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N104 - Aging > Week 2: Older Adult I > Flashcards

Week 2: Older Adult I Flashcards

1
Q

What is the age range for late adulthood?

A

65-120 years

Young old 65-74; old-old 75-84; oldest-old >85 years

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2
Q

Why must nurses not speak loudly to older patients?

A

Older persons can hear low-frequency sounds better than high-frequency sounds

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3
Q

Why does obtaining a comprehensive assessment on an older person takes more time than a younger counterpart?

A
  • longer life
  • medical history
  • potential complexity of that history
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4
Q

Why must nurses allow extra time when doing assessments on an older person?

A

Because some frail patients have reduced energy & limited endurance

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5
Q

Why is dehydration common in older adults?

A

Thirst response is reduced

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6
Q

What are some early indicators for acute illness in older persons?

A

change in mental status, falls, dehydration, decrease in appetite, loss of function, dizziness, and incontinence.

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7
Q

Good to know:

Instead of the regular UTI symptoms that a young adult experiences (fever, dysuria, frequency, or urgency) what symptoms are more common in older persons with UTI?

A

confusion, loss of appetite, weakness, dizziness, or fatigue

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8
Q

Good to know:
Younger adults experience fever and productive cough with pneumonia, however, older adults experience slightly different symptoms. What are they?

A

tachycardia, tachypnea, confusion

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9
Q

Good to know:

What are some common causes of functional decline in older adults?

A 
thyroid disease
infection
cardiac or pulmonary conditions
metabolic disturbances
anemia
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10
Q

Good to know:

Dizziness is a common sign of what in older adults?

A

various acute illnesses:

anemia
arrhythmia
infection
myocardial infarction
stroke
brain tumor
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11
Q

Good to know:

Common reasons for new-onset urinary incontinence?

A

UTI
Symptoms of electrolyte abnormality
Adverse drug reaction

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12
Q

What are some common integumentary physiological changes with aging?

A
  • decreased moisture and elasticity
  • increased spots and lesions
  • hair: grey/white
  • slow nail growth
  • atrophy in epidermal arterioles (in the skin)
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13
Q

What are some common sensory physiological changes with aging?

A
  • increased sensitivity to glare
  • difficulty adjusting from light to dark changes
  • decreased visual acuity
  • decreased ability to hear high-pitched sounds
  • decreased sensitivity to taste
  • decreased skin receptors
  • decreased awareness of body positioning in space
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14
Q

What are some common respiratory physiological changes with aging?

A
  • lung expansion decreases and the chest wall stiffens
  • inefficiency in gas exchange
  • decrease cough reflex and efficiency
  • increased risk of chest infections
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15
Q

What are some common cardiovascular physiological changes with aging?

A
  • decreased cardiac output
  • increased HR and BP
  • weak peripheral pulses
  • venous insufficiency
  • blood vessels: thick, less elastic
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16
Q

What are some common GI physiological changes with aging?

A
  • increased abdominal fat
  • decreased muscle tone and elasticity
  • decreased peristalsis
  • decreased gastric emptying (higher risk of constipation)
  • hemorrhoids
  • rectal prolapse
  • decreased rectal sensation
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17
Q

What are some common genitourinary physiological changes with aging?

A
  • atrophy of ovaries, uterus, cervix, vagina, and breasts
  • vagina shortens and dries
  • testes atrophy, erectile changes, less motile sperm, BPH (benign prostatic hypertrophy)
  • urinary retention
  • incontinence ( mean b/c of increased prostate size and women b/c of weak pelvic muscles/sphincter tone)
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18
Q

What are some common musculoskeletal physiological changes with aging?

A
  • decreased muscle size and strength

- decreased bone mass

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19
Q

What are some common neurological physiological changes with aging?

A
  • decreased balance and coordination
  • altered sleep patterns
  • decreased number of neurons linked with sensory changes
  • degeneration of nerve cells
  • decrease in neurotransmitters
  • decrease in the rate of conduction of impulses
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20
Q

What does functional status refer to in older persons?

