Vestibular ataxia
In Meniere’s disease

47
Q

Meniere’s disease

A

Caused by pressure within the labyrinth of the inner ear and swelling of the cochlea
Characterized by severe vertigo accompanied and usually preceded by tinnitus & progressive low-frequency sensory- neural hearing loss

48
Q

with aging Taste and Smell :

A

diminish with age
can lead to a decreased enjoyment of food
resulting in poor eating habits and decreased intake
Impairment of nutritional and immune status

A decreased sensitivity to odors puts the older adult at risk for noxious chemicals and poisoning (failure to detect the odor of smoke or leaking gas).

49
Q

Xerostomia جفاف الفم Risk factors

A

Disease status like Alzheimer’s and depression
Conditions like the radiation of head and neck, and mouth breathing.
Medications like antihistamines, antidepressants, diuretics, and chemotherapy.

50
Q

Dry mouth in the elderly can lead to :

A

Respiratory infection,
Impaired nutritional status, and
Reduced ability to communicate

51
Q

TRUE / FALSE
Subjective tinnitus is heard by the patient and examiner.

A

FALSE

Gerontology (3 decks)

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