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Gero Nursing
| Question | Answer |
|---|---|
| Aging | a universal process that begins at birth; it applies equally to young and old people. |
| Chronological age | the length of time that has passed since birth. |
| Functional age | definition of age based on how people look and what they can do; in functional terms, a person becomes old when he or she can no longer perform the major roles of adulthood |
| Ageism | the prejudices and stereotypes that are applied to older people based only on age |
| Multiple jeopardy | discrimination based on various attributes such as age, sex, race. (ex. 86 yr. female, Hispanic) |
| Implicit ageism | thoughts, feelings, behaviors toward elderly without conscious awareness. Negative feelings are triggered merely by seeing an elder. |
| Life changes with age | Retirement, Role changes, life review, widowhood, fixed income, health changes all have an effect on aging. |
| Gerontology | Study of aging and older adults: Broader scope looks at problems of the older adult, the process of getting old and adaptation |
| Geriatrics | Associated with diseases & disability of older adults: Medical focus is pathological, physiologic, diagnosis and management |
| Gerontological nursing | Focus in on scope of practice of the nurse caring for older adults |
| Health Promotion for Older adults | Screening Programs, Risk reduction, modification of the environment, health education |
| Normal Aging Changes | Aging is deleterious- decrease in function, progressive- occurs gradually, intrinsic- not modifiable, universal-affects all in the species, irreversible, genetically programmed. |
| Senescence | Progressive deterioration, increasing vulnerability: the study of the biological processes that cause mental and physical decline in old age |
| Lifespan: Maximum survival potential | 120 |
| Life Expectancy: Predictable length of time expected to live | Up to 80 or so usually |
| Genetic Theory of Aging | Supported by studies that indicate that life expectancy is genetically pre-programmed within a species-specific range |
| Genetic Theory of Aging | Supported by studies that indicate that life expectancy is genetically pre-programmed within a species-specific range |
| Wear and Tear Theory of Aging | Normal somatic cells are limited in their ability to replicate and function. Death occurs bc worn-out tissues can't forever renew themselves. Smoking, poor diet, alcohol abuse, or muscular strain can lead to the wearing-out process. |
| Cross Linkage Theory of Aging | proposes that molecular structures that normally are separated may be bound together through chemical reactions. A cross-linking agent attaches itself to a single strand of a DNA molecule and damages that strand. |
| Lipofuscin Theory of Aging | The increasing accumulation of lipofuscin in cells, like heart, muscle, nerve, ganglia and nerve cells demarcates aging. (stain found in fat) |
| Free radicals Theory of Aging | When free radicals attack molecules, they damage the cell membranes; aging is thought to occur bc of cumulative cell damage that eventually interferes with function |
| Neuroendocrine Theory of Aging | Changes in the brain and endocrine glands cause aging. Imbalance of nerve impulse transmitting chemicals in the brain interferes with cell division throughout body. |
| Apoptosis Theory of Aging | A process of programmed cell death by which cells undergo an ordered sequence of events which lead to death of the cell, as occurs during growth and development of the organism, as a part of normal cell aging, or as a response to cellular injury |
| Longevity Theory of Aging | The longer the cell functions, the more likely it will fail. |
| Human Needs-Maslow | Psychological needs, safety, love, self esteem, self-actualization. |
| Life-Course | Personality if predictive of the aging process |
| Disengagement | Social involvement decreases with age leading to aging |
| Activity | Physical and social activity leads to engagement with life |
| Continuity | Keeping things the same leads to less dis-ease and aging. |
| Subculture | Elders have their own norms, beliefs, habits, leading to less engagement with society. |
| PRIMARY aging | Changes occurring with age independent of disease or environmental changes |
| SECONDARY aging | Changes involving interaction of primary aging with disease processes and the environment |
| GENERAL Aging Changes | Fewer functional cells in the body, reduction in intracellular fluid, loss of subcutaneous fat, lower oral temperature, stature decreases: loss of cartilage in spinal column & thinning of vertebrae |
| Normal age related decline | Size of the thymus gland decreases, T-cell function decline, Decrease in cell mediated immunity, chronic conditions have ability to decrease immune function, exposure to pathogens |
| Primary Disease Prevention | (Prevent disease) The goal of primary disease prevention is to completely avoid the suffering, cost and burden of disease by intervening before the onset of any illness occurs. |
| Secondary Disease Prevention | (Catching disease)The goal is to identify, and treat if necessary, those people and catch the disease as early as possible to possibly avoid advanced disease and symptoms. |
| Tertiary Disease Prevention | When primary prevention has failed and secondary prevention has done all it can do to improve the patient's situation, tertiary prevention becomes the means to fight the disease. |
