Week 4

Question 1

what are the two factors that have caused the increase in the elderly population ?

Answer 1

1. aging of the baby boom generation
2. advances in health practices to manage chronic diseases

Question 2

What are some myths and misconceptions about old people ?

Answer 2

1. stereotypes as ill or disabled
2. not interest in sex and any interest in sex should be discouraged and seen as abnormal
3. unable to use computers
4. forgetful, bored, unable to learn new information, confused, unfriendly

These myths lead to the underbaluing the older population - some people view that older peoples knowledge and experiences are old fashioned - these notions underlue Ageism -

Question 3

What is a personal care home ?

Answer 3

is a private buisness that provides accomadation, meals, and supervision or assistance with personal care in a family like atmosphere

Question 4

What is Long Term Care ?

Answer 4

facilities that provide accomadation, 24 hour nursing care, and support servies for people whi cannot care for themselves but do not need hospital care

Question 5

What are the five factors that nursing assesment must take into accout for age specific approach ?

Answer 5

1. interrelatio between physical and psychosocial aspects of aging
2. the effects of disease and disability on functional status
3. the decreased efficency of homeostatic mechanisms
4. the lack of standards for health and illness norms
5. altered manifestations of and responses to specific diseases

Question 6

what are some complications one may face when assessing an older individual ?

Answer 6

1. extra time is needed and they are in no rush - periods of rest are needed and sometimes multiple sessions are required
2. older people may have visual or hearing impairment which may affect data gathering
3. memory deficits
4. culturally safe commuication may be required (1. identify how the older person may want to be addressed 2. assess health related beliefs and practices 3. know the beliefs and practices of the older persons cultural groups with regard to spatial requirements
5. classic signs and symptoms of diseases may be absent, blunted, or atypical in older persons this is due to age related changes in organ systems and homeostatic mechanisms

Question 7

What are the three common conditios that affect cognition ?

Answer 7

1. Delerium (sudden onset - acute and fluctuating onset of confusion) - reversible conditon which is linked to dehydration, malnutriotion, infection, pain, stress - it can sometimes be a symptom of pneumonia or UTI - may also have evironmental or psychosocial causes - there are three types of delerium which are hyeractive, hypoactive and mixed delerium
2. Depression (recent changes in mood - cluster of depressive epsiode sympoms)
3. Dementia ( gradual deterioration over set of months) - irreversible changes in the brain - cerebral dysfunction - there are five types ( alzhemiers, lewy body disease, frontotemporal dementia, CJ dementia, vascular dementia)

Question 8

What are the purpose of cholinesterase inhibiting medications ?

Answer 8

These medications prevent the break down of the neurotransmitter Acetylcholine by inhibiting the enzyme cholinesterase - increasing the amount of acetylcholine to transmit signals among neurons will improve there symptoms

Question 9

What are the differet characteristics of the 5 types of dementia ?

Answer 9

Alzheimers consists of amnesia, apraxia, aphasia, agnosia

Lewis body dementia cosists of dementia, fluctuating cognition, visual or auditory hallucinations, motor features of parkinsonism

Frontotemporal dementia has an insidious onset and progresses slowly - poor hygiene, lack of social tact, hyperorality, sexual disinhibition, repetitive behvaiours

CJ disease is a sudden onset of memory loss, difficulty with speech and movement, behavioural changes - there are two types of CJD (Variant CJD which is linked to beef eating products - classic or sporadic CJD occurs randomly)

Vascular dementia intteruption of blood flow to different areas of the brain -symptoms depend on the area of the brain affected

Question 10

What are some psychosocial changes ?

Answer 10

1. Retirement - major turning point in life
2. Social Isolation - is a lack of a sense of social belonging, social engagement, quality relationships
3. Abuse - Elderly Abuse is the mistreatment of an older person by other people who are in position of trust or power or who are responsible for adults care - there is sexual, physical, psychological, material, neglect and self neglect forms of abuse
4. Sexuality - older people need to express sexual feelings
5. Housing and Environment: there needs to be presence of age friendly communities (focus on transportation, lighting, sidewalks, etc)
6. Death

Question 11

What are some physiological health concerns for older people ?

