Week 2: Assessments

Question 1

What does FANCAPES stand for?

Answer 1

Fluids
Aeration
Nutrition
Communication
Activity
Pain
Elimination
Socialization

Question 2

Why do older adult assessments differ from that of younger adults?

Answer 2

-May take longer to complete, are more detailed as symptoms and signs often present differently in older people
-There is a focus on social complexity

Question 3

What are ADLs?

Answer 3

activities necessary to maintain ones health and basic personal needs

Question 4

Why do nurses assess

Answer 4

to objectively and subjectively identify needs and concerns of pt plus family
Timely and accurate assessment is crucial for interventions and safety
To obtain a documented baseline of health to compare outcomes to

Question 5

When is the best time to collect data?

Answer 5

Collect priority data whenever possible
Consider the state of the older person and collect supplementary data when they are at their best state

Question 6

How do we collect data

Answer 6

Observation
Physical assessment
Conversation

Question 7

From whom do we collect data

Answer 7

Self-report
Direct observation
Report by proxy

Question 8

What is the purpose of a screening tool

Answer 8

assesses for risk of a particular problem with a negative or positive outcome. Intended to identify those who require further examination.

Question 9

What is the role of an assessment tool

Answer 9

comprehensive process to define the nature of that problem, determine a diagnosis and develop a specific treatment plan/recommendations to address the diagnosis

Question 10

What can be used to objectively assess an older persons performance?

Answer 10

Grip strength, Shuttle test, timed walk, balance test

Question 11

What are examples of ADLs?

Answer 11

toileting, eating, ambulation, bathing, dressing, and grooming

Question 12

What are examples of instrumental activities of daily living

Answer 12

cleaning, yard work, shopping, and money management

Question 13

What tools can be used to assess mental status

Answer 13

Cognition: MMSE, Clock drawing test, Mini Cog Delirium Index
Mood: geriatric depression scale

Question 14

What five subscales does the Older Americans Resources and Services (OARS) assess

Answer 14

Social & economic resources; physical and mental health and ability to perform ADLs

Question 15

What does the Fulmer SPICES assessment stand for

Answer 15

Sleep disorders
Problems with eating/feeding
Incontinence
Confusion
Evidence of falls
Skin Breakdown

Question 16

What components make up an environmental safety assessment

Answer 16

Intrinsic safety concerns: vision and hearing, cognition, mobility problems
Extrinsic safety concerns: fire hazards, crime and abuse, poisoning, fall hazards

Question 17

What assessment can be used to assess social supports?

Answer 17

Social network and support scale, caregiver strain index

Question 18

What are the 4 components of a comprehensive geriatric assessment?

Answer 18

1. screening
2. Assessment
3. Creation of a problem list
4. Planning goal-directed interventions

Question 19

On a Mini-Mental State Exam, a score of 27 or less suggests potential dementia
True or False

Answer 19

False
A Score of 24 or less suggests potential dementia

Question 20

The Delirium Index is used to detect mild cognitive impairment
True or False

Answer 20

False
The Delirium Index measures the severity of delirium, based on the observation of a patient
The MoCA is designed to detect mild cognitive impairment

Question 21

In a MoCA, what score is considered normal?

Answer 21

26 or greater

Question 22

What factors must a geriatric review of systems specifically consider?

Answer 22

falls, cognition, sleep, pain, polypharmacy, mood/mental health, nutrition, continence

Question 23

What is report by proxy?

Answer 23

one person answering questions or providing information for another person based on their own personal knowledge. Utilized when a person who is cognitively impaired requires assessment but often underestimates their abilities and health

Question 24

What are the pros/cons of direct observation for data collection?

Answer 24

-may be the most accurate form of data collection
-but only captures a snapshot in time