A

Refers to the capacity and safe performance of ADLs and is a sensitive indicator for health or illness in older persons.

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21
Q

What is the fear of functional decline linked with for older adults?

A

Fear of dependence

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22
Q

What is functional decline an indicator of?

A

The onset of an acute problem or worsening of a chronic problem

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23
Q

When referring to functional decline, what does it entail (physical? etc)

A

physical, cognitive, and social functioning

24
Q

A patient who is functionally declining would struggle with what kinds of ADLs?

A

Washing, dressing, feeding, toileting, transferring, mobility, etc

25
Q

When a decline in function is identified, what should the nursing interventions be focused on?

A

Focused on maintaining, restoring, and maximizing the older person’s functional status so that he or she can maintain independence while preserving dignity.

26
Q

What are the most common cognitive impairments in older adults?

A

Dementia, delirium, and depression

27
Q

What cognitive changes occur in most older adults?

A
  • speed of processing information declines
  • selective attention declines
  • memory changes vary: episodic and working memory declines, not semantic memory (long term memory of personal experiences)
28
Q

What structural and physiological changes occur in the brain with aging?

A
  • reduction in the # ofcells
  • deposition of lipofuscin and amyloid in cells
  • change in neurotransmitter levels

These are all normal changes with aging and are observed in older persons whether they do or do not have cognitive impairment.

29
Q

Briefly explain disengagement theory:

A

When both the older person and society engage in mutual separation, as in the case of retirement.

They feel like they don’t have much to offer and society doesn’t have much need of them.

30
Q

Briefly explain activity theory:

A

Remaining as active as possible contributes to successful aging.

Age actively - to continue to participate fully in society. Keywords: physical activity, social engagement, productivity. Example - volunteering

31
Q

Name the 3 sociological theories of aging?

A
  • disengagement theory
  • activity theory
  • continuity theory
32
Q

Briefly explain continuity theory:

A

There is coherence and consistency of patterns over time. For ex: someone who enjoys decorating will choose a new activity in the same domain (ex-painting) rather than a new domain (sports).

Continuity’s prediction that retirement and the resultant relief from work pressure will bring increased psychological well-being

33
Q

Briefly explain Erikson’s 8th stage of life theory:

A
  • life review (unique to each person -reflecting on one’s past and piecing together a review)
  • integrity (positive memories) vs. despair (negative memories)
  • often begins once death is in sight
  • identifying and reflecting not only on the positives but also on regrets as part of developing mature wisdom and self-understanding.

Integrity examples: pride involving children ad parenting, careers, volunteering/informal caregiving, having a long/strong marriage, and personal growth.

Despair examples: low-income adults regretting about education, careers, and marriage -finance/money, family conflict, and children’s problems, loss and grief, and health.

34
Q

What kind of therapy can be used on adults who are experiencing despair (Erikson’s 8th stage theory)?

A

Reminiscence therapy - discuss past using photographs, videos, familiar items,

35
Q

Explain Robert Peck’s reworking of Erikson’s final stage:

A
  • Differentiation vs. role preoccupation (find new roles to occupy themselves after retirement)
  • Body transcendence vs. body preoccupation (cope with declining physical well-being - deterioration in physical capabilities)
  • Ego transcendence vs. ego preoccupation ( must be at ease knowing death is inevitable and approaching soon)
36
Q

According to the socio-emotional selectivity theory, when are knowledge goals prioritized vs. social goals?

A

Adolescence - knowledge trajectory (knowledge goals prioritized

Old age - emotion trajectory (social goals prioritized)

37
Q

Briefly explain socio-emotional selectivity theory;

A
  • older adults become more selective about social networks (few but important friends only) which maximize positive emotional experiences and minimizes emotional risk.
  • higher value on emotion-related goals than knowledge-related goals
38
Q

Briefly explain selective optimization with compensation theory:

A

Successful aging is linked to:

  1. selection- reduction performance ( i.e pianist playing fewer pieces)
  2. optimization-maintain performance through continued practice +new tech ( i.e pianist spends more time practicing now)
  3. compensation- increased level of capacity to accommodate performance potential (i.e pianist slowing down before fast segments, thus creating the impression of faster playing)
39
Q

Define ageism

A

Prejudice against others because of their age, especially prejudice against older adults.