Answer 11

1. Cancer: Malignant neoplasm is the most common cause of death for older people
2. Heart Disease: second leading cause of the death in older people
3. Smoking
4. Alcohol Abuse: the number of older people drinking has increased, Heavy Drinking is drinking 5 drinks or more per day - some older people drink in order to mask the pain -
5. Nutrition
6. Oral Health
7. Exercise
8. Arthiritis: higher women
9. Falls: can be caused by things such as poor lighting or medication
10. Sensory Impairments
11. Pain
12. Medication Use: due to the increase in chronic conditions (Polypharamcy) causes adverse effects

Question 12

What are some psychosocial health concerns ?

Answer 12

1. Therapeutic Condition
2. Touch
3. Cognitive Stimulation: in which the person engages in cognitive simulation such as playing games
4. Reminiscence: sharing past experiences
5. Body Image Interventions: how older people present themselves influences body image and potentially, feelings of isolation

Question 13

What are the three layers of the skin ?

Answer 13

1. Epidermis: contains resident flora that prevent the multiplicatio of foreign bacterial growth
2. Dermis
3. Subcutaneous layer

Question 14

What are the components of the nail ?

Answer 14

1. Nail Bed: lies under the nail, its a layer of epithelium cells
2. Lunula: crescent shape white
3. Cuticle: skin folds that cover the nail

Question 15

What are some characteristics of the oral cavity ?

Answer 15

the oral cavity extends from the lips to the anterior pillars of the tonsils

The Buccal Mucosa (oral mucosa) are normally light pink and moist

the floor of the mouth and the undersurface of the tongue are richly supplied by blood vessels which allows for the rapid absorptio of subingual medication

the mouth contains three pairs of salivary glands that start the digestive process by releasing enzymes, protect the mucosa from heat and chemical irritants, and provide lubrication

there are 32 teeth for chewing (Mastication) - the normal structure of the tooth consists of crown, neck and root

difficulty chewing can be caused from the inflammation or infected or when teeth fall out - oral hygiene is required to prevent Ginigivits & periodental disease

Question 16

What are some aspects regards to hygiene ?

Answer 16

1. Social Practices: during childhood, hygiene is influenced by family customs - during adulthood, involvement with friends or work groups shapes the expectations one individual has on there appearance
2. Personal Preferences
3. Body Image: body image affects the way hygiene is maintained
4. Socioeconomic Status
5. Health Beliefs and motivation
6. Cultural Variables
7. Physical Condition

Question 17

What are the types of bathes& care provided to patients ?

Answer 17

1. Complete bed bath:is used on patients who are totally dependent and require total hygiene care
2. Partial Bed Bath: involves only bathing the body parts that cause discomfort or odour if not cleaned, and those areas are not easily reached by the patient
3. Bag Baths: are used for for patients who are predisposed to dry skin and risk for infections
4. Perineal Care: is a part of the complete bed bath and are given to people who are at higher risk of getting infection
5. Back Rub: back rub or massage which is given to someone after a bath
6. Foot and Nail Care: patients with diabetes or peripheral vascular disease are at risk for getting foot ulcers as a result of poor peripheral circulation and decreased sensatation

Its important to examine the body when giving a bath to note any ulcers, bruising, or dryess

Its importat when bathing a patient to: provide privacy, maintain safety, maintain warmth, promote independence, anticipate needs

Question 18

What are some guideline someone with diabetes or peripheral vascular disease should follow for foot and nail care ?

Answer 18

1. inspect feet daily
2. do not soak feet - due to decreased sensation use thermometer for water temp
3. foot examinations once year
4. do not cut corn or calluses or use commercial removers
5. apply nonallergenic foot powder for people whose feet perspire
6. apply lotion - but do apply excessive lotion as it can be risk for infection
7. trim toenails straight across
8. do not use constrciting garments
9. do not walk barefoot
10. do not wear high heeled, open toes, or pointed toe shoes
11. exercise regularly
12. wash minor cuts

Question 19

what are common bed positions ?

Answer 19

1. Fowlers: head raised at 45 degree angle
2. semi fowlers: head raised at 30 degress
3. Trendelenbergs: entire bed tilted with head of bed down
4. Reverse Trendelenbergs: entire bed frame tiltled with foot of bed down
5. Flat

Question 20

How does one assist patients with feeding ?

Answer 20

1. Before feeding: the nurse must assess the risk for aspiration - the patient must sit as upright as possible with the head tilted slightly forward and may be supported by pillows or wedges
2. During Feeding: the patient should be upright
3. After feeding: patient should remain upright for 30 minutes after eating - intake should be documents and reported