| Nursing interventions | Wash hands, drink water/juice/milk with meals, take care of everyday tasks, range of motion, eat healthy,: low acid, protein (lean meat), low salt. |
| Fulmer SPICES | S: SLEEPING DISORDERS P: PROBLEMS WITH EATING I: INCONTINENCE C: CONFUSION E: EVIDENCE OF FALLS S: SKIN BREAKDOWN |
| Nosocomial Infections | Acquired in the hospital, are often antibiotic resistance MRSA/VRE, they are bad bugs in the hospital, the elderly are quite vulnerable r/t decreased immune response |
| Iatrogenic infection | Nosocomial infection that results from a diagnostic test/procedure |
| Emotional Reactions to Hospitalization | Anxiety, Depression, Agitation, Disorientation. ALL can lead to falls and other injuries |
| Syncope: Vasomotor instability | Age related decline in body water and plasma volume. Bed rest results in loss of plasma volume leading to postural hypotension and syncope |
| Hazards of Bedrest | Muscle mass and strength reduced, leads to limited ROM, increased risk of confusion, reduction in sensory input, hearing&vision impairment, sensory deprivation, overstimulation |
| Complications of Disease: Respiratory function: | decreasing PO2/closing volume of alveoli |
| Complications of Disease: Demineralization: | loss of bone is normal in aging and also increases with bedrest |
| Complications of Disease: Urinary incontinence: | increased tendency in older adults, capacity is reduced |
| Complications of Disease: Thirst and Nutrition: | age related loss of taste and smell, sense of thirst also decreases with age, problems with dentition/dentures |
| Necessity of early discharge planning measures | begins on admission. Continuity of care, to patient, family, MD, nurses is important. Get home to recover in own environment, each person will be different. |
| IADL | instrumental activities of daily living...essential for accessing the function in the community ex. getting groceries, pay bills, balance checkbook |
| ADLS: Most important in community setting | personal care activities necessary for everyday living, such as eating, bathing, grooming, dressing, and toileting; a term often used by health care professionals to assess the need and/or type of care a person may require. |
| Role of Nurse in Long term care | Understanding the special needs of elders is vital, advanced assessment, home visits, staff education |
| Role of Nurse in community | Develop local services, help with screenings, home care coordinator, meet specific cultural needs of a population |
| Medicare | Medicare - Medicare is a federal insurance program which primarily serves those over 65 years old and younger, disabled people and dialysis patients. |
| Medicare Part A | * Medicare Part A covers inpatient hospital services, nursing home care, home health care and hospice care. |
| Medicare Part B | * Medicare Part B helps pay the cost of doctors' services, outpatient hospital services, medical equipment and supplies and other health services and supplies. |
| Medicaid | The federally supported, state operated public assistance program that pays for health care services to people with a low income, including elderly or disabled persons who qualify. |
| Common Chronic Conditions | Arthritis: MOST COMMON, heart conditions, hearing impairments, hypertension, cataracts, diabetes, elimination problems |
| External Ear | Pinna & ear canal |
| Cerumen | cleanses, protects, lubricates. Builds up due to hair growth, keratin buildup. Fewer sweat glands in external ear. Cerumen buildup can affect hearing |
| Tympanic membrane: Middle ear | transmits sound energy to the middle and inner ear. Collagen replaces elastic tissue-stiffer |
| Ossicles: Middle ear | Malleus, incus, stapes-amplify sound. Bones become calcified |
| Muscles & Ligaments: Middle ear | Contract in response to loud noise. Muscles become weaker. |
| Cochlea: Inner ear: fluid filled | Receives sound vibrations and concert to nerve impulses in vestibular nerve. Loss of hair cells, reduced O2, less endolymph, loss of neurons lead to hearing loss termed presbycusis. |
| Medication Effect on Hearing | Damage to the cochlea or vestibular part of auditory nerve. Quinine, salicylates, furosemide, toxic effects are generally dose related. |
| Disease Processes Affecting Hearing: Otosclerosis Meniere's disease Acoustic neuroma | Otosclerosis: Hereditary disease of ossicles. Generally conductive hearing loss. |
| Tinnitus | ringing, buzzing noise that does not originate in the external environment |
| Prebucusis | hearing loss associated with age-related degeneration of ear structures |
| Hearing aids | can amplify sound but also amplify background noise |
| Arcus Senilis | Lipid accumulation in outer part of the cornea with yellow ring developing between the iris and the sclera |
| Enophthalmos | loss of orbiatal fat, wrinkles and less elastic eye muscles |
| Blepharochalasis | Upper lid impairs vision |
| Corneal changes | Becomes opaque and yellow, interferes with the passage of light to the retina, scatters light causing blurring |
| Lens Changes | Layers of clear crystalline protein. With eye muscles, it changes shape to accommodate near and distant objects. Regenerates by forming more external layers. Lens gets stiffer. Becomes more opaque. Difficulty distinguishing blue color. |
| Iris Age-Related Changes | Controls pupil size regulating light reaching the retina. Becomes more sclerotic and rigid reducing the size of the pupil. |
Created by:
BG
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