40
Q

What factors increase the chance of elderly abuse?

A

Being frail, disabled, and/or suffering from dementia or Alzheimer’s disease.

41
Q

What are the most common forms of elder abuse?

A

Emotional, financial (top two)

then physical, and neglect

42
Q

LIst the 4 types of ageism:

A
  • personal (learned, family/media influences)
  • institutional (workplace, healthcare)
  • intentional (taking advantage of vulnerabilities of older people e.g scams elder abuse)
  • unintentional (implicit bias, jokes, elder speak)
43
Q

What are some risk factors for abuse/neglect:

A
  • isolation
  • lack of support
  • cognitive impairment (i.e dementia)
  • responsive behaviors
  • living with a person who has a mental illness
  • living with people who engage in excessive alcohol or drugs
  • dependency on others to complete ADLs (including banking)
  • recent worsening of health
  • arguing frequently with relatives
  • being depressed
  • experiencing abuse at an earlier age
  • feeling unsafe with the people who are closest
  • being unmarried
  • being female
44
Q

Why are elders afraid to report abuse?

A

Fear of shame, embarrassment, intimidation, or fear of retaliation (punishment for report), or reporting to lead to no caregiver whatsoever if the only caregiver was the abuser.

45
Q

Why are older persons in hospitals, LTC, or retirement home more vulnerable to abuse/

A

Isolation and dependence

46
Q

In institutional abuse, what are the risk factors for resident-to-resident abuse?

A
  • female gender
  • cognitive impairment
  • wandering behavior
  • limited mobility
47
Q

In institutional abuse, what are the risk factors for resident-to-staff abuse?

A
  • lack of knowledge of holistic care
  • job stress
  • low levels of job satisfaction
  • low levels of education/experience
  • personal hx of violence and stress
48
Q

What decreases the risk for institutional abuse?

A

person-centered care philosophy

49
Q

What are some reasons that an older person would decline services available for abuse/neglect?

A
  • nurse fails to develop a therapeutic relationship
  • the person thinks they don’t need help
  • financial/emotional costs of accepting are too high
  • pressure to maintain family’s reputation
  • services are culturally or linguistically inappropriate
  • person hold culturally based beliefs that are inconsistent with accepting services
  • cost of legal services is too great
50
Q

How can institutional abuse be prevented?

A
  • improve management practices (organization of work, staff well-being, staff qualifications, quality of supervision, job pressures)
  • educate staff about ageism; resident’s rights; abuse, neglect, and the factors that contribute to them; and staff members’ responsibilities to report abuse.
51
Q

What is dementia-ism?

A

Unintentional ageism

  • stereotyping based on perceived cognitive impairment and incompetence.
  • focus on care tasks -ignore the person
  • dismisses autonomy and agency
52
Q

Stereotypes (unfair ideas or judgments), prejudices (negative opinions), discrimination (seeing a group different), and stigmatizing (identity or label) are all forms of what?

A

Ageism

53
Q

What is the key difference between abuse and neglect?

A

Abuse - an action that results in harm or distress.

Neglect - lack of action that results in harm or distress.

54
Q

List some signs of elder abuse:

A
  • fear, anxiety, depression, or passivity related to caregiver
  • unexplained physical injuries
  • dehydration, poor nutrition, poor hygiene
  • improper use of meds
  • confusion about new will or mortgage
  • sudden drop in cash flow
  • reluctance to discuss the situation
55
Q

What do friendships look like in an older person’s life?

A
  • little opportunity for new friends
  • death of spouse/partner
  • socio-emotional selectivity theory -increasingly selective re their social network
  • friends (social support) promotes positive health outcomes

N104 - Aging (6 decks)

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