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Gerontology 2 of 3
| Question | Answer |
|---|---|
| Nursing interventions for nutritional support: | serve the food in an attractive manner; make the environment as pleasant as possible; offer liquid dietary supplement to help meet dietary needs |
| A ______________ may be necessary to help an elderly patient meet dietary needs. | liquid dietary supplement |
| _________________ may have to be used if attempts at oral feedings fail. | Tube feedings and parenteral feedings |
| When tracking nutritional status, report a loss or gain of ______. | 5% |
| Common problems of the elderly: | vision deficit; hearing deficit; polypharmacy |
| ability to focus on near and far objects | visual accomodation |
| Visual accommodation __________ with age as a result of weakening of the muscles that control the lens. | decreases |
| age-related decreased ability to focus on near objects | presbyopia |
| accumulation of fluids inside the eye that exert pressure on the optic nerve, eventually causing blindness | glaucoma |
| clouding of the lens | cataracts |
| gradual loss of acute, central, and color vision | macular degeneration |
| Nursing interventions for the visually impaired: | orient pt to any new environment; use bright lights and remove any hazards; identify yourself when entering a room;state when you are leaving the room; to not rearrange the pt's belongins without permission; offer your arm for assistance when ambulating |
| Screen magnifiers, large-print books, or _______________ can be offered to the visually impaired. | talking books |
| inability to hear high-pitched sounds and spoken words; naturial hearing loss | presbycusis |
| ringing in the ears; may cause a further loss of hearing; can lead to frustration and embarrassment | tinnitus |
| If a patient has a hearing aid, the nurse should know how to __________. | operate it (be familiar with where batteries go, etc.) |
| For the hearing impaired patient, _______________________ when talking. | face the patient and speak clearly. |
| When a pt is hearing impaired, you should observed their _____________ for feedback. | facial expressions |
| Speak into a person's _____________ if possible. | good ear |
| If the patient has glasses, they should be __________ when talking to them because some pts read lips. | worn |
| Environmental noise should be kept to a _________. | minimum |
| ___________ are helpful to use if messages are unclear. | A pad and pencil |
| The nurse should help older adults maintain their ___________ and _____________ by promoting hygiene and grooming. | dignity; self-respect |
| Don't do everything for the pt to take care of their hygiene and grooming. Give them some __________ to do what they can. | independence |
| Clients feel better about themselves when: | their hair is neatly arranged, their skin is clean and healthy, and they are dressed attractively. |
| The nurse always encourages: | self care |
| The thoughtful nurse prepares everything the client needs for self care and then lets them: | proceed at their own pace to complete what they can. |
| Decreased circulation to the ____________ results in prolonged healing time for injuries or ___________. | extremities; infections |
| Creams or lotions are necessary for: | dry skin |
| Thickened, brittle toe nails are carefully trimmed after: | soaking feet in water. |
| If the older adult has very thick nails, diabetes, or a peripheral vascular disease, ___________ nail care is indicated. | professional |
| A daily partial bath and a ______________ tub bath or shower are adequate because frequent bathing dries the skin. | biweekly |
| use of multiple medications; result of multiple physicians, each unaware of what the other is prescribing | polypharmacy |
| ______________ and ____________ can result in behavioral or cognitive changes that may be mistaken for dementia can result from polypharmacy. | drug interactions and toxicity |
| The rate at which drugs are metabolized and __________ is altered when polypharmacy is happening. | excreted |
| Metabolism happens in the: | liver |
| excretion happens in the: | kidneys |
| Nursing interventions for polypharmacy: | First step - take a thorough medication history; assess their current prescriptions, OTC drugs, and any vitamins and herbal preparations being taken |
| For a comprehensive assessment, check that the pt ______________ what they should be taking. Help maintain a therapeutic ______________. Identify _______ needs.; elminate ________________ medications; reduce the risk of adverse ___________. | understands; medication regimen; educational; unnecessary; drug reactions |
| Attempt to reduce the complexity of the medication regimen by: | improving self-medication practices (pill box, magnifying glass, family member, etc). |
| Changes in cognitive functioning; early signs of dementia: | benign senscent forgetfulness or age-associated memory impairment; age-related changes in mental processes; modest decline in short-term mental processes; modest decline in short-term memory; slight and gradual decline in cognitive skills |
| Elderly people (are or aren't) as capable of learning new things as younger people, but their speed of processing information is __________. | are; slower |
| Major declines in cognitive functioning usually result from conditions such as: | dementia; metabolic disorders; stress, alcohol abuse; undesirable medication effects; vision or hearing impairments |
| Mental changes not caused by the normal aging process: | confusion; disorientation; inappropriate behavior; depression; inability to follow directions. |
| Conditions associated with confusion: | vascular insufficiency; trauma; tumors (esp. brain); CNS infections; hypotension; systemic disorders; pulmonary/cardiovascular diseases; metabolic disorders; electrolyte imbalance; anemia; altered renal function; drug toxicity; endocrine disorders |
| More disorders associated with confusion | nutritional deficiencies; stress; pain; anesthesia; altered body temperature; dehydration; anxiety; depression/grief; fatigue; sensory deprivation/overload; new environment; toxic substances |
| Most common electrolyte imbalance: | sodium |
| not enought blood volume | anemia |
| not getting rid of toxins causes: | altered renal function |
| After anesthesia, you should encourage pt to: | cough, turn, and deep breath (to get rid of anesthetic in system) |
| An older adult with significant changes in mental functions hould be given a: | comprehensive mental status examination |
| Comprehensive mental status exam includes: | detailed and accurate medical history and physical examination |
| Allow the elder enough time to ___________ during a comprehensive mental status exam. | respond to the questions |
| Compensate for _________________ during the comprehensive mental status exam. | sensory limitations |
| Mental status exam tool: | Mental Status Questionnaire (MSQ) |
| During mental status exam, observe the elderly and confused pts and question them and significant others about: | events preceding admission |
| Assess for factors that contribute to _____________ during the mental status exam, including medication effects, a new ____________, and _____________. | altered mental state; environment, disease processes |
| difficulty remembering, learning, following directions, and communicating their needs; can significantly influence a pt's dignity, independence, personality, and support system; may complicate diagnosis and treatment of a pt's illness | confusion |
| an acute confusional state that can occur suddenly or over a long period; a result of an underlying biologic cause or psychological stressor | delerium |
| Left untreated, delerium can lead to: | coma or death |
| Examples of an underlying biological cause of delerium would be | |
| appearance or increase of symptoms of confusion or agitation associated with the later afternoon or early evening hours and usually continuing into the night | nocturnal delirium, or sundown syndrome |
| a generally permanent condition characterized by several cognitive deficits that has a slow, insidious onset that affects memory, intellectual functioning, and the ability to problem solve; has a gradual onset | dementia |
| Dementia is primarily seen in: | Alzheimer's disease |
| Dementia also occurs with brain tumors or with: | serious medical or surgical disorders |
| Interventions for confusion and disorientation - Psychosocial intervention: A behavioral approach is _____________ to enhance a dementia pt's quality of life. | essential |
| Interventions for confusion and disorientation - Psychosocial intervention: The primary goal is to produce a feeling of: | well-being in the confused and disoriented elder. |
| Interventions for confusion and disorientation - psychosocial approaches: | reality orientation; validation therapy; reminiscence; remotivation therapy; resocialization |
| Interventions for confusion and disorientation - reality orientation | orient to time, place and person; maintain consistent interaction with staff and family; maintain consistent schedule for mealtimes and activities of daily living; encourage use of memory aids such as clocks, newspapers, TV, radio and calendars |
| Interventions for confusion and disorientation - validation therapy | decreases stress and promote self-esteem and communication; use group support to encourage respect for the feelings of the individual (listening); encourage activities such as singing favorite songs, reminiscing, and sharing mementos or family photographs |
| Interventions for confusion and disorientation - reminiscence | reexamine the past to promote socialization and mental stimulation; wrap up unresolved issues; individual or group sharing of life experiences |
| Interventions for confusion and disorientation - remotivation therapy | stimulate senses and provide new motivation in life through factual information rather than feelings; introduce pictures, plants, animals, or sounds to encourage interaction; consider art therapy or music |
| Interventions for confusion and disorientation - resocialization therapy | encourage socialization patterns within a group; assign socialization roles in a group such as serving each other refreshments; encourage group projects or participation in games |
| Interventions for confusion and disorientation - pharmacotherapy | major tranquilizers, minor tranquilizers, antidepressants |
| major tranquilizers | chlorpromazine (Thorazine), haloperidol (Haldol) - can be given IM |
| used to manage anxiety, agitation, hostility, and paranoia | major tranquilizers |
| may be used to treat symptoms of agitation and anxiety | minor tranquilizers |
| may be used if depression coexists with dementia; may improve appetite and sleep habits, enhance socialization, and increase energy levels | antidepressants |
| antidepressants | citalopram (Celexa); duloxetine (Cymbalta) |
| Families of pts with dementia need social and _________ support. | emotional |
| The family of dementia pts often experience changes in: | lifestyle, privacy, and socialization |
Created by:
akgalyean
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